Joan Fisher, an IBCLC in Ottawa, has a protocol that she's spoken on at ILCA
twice, for dealing with bloody-stooled or otherwise severely distressed
babies for whom oversupply is a likely contributing factor.  I haven't heard
her updated talk, but a few years ago she was using a 4-step approach,
moving from one step to the next only as needed:

1) address any oversupply issues
2) remove dairy from the mother's diet
3) assess role of other possible allergens in her diet, and possible role of
meds (hers or baby's) or any foods mom ate copiously during pg (for one
mother, she said, the culprit turned out to be Kool-aid)
4) have mother pump for bottles that she treats with lactase.  Baby is fed
this almost-lactose-free milk until stools return to normal, when direct
breastfeeding is gradually reintroduced.  Some of us proposed feeding
lactase directly and bfing directly; others (including Joan) have found this
simply isn't effective enough in severe cases.  A compromise would be
combining direct bfing with treated bottles.

--
Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY
www.wiessinger.baka.com

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