On Thursday afternoon I spoke to a mom of a 9 day old on Soy formula because of mucusy running stools on cow's milk abm. The baby continues with mucusy stools with were hem positive in the office the previous day. Baby also has bad diaper rash and mom was feeling badly for her. Stool WBC were negative but since I don't think the baby's small anal fissure is the cause of the blood I suggested an elemental formula, sending a stool culture and checking a CBC. I told mom her choices of elemental formula and to give informed consent said "or you can try lactating" To which mom said "Can I still do that" We talked some and arranged an appointment the next day. Yesterday I met with mom who says her husband is supportive, she did get the baby to latch for a few sucks the night prior and she had bought some elemental formula and said "I can't afford that" Encouraging also is her post partum hx of developing engorgment on day 4 and not feeling relief until day 8 so this mom was only 2 days from lactogenesis. One of my nurses, who should sit for her IBCLC exam b/c she is very good, got an SNS attached to mom and the baby latched wonderfully. Mom and Gmom are very into herbs and like the feenugreek/ blessed thistle idea. I gave mom some of Jack's handout and a number for pump rentals and a LLL number. My nurse will call her today and an office visit is scheduled for Tuesday. This is the first time I've done this. Some questions. If mom feeds the baby 8 or more times a day with the SNS does she need to pump? How to wean off the SNS? When she can pump visable milk or we can tell the baby is swollowing milk without the SNS? -Rob PS: CBC shows increased eosinophils Rob Cordes, DO, FAAP, FACOP Wilkes Barre, PA mailto:[log in to unmask] *********************************************** 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