Baby refusing breast and bottle - doctors being most unhelpful!

[princesslina]

HI
Emailing for a bit of a second, third, forth opinion really.
A friend of mine in France who has a 6 month old little girl is having a really bad time of it. Baby has been BF exclusively up until now. Friend living with MIL and situation has been very fraught the whole way through since labour. Basically mainly throught stress milk spply has dwindled, she manages to get it back a bit when it goes again (tried domperidone etc)and baby refuses all bottles and cups with both EBM (the little she can get) and Formula she can get a little froma syringe but that is it. Also think baby is lactose intolerant. She saw doc at hospital yesterday who basically said feed her carrot 3 times a day we do not know what to do about milk! My frind is in an absoulute panic. I am going to see her later today. I have tried giving baby bottle and she will take a little but it is my impression that she has become more refusing since my last visit. Baby has now started to loose weight as only managing to get a very little milk from breast - snacking really. I have offered lots of advice but apparently nothing is working. I know a few people have had sucess in just stopping the breast completely and offering bottle, I don't know if my friend would do this - any opinions? Also does anyone know where I can get the brother max cup as I read an article in mother and baby ad they suggested this was a good one to try - it is on amazon but delivery is 2 to 4 weeks and I need one now!
Thanks
Caro

Is it possible the baby could be tongue tied?

Already checked this and they are not, but thanks anyway!

princesslina. not really sure what's going on here. Very unlikely the baby is lactose intolerant - this is very very rare and the baby would have had unmistakable symtoms by now. Some babies may have temp LI after a serious tummy upset but I don't think this is what you mean. Do you mean cows milk protein intolerant?

It could be nursing strike - there is info about this in mumnste archives.

This is temporary, too.

A baby who is actively losing weight may be ill.

Perhaps your friend can get in touch with La Leche League - they exist in France.

Is baby lactose intolerant or does he/she have an allergy to cows milk protein? I would rather suspect the second because the first is really quite rare in babies. If the baby has an allergy to cows milk protein your friend needs to stop offering standard formula immediately. Milk proteins will also enter your friend's BM via her diet and if the baby has been sensitized to cows milk protein, it is common to refuse both formula (which is based on cows milk) and breastmilk (which contains proteins having come from the mothers diet). This happened with my ds2 wh suddenly started to refuse breastfeeds at arund 16 weeks having fed extremely enthusiastically in the previous weeks(he was sensitized to cows milk protein because he was given half an oz of formula at 16 weeks - the first time we tried him with it because we wanted him to take bottles and wean him off the breast). Get your friend to try a completely dairy free diet (she will need to be strict and if possible get the help of a qualified dietician) and see if this helps encourage baby to start BF again. If your friend wants to use formula occassionally or eventually switch to formula, she'll need a hypoallergenic one (available on prescription in UK). If the baby is allergic don't whatever you do stop BF until baby is well established on a hypoallergenic formula because he/she will not be able to thrive on regular formula.

Ok
Sorry I meant cows milk protein rather than lactose! And infact this is currently a suspicion follwing a reaction to the first formula they tried, the doc prescribed both neocate and nutramidgen both she refuses. I think that mum cut out dairy for a while but at that time it made no diff and baby was feeding well I think (info from mum can be a bit muddled as she is in quite a state). They tried baby on petit filous type yoghurt two days ago and she came out in red patches (which is why they went to hospital yesterday and doc said feed carrot and banana 3 times a day) She has contacted la leche league (they could only advise over the phone and it was pretty much the same advice that I had given she needs to rest and destress to encourage milk suppy. She has tried mumping to keep supply up but MIL creates huge probles with this, and I had several emails with dr ack newman who gave me lots of info re nursing strikes etc which I passed on to my friend, but she really didnt take much of it on board die to the MIL - ie MIL will not 'let' her babymoon.
Baby has been hospitalised once the first time she stopped feeding which was over xmas as she had urine infection (took them a week to pick it up - mum was being accused of imagining it) they went back to the hospital yesterday but baby got in such a state that mum refused to have her admitted. I am going to see her in a bit and see if I can work out why exactly and what is going on, it was a very garbled conversation I had with her this morning, I am extrememy worried for them. Before I went away 3 weeks ago baby weighed 6ky 50g I think, wnet up to 6kg300 when milk supply up a bit now down to 6kg200 I think she said this morning.

