> >I had a busy day today and had three questions from parents that I had to >tell them that I'd have to read up on. Maybe you can help. >Thanks for your thoughts. Kim Burlingham, MD 250 feet above sea level, no >comments on personal breast endowment >Question 2. A pregnant woman with silicone breast implants asks if it's OK >to breast feed her baby. I remember reading something about scleroderma >type esophageal problems in these breast fed infants. Would you recommend >breast feeding? I asked some experts in the community when the controversy started a few years back and was given vastly differing opinions. The hard core lactation folks said it's definitely O.K., the soft core lactaction folks said it should probably be O.K., the GI folks said there's a risk but the benefits outweigh the risks. And one person (I don't remember who) said not to nurse. The general consesus seemed to be, as other list members have posted, go for the nursing! And that's what I recommend. A more significant problem though, depending upon the type of surgery (actually more common with breast reduction in my experience), is an inadequate supply from the surgeon cutting the milk ducts. This I don't know how to resolve. >Question 3. The mom of a 4 week old who presented with a severe cow/soy >formula intolerance characterized by bloody stools and vomiting says that >her baby refuses the hypoallergenic formulas but will take goats milk. It >is canned with added folic acid. She refuses to retry or even wean back to >the hypoallergenic formulas. What do you think? I go with the "force the formula until the kid takes it" camp. An older infant might legitimately refuse it because of taste, but I've never seen a 4 week old who couldn't be fairly quickly convinced. Michael Sachs, M.D.