What does the baby get if not breastfed? It is clear that the intake is not adequate!

Maryse Arendt 

The mother feeds diluted milk and sometimes porridge

This mother needs information that this not enough and not adequate in a repectfull cultural sensitive way and listening what options she would choose for her child nutrition and health.  She woud need counselling ! If relactation is an option than the baby needs donor milk/ BMS by the same way he /she got the diluted milk until sufficient breastmilk is coming, donor milk? wet nurse? or in the last instance BMS in adequate quantity for the time the baby needs BMS and of course a one to one demonstation and exercise on how to prepare formula in the most safe way. 

Dear Anonymous_40866

This baby and mother are in urgent need of medical attention. The crtical first step of the the MAMI Care Pathway Package (integrated care model) is assessment of IMCI danger signs. See the assessment guide here. This baby is below his/her birth weight and is deydrated.  He/she may well be clincally ill. Do you have access to relevant national/local guidelines and protocols for IMCI and for severe wasting mangement?  Have you seen them in the community or at a health centre?  Is there somewhere they can be referred to and any help to enable this, like transport?  You describe the mother as uncoperative - she may be medically unwell too and/or have challenging home and social circumstances that she is contending with.   It is really critical that they get individual medical assessment and support.

Please do continue to use this forum to help support you in such a challenging situation but we must avoid attempting to mange this individual case online as this is no subsitute for the skilled assessment and support needed urgently.

Thank you @ Maryse Arendt for the response. We counselled the mother during 2 weeks visit for postnatal clinic on importance of breastfeeding and how to reestablish breastfeeding becouse wet- nurse is not culturally acceptable for her and she can not afford commercial BMS. 

Thank Marie McGrath for the response.

The mother- infant pair have been referred to an inpatient care in a different facility and also linked up with CHW within her reach. She was aslo accupied to the inaptient facility by the CHW to ensere that she surely get to the facility.

Dear Anonymous,

Thanks very much for the update and I am very glad to hear that the mother and infant have been referred and supported to access the critical services. This is a highly challenging case you faced and you absolutely did the right thing by asking what to do on this forum. But like I said, it is important for all to appreciate that this is not an individual medical support platform.  With this limitation in mind and with regard to this particular case, I have been contacted by two experienced paediatricans well known to the ENN who are happy to follow up with you to provide further offline support if you wish.  If you would like this, let me know (marie@ennonline.net) and I will connect you.  Warm regards, Marie

First, the mother and the child need urgent medical attention. While at it, the mother will require counselling to asure her of her ability to breastfeed, as well as find out what factors may have led to her low lactation. The attachment of the baby to the breast, as well as positioning during breastfeeding should also be assessed and if need be, corrected. A good family support and socio-cultural systems are also key to successful breastfeeding as they reduce any risks of psychological stress that may affect the mother.

Thank you very @Marie McGrath

@ Joel kiarie mwaura. 

Thank you very much for the response