BTW baby not 'refusing' breast just not enough milk so then baby gets frustrated after a while

Sounds as if your friend needs a lot of support and someone to explain to her that she has to put her baby's health before her worries about going against her mother in law. Perhaps her DH can intervene here. It is preposterous that the MIL can prevent her expressing and babymooning.

Is your fried depressed? Sometimes, depression can make people very non-assertive, unable to have confidence in themselves and unable to tell other people to get lost.

To be honest, getting all this support from leading advocates like Dr Jack Newman, getting you to search out information, is a waste of time until she is in a position to put the information into practice. Dr Newman can spend his valuable time helping people who can put it into practice....

This is not to criticise you, or her, but to point out that the problem lies closer to home. If the baby is losing weight, then I have to say it again - the baby may be ill

Thanks Tik Tok I agree and have had a quiet word with DH, I was worried about the possibility of PND and when I was home (I work away a lot) about 3 weeks ago took her to see my doc (she would not see family doc for fear of MIL) who said it is not PND but acute stress and to try and find a way of getting awya from the situation. DH is away quite a lot trying to find work in Paris - currently they are living with MIL very small village where work is scarce and DH cannot find anything. She also does not tell DH half of what is going on as she does not wat to worry him. I have tried to ecourage her to be open with him but feel that it is not my place to intervene in their couple, I have however expressed strong feelings to her that she must not be intimidated by MIL and that baby is her baby not MILs and that she has a right to raise her as she wishes.

I too felt a little exasperated that she has asked for help but does not follow through on the advice (I had given a donation to the Jack Newan clinic as I was so grateful when he replied to my email) but I cannot force her follow the advice, I think she has got herself into a real muddle and does not know what to do for the best. I also feel that she does try her best but does not have the support system in place to help and reassure her throught the diffiuclt times. I can only be there for her and encourage her to seek professional advice but it seems that they are at a loss too and I am sure it will come to a point where baby will need to be fed IV if she keeps refusing to eat.

princesslina, sounds like you have some insight into the situation. It is quite worrying. The baby may be reacting to the stress around him - babies can do this, and 'strike' he is undertaking may be part of this.

Her DH needs to know how bad things are. His wife has been diagnosed with 'acute stress' and his baby is refusing to eat....and yet his wife is unable to seek medical advice for herself because of her mother in law? She must tell him, or if she does not want to, she needs to give you permission to tell him on her behalf. He may be able to take time off work to help with this.

Goodness how awful for her not feeling supported by the people who should be helping her. I think she definitely needs to let her dh know the situation for her and the baby's sake.

If the baby is happy with the breast but it's the supply, is she putting the baby to the breast lots? This is very important otherwise the milk supply won't increase and a baby is much more efficient at getting the milk out than a pump. Can she not forget about bottles and just go for breastfeeding on demand? If she let the baby feed/suckle whenever it wanted her supply should increase.

Also keeping the baby close by carrying the baby in a sling would be a good idea.

Tiktok - you and I seem to think alike, I have already spoken to both of them about baby picking up on stressas I feel strongly that she is being affected by the situation. I am going to try and talk in a gentle but very frank manner this afternoon I have spoken to DH about how concerned I am and tried to tell him I really think she should go to her mother in morocco for a while where she will have the constant support she needs, he did seem to have taken me seriously. He does not have work and is trying to get some as financially they are in dire starights he is at home at the moment due to the current situation so it will be good to see them together to chat about things. The worse off they are finacially the more they are reliant on MIL it is a vicious cycle, I have offered to may for a tciket to morocco I can do no more, as the proverb goes...you can take a horse to water...

