Thank you Jan for a way to administer lactase to breastfeeding infants

  Unfortunately this Mom has decided to switch to formula,  inspite of the fact that I told her that the problem may persist on formula also.  She had put the baby on Isomil herself without any improvement and came to see my partner on Sunday who swithced the baby to Nutramigen.  I called the mom on Monday.  The baby was no better.  When I suggested that since there was no improvement she go back to breastfeeding she said that well the baby was a little better since she didn't stop and cry during the breastfeeding and but cried just as much between feedings.

I really think this is just a baby with poor self comforting skills and some sensory integration issues with perhaps a problem handing the increased flow with letdown. have been discussing.  It is similar to the situation I see in adolescents who are smoking.  They now it is bad but they don't want to stop smoking.

While I have your attention I wanted to talk about formula switching in general.  Unfortunately I have quite alot of experience with formula fed babies (being a pediatrician).  Some babies are just hard to comfort in the first few weeks.  The moms want to try differnet formulas and wind up switching from cowsmilk formula with iron, to formula without iron, to soy formula to elimental formula.  Each formula seems to work alittle bit for only a few days.  I don't know if this is placebo effect or what.  But I've seem it alot and eventually the baby seems to cry less and I've called it developmental fussyness.  I think this happens in some breastfeed babies too.  Things just get better when they get older.  They may have some sensory disturbance which is developmental. But it is hard to get some breastfeeding moms who may not be as committed to breastfeeding as those who seek out lactation consultants specifically to continue breastfeeding during this developmental fussiness phase ( which I used to call colic when I first went into practice 25 years ago.)

  
 Mom perhaps did not persist enough when I asked her to try several feedings on the same breast for several days and more skin to skin time.

This is the point when I really wonder to myself whether I should talk about the "benefits of breastfeeding"(of course all the benefits while you are breastfeeding but especially all the long term benefits like reduction of obesity and autoimmune disease and cancer) but some kind of switch seems to have come down in the Mom's brain where she will not listen anymore.  The decision has been made.  It is very frustrating.  I think this is related to the emotional decision making we talkedabout
Penny Soppas, MD, IBCLC
Drexel Hill Pediatric Associates