Thanks for sharing your very interesting case Diane!
I have a few intitial thoughts but need to make them quick as my kids neeed
bed!
Diane writes;
>>A search of
the archives yielded nothing useful on malrotation, tho a whole lot on bloody
stools -- nothing on any possible relationship between the two.<<

Thats because there is no relation between the two that I know of.

>>Mom already was on almost no dairy, so it was
not hard to cut out cheese and chocolate. Mom also eliminated red meat and
legumes; she already avoids citrus as she is allergic to citrus, and stopped
coffee and green leafy vegetables.

Cultures were positive for C. difficile infection and Flagyl was prescribed.
Baby was on a 10 day regimen, but saw no significant change or improvement
after 10 days so vancomycin was prescribed and baby was seen by pediatric gi<<

Assuming that the cultures remain positive, why couldn't this all be related
to the infection?
 It seems plausible that the infection coupled with the trauma from the poor
fdng start and surgery could have badly damaged the intestinal lining,
specifically brush border and since research has demonstrated that breast
milk helps to restore this brush border in patients s/p chemotherapy, breast
milk would be the food of choice. Elemental formula isn't going to do that.
 Did this baby have a biopsy for Hirshprung's?
It sounds as if she has eliminated many possible culprits from her
diet...corn?, soy?.
I can't help but wonder if this baby were already on an elemental formula,
what would this doc advise? I have a feeling he would advise waiting for the
GI tract to heal before changing the formula SINCE the baby seems to be
uncompromised by the stooling pattern and he might just monitor the
hematocrit.

Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html