I sent a private letter to the writer

Dear Mr. Somerson.

Your column has been shared among a worldwide consortium of breastfeeding advocates and counselors (1600 members), so you will no doubt get many responses, and I hope everyone treats you kindly.

Dealing with a sick child is hard enough, without having one who is chronically ill, with nobody able to diagnose, or improve the situation.  I ache for you and your family, and send cyberorchids as well, for  going this long without becoming alcoholics, or worse, in the process.   I am very sorry you have had this horrible experience.  I hope that with bringing it up in your column there will be local people who will be able to help you, even at this late date. 

Statistics from around the world show that your experience IS the exception, not the rule.  By and large, and being a medical writer you are able to verify this information, babies are better protected, get sick less, have fewer allergies and have a much lower incidence of mortality, if they are breastfed.  This is true not only in emerging nations, but in this country -- not only among the poor, or in the boondocks, but among the middle class, and in cities with advanced medical care, as well.   I am glad you make this point in your article, while (rightfully) bemoaning your daughter's fate and the life you have led as a result.  

While your column does justice to the general facts relative to breastfeeding and it's protection, your slant does not.  I fear many people will read this and find one more reason, if they needed one, to not breastfeed.  "Well, so-and-so breastfed and his baby was still sick all the time, anyway, so why should I bother?"   If I would change your article at all, I would probably only change one thing -- after giving the facts, I would say only that whatever the statistics, they are no comfort when it is your own child that falls off the curve.   That is my response as a breastfeeding activist (lactivist).  

When other expectant parents look for advice, don't bite your tongue -- people have the right to make informed choices.  You have access to all the articles and information that many people would never see, and you have valuable information to impart.  You can tell them that breastfeeding is not 100% perfect as protection -- nothing is.  And you can share your experience, if you feel like it.  But remember, and remind others, one case doesn't make a "rule."  Even if 1 out of 10 babies still get sick with breastmilk, that is far better than the number that get sick without it.   

As a lactation consultant, I have another response.  The sad fact is that for all the good breastfeeding does and can do, even breastfed babies do get sick and can have chronic health problems.  Breastmilk, as good as it is, is still not perfect protection against illness and disease in infants, wherever in the world they are.  

You ask "Why Caroline?"  Parents and spouses and children have asked this since time immemorial, when loved ones are ailing.  I certainly have no answers, on the metaphysical plane.  On the physical plane -- I am assuming, since you are medically knowledgeable, and since Columbus is not a medical backwater, that you have done all manner of testing, and tried many different regimes, to try to find the root of your daughter's almost perpetual illnesses.   I am assuming you have seen specialists as well as general pediatricians, and been to all manner of clinics. 
 
I question, and I am sure you do to, that if your child is this sick as a breastfed baby, what might have happened if she was formula fed?   You do not say whether you tried formula, but I assume that if you did, it didn't work, either. Otherwise your column would have been in a very different vein.  And my expectation is that formula feeding would not have improved the situation, only compounded it. 

I am assuming you have also ruled out allergies or responses to things in mom's diet.  Of course, at 19 months, it is too late to prevent food allergies, only time to ameliorate some of the consequences.  And the most common allergy is to cow's protein.  Some babies, even without ever having had a drop of formula, are allergic to cow's milk (perhaps developing in utero allergies or predispositions).  And if mom has any dairy in her diet, an infant may respond with allergy symptoms, with colic, or with chronic illnesses involving the GI or respiratory tracts.  But perhaps, even now, if your wife modifies her diet, and you modified your child's diet, with regard to just the overt dairy they take in, you would see some improvement in the symptomatology.  (It takes at least two weeks to clear dairy from your system).  If you see some minimal improvement, you might want to do a more rigorous elimination of dairy for more maximal effect.  I have just talked about milk allergy here, since that is the most frequent culprit -- but it could be other protein instead, or as well.   And looking at allergies is only one of many phases to ruling out possible roots to the problem.

My wish for your New Year is that these problems begin to dissipate, either because Caroline is growing out of them, or because some heretofore untapped resource in your area knows something, or can find something, that others have overlooked.  And I hope to be advised, some time in the future, of a column that deals with her improvement in health, whatever lead to it.

Sincerely,  Chanita Stillerman-Evans
                 BSc, RN, IBCLC and CWC (concerned world citizen)
             San Francisco, California