SUBJECT:  BLOOD IN THE INFANT'S STOOL
I have an interesting case that I need help with!  A first time
mother with a 2 1/2 mo old exclusively breastfed infant noticed
a small amount of blood in her baby's stool. She took the baby to
her health care provider and was seen by the PA. Physical exam
was normal.  He confirmed blood in the stool by Hemocult slide
and told the mother to eliminate all red meat, dairy products,
and everything else except rice and yellow vegetables in her
diet.  She was to return in four weeks.  She called me with
concern that she would not be healthy on this diet (or sane).
She is a vegetarian with good knowledge of protein
complementation and does not drink milk, although she does use
other dairy products.  She does use a lot of soy/vegetarian meat
substitute products.  The baby has so far shown good weight gain
and seems in all respects healthy.  My recommendation was to
review these instructions with her MD prior to making drastic
changes - my concern being for the reductions in her diet, not
checking the infants weight or bleeding for four weeks ?! I know
milk products in the mother can be problematic, and it may be
worth not eating soy, but everything else seems extreme,
especially all eliminated at the same time.  A few years ago I
heard a physician speak on infants with some degree of allergy
who presented with blood in their stools but were otherwise doing
well.  While the study of this was still in process, this MD's
opinion was to do nothing as long as weight gain was adequate and
blood loss was minimal.  In his experience, the condition
resolved by 6 - 8 months of age.  Does anyone know anything about
this or had a similar situation?  I'd also appreciate any
references to share with the physician group involved.  Thanks.

Kathy Bell RN, IBCLC