I am undergoing testing for chronic diarrhea--worried about baby's nutrition

[@llli*strineski]

Hello! My son was born last October. In late January, I started having chronic diarrhea, weight loss, low-grade fevers, and night sweats. I met with several doctors early on who were not specialists and they started the testing process; I finally met with a GI doctor on March 31 and I go in next week for a colonoscopy/endoscopy. They suspect Crohn's or Celiac Disease. The first doctor wanted to put me on Flagyl, just in case I had a parasite that was not showing up in the stool cultures, but you can't take Flagyl while breastfeeding so ignored the advice, hoping the symptoms would just go away. The GI doctor is comfortable waiting until after my tests next week before having me take Flagyl. My biggest concern is whether my diarrhea would be interfering with the amount of nutrition my baby gets through my breastmilk, especially since I've lost 20 pounds of weight? Part of that weight loss is decreased appetite, but I'm sure it comes from malabsorption due to the diarrhea, and probably a lot of the weight loss is from breastfeeing on a reduced calorie consumption. He appears to be thriving; he has always been in the 90th percentile for height and weight, he nurses often but not any more often than before the diarrhea started, and sometimes I have so much milk that I squirt. So I worry most about the quality of the breastmilk than the quantity. I haven't specifically asked my GI doctor about this issue, but he is aware that I'm breastfeeding; he is young and does not have children of his own, so I think people here in this forum will be more knowledgeable. Thanks so much!

[@llli*sixyearplan]

Real quick- who told you flagyl is not ok while BFing? It's used in pediatric patients all the time. It's safe.

Ok back. Women in impoverished areas of the world that are malnourished are able to provide breast milk for their babies. While I would certainly work on finding the cause of your illness, I wouldn't be overly concerned with the quality of your beast milk as your LO appears to be thriving.

I hope you get an answer soon!

[@llli*mommal]

with the PP. The proof is in the pudding! If your baby is thriving and in the 90th %ile, there's nothing wrong with the nutritional quality of your milk. (Sounds like quantity isn't a problem, either!) And as the PP said, malnourished women can provide good milk for their babies, so even if you are not eating enough you're still very likely to do okay unless you're at the point of starvation. The weight loss you're experiencing may be related to breastfeeding, and not so much to the gastro problems- I lost 30 lbs while nursing, even though I was eating pretty much everything I wanted.

[@llli*strineski]

Thanks so much for these replies. I feel so much better knowing that I'm giving the baby what he needs! I can't believe my supply hasn't been affected given how little I'm eating and how bad the diarrhea has been.

One of you asked who told me not to take Flagyl. The company that makes Flagyl says not to take it while breastfeeding, but my pediatrician also pointed to the following quote (found on a web site) and therefore he had concerns about it and preferred that I switch to formula while taking the five-day course of Flagyl. They do give Flagyl to kids, but apparently the dosage that goes into the breastmilk is very close to the adult dosage.

"Metronidazole is secreted in breast milk in concentrations similar to those found in plasma. Because of the potential for tumorigenicity, shown for metronidazole in mouse and rat studies, decide whether to discontinue the drug, taking into account the importance of the drug to the mother."

So I'm really torn. I'm thinking of compromising by giving him formula during the day but nursing him at night; he still wakes 3 to 6 times every night to nurse. He's never had any formula so I worry about how his system will react to it, especially if I quit nursing cold turkey for these five days.

Thanks so much for your thoughts again!