Lindsay, you got some good suggestions already. Here are my 2 cents - these are the questions I would ask and the things I would like to explore with the mother:

First of all - could there be hyperlactation issues and OAMER involved? Baby's weight gain is great - and he gained a whole pound last week, so that could be an issue. How are the feedings going?

If that's not the issue, it would be good to explore some other things too.

Mom says she is not on any meds now, but what happened during the birth and in the pp period - did mom and/or baby get abx then?

Was the poop tested for infection? In mom's post there was some info about testing for blood, but was a microbiology testing done too?

Vegan diet is good - but what about soy consumption? Soy is as much an allergen as cow milk protein and some mom's diets are fairly rich in soy proteins.

Christina Yaneva
BF Peer Councellor
Bulgaria



--- On Fri, 7/2/10, Loes Lindsay <[log in to unmask]> wrote:

> From: Loes Lindsay <[log in to unmask]>
> Subject: blood in stool
> To: [log in to unmask]
> Date: Friday, July 2, 2010, 6:31 PM
> Hello all,
>  
> With permission to post, I have a mom of a 2 month old that
> contacted me after seeing her pediatrician and a specialist
> about her son having blood in his stool.  She was
> advised by the specialist to stop breastfeeding, but her gut
> is telling her not to :)
>  
> Below is her story:
> "My baby is two months old and has been having blood in his
> stool since he was two weeks old.  I have been dairy
> free for about a month and this past week I have begun a
> vegan diet.  He still has blood in stool and is
> extemely fussy when going to the bathroom.  The
> specialist wants me to start formula but I do not want to go
> that route yet.  My pediatrician is all for
> breastfeeding but we do not know what else I should
> try.  I am really confused about what to do and I am
> hoping that a lactation consultant can advise me in the
> right direction.  My gut is telling me to not stop
> trying.  I really do not want to start formula feeding
> my baby until 6 months old.  Have you heard of this
> before and what else can I try? My baby is in pain from a
> possible milk allergy and I don't want to keep inflicting
> this on him but I know breastmilk is so much better than
> formula!  An anal fissure and overlactation have been
> ruled out already so what else could it be if not a milk
> allergy?!"
>  
>  
> then I asked her for more details, and she wrote this:
> "I stopped with my dairy consumption because the
> pediatrician recommended it after he had blood in his stool
> for two weeks.  The painful bowel movements started
> after he was two weeks old (may 18) and I stopped the dairy
> on May 28th.  There are no allergy issues in my family
> and my husband had some minor lactose problems as a child
> (never as a baby) but outgrew them.  Andrew (my baby)
> is a very healthy baby otherwise and the pediatrician could
> not think of what it could be because no secondary symptoms
> were present so he advised us to see a pediatric gastro.
> specialist.  After completing a stool dye test, he
> concluded that it must be a milk allergy because he has no
> other signs.  I asked if there were any other diets I
> could try but he said I could starve myself and it probably
> would not make a difference so formula was the way I had to
> go.  I disregarded his recommendation with the support
> of my pediatrician who also wants me to continue
> breastfeeding and have changed my diet again and I have an
> appointment to see another specialist next week. I have no
> medical issues and neither of us are on meds but I am taking
> prenatal vitamins plus an iron supplement.  Andrew has
> a bowel movement after each feedings and they are pretty
> explosive.  In the beginning they were yellow mustard
> where now they have become more brown and green and
> sometimes appear to be watery which could mean diarrhea but
> the doctors do not think it is.  He has gained weight
> consistently since he was born.  He was born at 9lbs.
> and 21 1/2 inches, left the hospital at 8.4lbs. and each
> week he gained at least 8 ounces and last week he gained a
> full pound.  He is currently 12 lbs and 24 inches
> long.  He is generally a very happy baby and laughs and
> is very alert most of the day with the exception of going to
> the bathroom.  It seems to hurt him so much that it
> wakes him from his sleep.  We have tried mylicon and
> gripe water which definitely helps him release gas but does
> not alleviate the actual stool passing.  I appreciate
> you taking the time to help me.  This is all very
> emotional and like I said before, my gut is telling me I
> should not give up on breastfeeding yet."
>  
> I have not seen her yet, and I would want to rule out a
> maternal source of the blood first, but does anyone have any
> other suggestions? Have you had experience with a similar
> situation? Is this strict diet really necessary for
> mom?  It seems like it is not making a difference...
>  
> thank you very much!
> Loes
> Loes Lindsay, RN, BS, IBCLC, RLC
> Bellies and Babies Inc.
> East Setauket, New York 11733
> 1.631.487.7130
> www.belliesandbabies.org
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> This email may contain information of a CONFIDENTIAL
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