urgent nursing advice needed for a friend

[firstbaby]

My friend just called me sobbing leaving her ped's office. Her 1 week old DD has some blood in her stool and her ped ordered her to stop nursing immediately and to give her DD Alimentum in an effort to rule out dairy intolerance / allergy vs a more serious gastro-intestinal issue. While I realize that blood in the stool is not a small issue, but does this sound right? Any one BTDT?

Thanks!

[egoldber]

Was it a lot or a small amount? Unless it was a huge amount that seems to be a huge over reaction to me. Blood in the stool can certainly come from a milk protein intolerance but cutting out dairy in mom's diet seems like a more reasonable first approach.

[missym]

I would have your friend get a Lactational Consultant involved right away. She should seriously question this advice from her ped, since the "fall-back position" of many peds is to stop breastfeeding whenever a problem presents itself. Blood in the stool can be cause for concern, certainly, but it would be a shame to jeopardize breastfeeding at this crucial stage unless it was necessary.

I did a search and found a couple of helpful articles. In particular, this caught my eye:
"According to Breastfeeding: A Guide For the Medical Profession, Ruth Lawrence, MD, 1994, while diagnosing the problem, 'breastfeeding can be maintained, meanwhile, unless a lesion requiring surgery is identified. More than 50 percent of cases of bleeding in the neonate go undiagnosed ... Allergy to human milk is unreported as a cause of intestinal bleeding.'"
http://parenting.ivillage.com/newborn/nbreastfeed/0,,3wzn,00.html

Also from that article: "The first thing that is typically done when there is blood in the baby's stool, is have the blood tested to find out if it's fetal or adult hemoglobin (meaning, does it come from baby or mom)."

Some other articles to check out:
http://www.medela.com/NewFiles/faq/colitis_bfdinfant.html
http://www.kellymom.com/babyconcerns/bloodystool.html
http://www.jpgn.org/pt/re/jpgn/fulltext.00005176-199910000-00069.htm

Missy, mom to Gwen 03/03 and Rebecca 09/05

http://bf.lilypie.com/r2Qhm4.png

[lisams]

I'm so sorry! How heartbreaking for your friend. I really hope she is able to get a LC soon to help her out and perhaps see another ped. for a second opinion. She could eliminate dairy from her diet and see if that improves the situation. For children than have food allergies breastmilk is even more important.

It sounds like she really wanted to breastfeed so I hope she gets better advice soon before she does something she might regret.

If she does follow the peds advice hopefully she'll pump to keep her suppy up until she sees an LC who can guide her through an elimination diet.

[Bean606]

My DS had the same exact issue, but when the pedi told me to stop nursing and move to Alimentum, I burst into tears and asked if there was another option, and she said the other option was to eliminate all dairy from my diet, including casein, whey, etc., and that is what I did until he was 6 months old, when I slowly began reintroducing dairy into my diet. So, if your friend is really committed to BF, she can try the no dairy route. We noticed some blood for a couple more days until the dairy was completely eliminated from both our systems, but the pedi said that was OK. She then had him come in every week for weight checks and we had another bloody stool when he was about 2 months old, but that was it. Good luck!

[firstbaby]

I spoke with my friend again and she is going to pump for the next 24 hours to give her body a chance to eliminate the dairy from her system and she's going to start nursing again. She also has a call into her main ped. - she saw one within their practice but the main one is the one she's most comfortable with. She wasn't sure with this baby how committed she would be to BFing since she had a rough start with her first, but this experience has really affirmed her commitment to BFing. Thanks for all of the great support!

[hillview]

Unless a ton of blood and / or baby has other health issues sounds like an over reaction to me. A mommy friend had this issue with her new born and the doc worked very closely to try to find the source AND keep BF. Hope her other doc has some other options.
GOOD LUCK!
/hillary

[aa2mama]

To me this sounds like an over the top reaction. DD had blood in her stools and her pediatrician NEVER ONCE told me to stop nursing. I was simply advised to cut dairy from my diet. Your friend should be aware that it can take up to two weeks for the dairy to work its way out of her and her DD's systems.

With my DD we went in for weekly weight checks for a couple of weeks. Once they confirmed that she was gaining well and the bloody stools stopped, we were sent on our merry way (well, as merry as one can be without pizza and ice cream).