Dear Jean, In response to your question about cystic fibrosis and foul-smelling stools: I, too, thought about this when I read the post but I think I remember that weight gain was ok and stools did not appear greasy. In State Of The Art: Cystic Fibrosis by Davis, Drumm and Konstan (my daughter's doctor last year!) in Am J Crit Care Med Vol 154 pp 1129-1256, 1996: "The gold standard" for diagnosis of pancreatic insufficiency (PI) is the demonstration of inadequate enzyme and bicarbonate output from the pancreas into the duodenum after secretin stimulation by collection of the pancreatic output via a triple-lumen tube placed in the duodenum. However, this complication is so prevalent that seldom is such an invasive test required for clinical purposes. Documentation of steatorrhea by 72 h stool collection on a controlled diet is also diagnostic but it may be sufficient simply to demonstrate fat globules in the stool on Sudan stain, or reduced serum carotene levels, abnormal serum trypsinogen, or reduced excretion of para-aminobenzoic acid (PABA) in the urine after oral administration of benzyl-tyrosyl (PABA). Once the diagnosis is established, pancreatic insufficiency in most patients is readily treated by provision of pancreatic enzyme supplements available in encapsulated microspheres to avoid destruction by gastric acid and to allow enzyme release in the small intestine,where pH is more favorable for activity." As they point out, (and they are in your home state, Jean, at Rainbow/Case Western in Cleveland) these enzymes are specific for pancreatic insufficiency and are available only by prescription. Recently, in Charlotte, a 4 month old who was negative for the sweat test, (where elevated sodium chloride levels are usually diagnostic) the other diagnostic and main test for CF, was put on them anyway to see if they would help. So, to answer your question, some docs will try prescription enzymes to see if they help, not necessarily diagnose. The babies I have worked with and the moms I have talked with usually recall roof-raising odor to the stools. On CF day at the hospitals I have been to all have the telltale odor in the restroom. Even when steatorrhea is improved, there is still an odor for a lot of patients. When I ask my daughter's first CF doc, "When will she have a normal stool?" I'll never forget his response, "She'll NEVER have a normal stool!" One more thing, PI sneaks up on these babies, meaning they may not demonstrate malabsortion-maldigestion immediately (esp. w/ lipase in Mother's milk) but it can happen anytime. The stools can be yellow or "normal", green, frothy, greasy. bulky, bluish etc. But the odor is usually pretty apparent once pancreatic insufficiency becomes a factor. And a lot of gas. The other symptom I usually see is an adequate and often times "over" milk supply, with slow or FTT in the baby. Hope this helps. Most peds will just start out with the sweat test. The baby in question also went awhile without stooling, which is just usually the opposite with PI. Please feel free to contact me if I can be of help with other questions. My references are all here at my house. Jan Ellen Brown RDH, IBCLC Charlotte, NC USA