sleeps for wimps - she is putting baby on breast lots but then changes mind and decides not, I feel that she needs to have a coherent plan of action so as not to confuse that baby, rather than chopping and changing, although she does this because she is confused so baby is getting all mixed signals. SHe has always demand fed but now is panicking becase baby not getting enough and all the health care 'official' are saying get the baby on the bottle. (Not a lot of support for bf here in rural france).

tbh I do not think she will take the bottle and will eventually go straight to a cup with water whilst still BF if the supply can be reestablished. I feel that the best bet is to do everything possible to restablish the supply as in the first few months BF was going really well and there was lots of milk. Whether there will be enough support for this to be able to happen I cannot say.

Off to see her now so will updateon my return.

Thanks for the support, its been great getting those extra bits of advice and support, and to vent off a bit of the worry.
xxx

I think I can identify very well here because I've been there. For me, ds2 fed really well till 16 weeks (9oz per week weight gains ), but then started to refuse BF after getting sensitized to cows milk proteins and he stopped gaining weight. He hardly gained any weight for 8 weeks and I was so stressed, was due to go back to work and the GP had to sign me off as sick because tbh I think I was probably going slightly loopy with stress, esp as not getting any help/support from family or HCPs. Your friend has a good friend in you and that is fantastic because there is nothing worse than the feeling that comes with the feeling that you can't get your baby to do the most basic thing which is eat and grow.

It is very important that she does not persist with regular formula or dairy products. I learnt this the hard way when ds2 had anaphylactic shock and I've truly never been so scared, but allergic reactions typically get worse with each exposure and you can not predict the severity of the next reaction. In my case ds2 had only had 2 previous exposures to cows milk protein before the anaphylactic episode so it can happen suddenly. Try Cow and Gate Pepti which is more palatable and generally better accepted by babies than Nutramigen or Neocate or otherwise try Nesquick powder in Neocate and then slowly reduce the Nesquick powder over several days/weeks.

Also with the dairy free diet, she should be very, very strict (no dairy at all, not just no lactose and remember that dairy is hidden in lots of products). It can take a long time to get out of the system (several weeks) but you should see an effect and baby may be encouraged back to the breast again after this. Without a dairy free diet, baby can have problems with not being able to absorb nutrients in the milk. Does the baby by any chance get small amounts of blood in stool samples? This can be an indication of gastrointestinal problems caused by milk allergy.

HI
Thanks for tha advice. I have just returned from seeing my friend, she is in a bit of a state. Turns out she is not totally sure that baby in allergic so i suggested seeing a specialist to find out as this is impacting greatly on the range of things that baby can be offered. She had not cut out dairy from her own diet and baby had been fine on breast milk. She basically is searching for me to say that if she stops BF then baby will def take the bottle, this is not something I can do, I cannot make promises to her like this and I did say that if she does this and baby still refuses then she may need to get baby back to the hospital as she cannot go on like this indefinately. I feel that sadly she has given up hope of reestablising the supply especially in the current situation. She also said that 10 days ago when MIL was away for 5 days milk supply was much better and baby drank one feed a day in the bottle and slept well so I def think the stress of MIL is playing a major role in all of this. She is also under pressure from DH to keep up breast feeding as he sees formula as really bad, I did say to him that if she cannot increase her milk (and cannot be given the support needed to do this) then it will have to be formula as baby needs milk and he is just making mum feel incredibly guilty about not having any breastmilk at the moment whcih is not what she needs on top of everything else. He also does not seem to be standing up to his mum and says that he would rahter not rock the boat. However they are thinking of going to Morocco in a coupl of weeks time and there she will def ahve the support she needs (her sis is a nurse in a maternity ward for example and her cousins is breastfeeding at the mo and has offered her breast milk. SOrry this is all very waffly and prob not making any sense. I am hoping that they will make appointment with new pediatrician (not impressed by one they saw at hospital yesterday one of the reasons they walked out) and with an allergy specialist. Whatever happens they are going to need some professional help as baby is def not getting enough nutrition.
Thanks for all the advice.
xxx