Dear all:

In terms of allergic babies, ever since I first read Lawrence's "Breastfeeding:  A Guide for the Medical Profession" in 1985, the well-documented advice was to start with removing allergens from the mother's diet first.   I totally understand that a student might think it is normal to start with some semi-hypoallergenic formula when so few instructors for health professionals actually read the wide body of evidence readily available in this standard text. 

I am really quite frustrated with the fact that evidence about the appropriate first line interventions for allergies do not seem to penetrate the education of health care professionals.  

I am working with a sweet baby who has multiple issues and has multiple surgeries and every time I turn around, the mother is being given advice from yet another health care professional who has not thought through this babies feeding issues.  The mother has a marvelous supply.  To date they have intervened with fortifier, rice cereal, oatmeal and now elecare.  Each and every time this baby vomited profusely and lost weight. Because of his medical issues it is not possible for him to gain in a "normal healthy manner".  It is possible for him to grow better.  Growing better has always 100% of the time been when he has been left alone to drink his own mother's milk.  He may have allergies to cow's milk proteins or he may have had a reaction to the third round of postsurgery antibiotics.  Only time and the elimination diet will tell.  What is VERY VERY clear however is that any form of formula for this baby slows his growth.

Even more frustrating is that not one single "specialist" ever even considered assisting this mother with her diet. The message was "eliminate" not here are all the wonderful healthy foods you CAN eat.  

So, I recommend every single health care practitioner who ever comes close to anything to do with infant feeding read Lawrence from cover to cover before they ever open their mouths to suggest formula over moms own milk.

Sincerely,

Susan E. Burger, MHS, PhD, IBCLC, RLC

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