Re the 33 wk premie whose belly was so bloated with gas etc supposedly from
the lactose in breast milk.  All the regular cow's milk base abm have
lactose, including the 24cal premie abm.  The soy abms have either sucrose
(table sugar) or glucose.  The predigested special abm have glucose or
sometimes another sugar that isn't  easy to absorb as glucose but easier than
lactose.  Lactose and sucrose are disaccharides--sugars with two molecules.
 Both need an enzyme produced in the gut to break them down to be absorbed
(lactase, sucrase).  Anyhow, I didn't see that you had specified which
formula the baby "tolerated" at the time that he got bloated on the breast
milk.  (The idea of "diarrhea" on breast milk is a difficult concep, because
of course, normal breast milk stools can be really watery.  I have seen and
heard from moms about a change in stools with illness, e.g. foul odor, "sick
smell.")  Anyway,  is the mom consuming something passing through the
milk--meds or cow's milk?  Also, I agree with the reply I saw questioning
whether the lactose intolerance as the primary thing.  Maybe there is gut
damage with lactose intolerance as a symptom.  A biopsy should be considered.
 There is material in the literature about breastfeeding through
gastroenteritis instead of going to clear liquids, because human breast milk
lactose seems to be better tolerated than other sources of lactose.  If the
only abm that the baby tolerated was a predigested type, there may be enough
gut damage to create a problem with the human milk lactose.  The damage
should be temporary however, hopefully.  I would be curious if any others
have more info on this.  Will check out my sources and follow up.

Loni Leparulo
(Y. Leparulo, MD, FAAP)
[log in to unmask]
Redlands&Yucaipa, CA
(btwn LA & Palm Springs)