Karen

With your case I am thinking oversupply issues. Often, these moms have more 
frequent bouts of mastitis. You also say the baby is thriving, and often 
these babies have abundant weight gain. Also you said "Settles reasonably 
well with a quick feed" which might mean that there is a sort of cycle going 
on where baby is fussy and given a feed and then fussy again and fed again, 
etc. This might be super-stimulating her supply. Also could he be teething? 
He might be getting alot of comfort feeds for this, again overstimulating 
her supply.

For most moms, I think giving these quickie feeds and comfort feeds is 
totally good and not a problem. But for a few, maybe, it overstimulates the 
supply. So the treatment would be the usual oversupply measures like keeping 
baby on one breast for a time, getting more hindmilk, etc.

The explanation for oversupply is that baby gets a relative 'lactose 
overload' but is not intolerant to the right amount of lactose. In my 
recollection as an nicu nurse in the past, certain stool tests react 
positive in the bf baby because lactose will be present (reducting substance 
test?). This does not equate to lactose intolerance.

The antibiotics in mom could possibly have changed baby's gut as well, but I 
think the oversupply care plan may work best for this mom. Perhaps you could 
inquire further about supply, letdown, early weight gains etc to see if this 
might be the culprit.


Laurie Wheeler, RN, BSN, MN, IBCLC, RLC
New Orleans Louisiana, s.e. USA

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