The history of the infant with vomiting/diarrhea and "shock-like" reaction
sounds suspiciously like metabolic disease (and probably not related to
breastfeeding).  Carnitine deficiency and the mitochondrial enzyme
deficiencies (which vary hugely in presentation) come to mind immediately;
I'm sure there are many other suspects.  I would make sure this child has
been worked up by an expert in the field of metabolic disease--this might
include some very fancy, research-lab-type tests, skin biopsies, etc.

I would encourage the mom to resume breastfeeding, perhaps even doing a
breastmilk-challenge while the child was under close hospital observation.
Allergic reactions should leave measurable effects in blood tests, etc.
Metabolic problems can sometimes be hard to diagnose.

Linda Shaw MD FAAP

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