Help!  You know this field does keep you humble!  I have learned
enough to know that I will always fall short of having enough information
about breastfeeding; am so thankful for the conglomerate knowledge and
education of this forum. (This is long, sorry)
        Anyway, here goes, with permission from mom.   This mother delivered
a BB on 8/5/04.  He was 8#1oz at birth, she wanted to BF and so was began to
BF immediately after birth, but soon stared supplements of formula.(Nothing
is perfect in the hospital setting here).  When she was discharged she told
me that she was given a sample pack of formula (the newest from the MJ co)
and thought that this was a message that she was to feed him this after
every feeding.          Miraculously, he continued BF, despite being
supplemented after every feed.  He was eating every 2-3 hrs, 20-30min at the
breast, then sup with 2-4 oz of formula.  He grew well.  At a well child
exam in mid Sept, the mother told the dr. that she thought he was acting
fussy, passing lots of gas and was drawing his legs up to his abd. with
crying when he passed stool (the picture of an uncomfortable child)  She was
given a referal to a GI specialist, who after exam (wt 12#1) suggested that
she change the formula to Nutramigen, which she did and kept BF.  The baby
was a bit more comfortable, but still had problems with constipation,
fussiness and gas.  When mom reported a week later, the GI dr. suggested she
try not breastfeeding for a week.  She also, on her own, decreased her diet
to orange juice and bread, being afraid that the greens she was eating were
causing the baby distress.  (She really wants to BF for 1 yr, at least).
        So, then she calls me.  When I got the complete story, I realized
that this baby has been on this formula most of his life and that he's never
been just a BF baby.  I suggest (and send reports to the ped and GI
specialist) that after the OK from the specialist,
        1)she go back to BF,
        2)pump to reinstate her milk supply(since she hasn't been pumping
regularly for the week she stopped BF),
        3) start her diet (which has NO dairy, and is well balanced with
plenty of fluids, fruits, veg, protein foods, etc and eat well, take her
PNV.  So, feeling like I've 'nailed' this one, she went home, restarted BF
without checking with the dr.  After two breast feeds, she called me to say
that the baby was colicky, crampy, fussy, etc, just like before....she is
discouraged, she went back to Nutramagen. I suggested she keep her milk
supply up with the pump while I search...
        What do you think??  Of course,  I thought that it was the first
formula that was causing this problem, that it might take more that a week
for the effects of the other formula to wear off.  That that is why it took
2 weeks for the baby to be more comfortable off that other formula and then
the breast milk. The baby was happy and eating well, not crampy, fussy
behavior, now with BF it's started again.  Her diet contains no dairy, what
else could cause this?  maybe wheat products?? since she loves bread?
Thank in advance.  I need your words of wisdom!
Betsy Wells-Gephart RN, IBCLC
                                    Lactation Specialist
                                    Chandler Regional Hospital
                                    Chandler, AZ, USA

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