My name is Kristin, and I'm new to the board. My husband and I have two little ones (Isabel, 3 yrs, and Sofia, 3 months).
I was wondering if anyone else has had a baby who gained weight slowly and also had elevated liver enzymes (ALT/AST). And if so, whether the enzymes eventually came down or not.
This post is pretty long and rambling. Pls forgive. It's just I have a lot on my mind.
Little Sofia started out big -- she was 9 lbs, 11 oz at birth, but now at a little over 3 months, weighs only 11 lbs, 7 oz. Some weeks she gains 1 ounce, sometimes 3, and sometimes none. We've had a few weeks where she gains more -- last week, for instance, she gained 5 ounces. But they're far and few between. I can't say I see a huge difference in her feeding style, week to week.
She was a sleepy baby for the first six weeks or so, and I had to wake her for feedings at night, for instance. I've pretty much run the gamut in terms of trying to find ways to bulk her up -- met with a lactation consultation, took fenugreek, pumped milk and gave it to her first with a supplemental feeder, then a syringe (because she kept pulling the feeder off), and now finally a bottle (we've really had a hard time getting her to take one.) I also supplement with formula (I was dead-set against it for a long time, but now I'm just so desperate for her to put on some weight.) My milk supply, at least in terms of volume, doesn't seem to be the issue. When I pump, I have enough milk. The lactation consultant told me the latch seemed fine. And she poops and pees regularly. I also sucessfullyi nursed her big sister for close to 3 years.
After a few weeks of Sofia not gaining much weight, I agreed to let the doctor run a metabolic panel on her. Everything came back fine, but her liver enzymes (ALT/AST) were elevated, in the 100s and then 200s. They came back down for a bit -- still in the abnormal range -- but then went up again. She has since had several blood tests done to search for metabolic disorders and infectious causes, and so far everything has come back negative. She's also had two ultrasounds and both times her liver and everythiing else looked fine. Developmentally she seems right on target -- she's happy, alert, holds her head up, can roll over. And she's growing lengthwise (she's long and skinny). She also cues more to eat now, and seems to eat well -- my breasts are usually empty afterward, and if i feed her pumped milk or a bottle of formula, she'll eat 3-5 ounces at a time. No spit up issues and she's never had jaundice.
But now the pediatric GI specialist is pushing us to have a biopsy on her liver. She insists that there must be something more going on, or her liver enzymes wouldn't be up. (By the way, I take no medications and even stopped the fenugreek, once we established it wasn't an issue of my milk supply.) I'm torn, on one hand, I of course would want to know sooner rather than later if there is something wrong with her liver.
But I also don't want to put her through something so major as a liver biopsy prematurely. In every aspect except for the weight gain, Sofia seems happy and healthy. It seems like a lot of times people's doctors don't even do a blood workup if the baby seems healthy and developmentally on target. They just say the baby is skinny and let it go at that. I can't help but wonder sometimes if maybe her lilttle liver is just getting a slow start in life and things might work out on their own. But maybe that's just wishful thinking. In other words, I don't know whether to think the doctors are being proactive in a good way or overly alarmist.
If anyone out there has experienced something similar, or can share any other insights related to liver enzymes and infant wieght gain, I'd love to hear from you. Thanks much.