I have talked to this mother several times now. Would deeply appreciate
any insight and ideas for her to consider with her baby's doctor.

Baby boy, normal birth weight, good weight gain up to now (4 mos.). Mom
describes first 6 weeks of trying to breastfeed as a "nightmare".  One
thing after another--sleepy baby, weak suck, low milk supply, sore
nipples, very fussy baby.  Mom determined to at least provide her own
milk, so finally began expressing (hand) and giving EBM in bottles.
Supplemented with ABM.  Baby is miserable.  Screams and is very
"gassy".  A friend suggested milk allergy.  Ped agreed it was a
possibility, put baby on a lactose free ABM. Mom began eliminating all
dairy 2 weeks ago, but nothing got better.  This is when she called me.
Wondering about eliminating dairy and about how to increase her supply.
Actually, it must be a wonder, because she was getting 15-17 ounces a
day, *by hand*, expressing 4-5 times. We talked about dairy elimination,
the usual tips to increase supply, and I shared the fact that breast
milk is quite high in lactose, so maybe she could ask her ped if it was
the *lactose* that's the problem in the ABM. Neither parent has any
allergies, but she says she drank a lot of milk during pregnancy and
that her mom says she was a "very fussy baby". Gently inquired as to
whether or not she would be interested in trying to nurse again.  She'd
think about it. Wonderful. Talked to her again.  Baby had a day where he
got nothing but breast milk and things were great--no screaming, no
gas.  Also had a day like this before when he had soy ABM, but now he
refuses to drink it. Otherwise, baby is still miserable.  Screaming is
not limited to any particular time of day, but some days are better than
others. Stools are yellow and soft, but not "seedy". She saw Nu*****n at
the store and asked dr. about it but she had never heard of it.  Told
her I couldn't be much help there (But something tells me that if her
little one won't drink soy he's not likely to be wild about this
either!).  Her supply is gradually increasing with the additional
expressing, so she hopes to be able to provide all milk soon. Dedicated
mom.  I inquired again about putting baby to breast.  Said she had tried
once, and he actually seemed to latch on pretty well, but wouldn't nurse
long enough to inspire a let-down.  Praised both to high heaven for this
step!! Now my questions: With all the history of nursing problems, what
is the likelihood this little guy will go back to the breast?  Obviously
if he doesn't, mom will continue to provide her milk, gratefully, any
way she can.  She says it takes him about an *hour* to drink a bottle.
She wonders if there is something else in her milk that could be making
him so "gassy". She has eliminated just about everything obvious, but
did ask if beans could be a culprit. And she does eat beef. One thing
that struck me was that she said he often begins to scream hours after a
bottle of ABM (and often has had a feed or two of milk in the
meantime).  Does this mean anything or is this common in allergic
babies? What is the likelihood she will be able to maintain the
necessary volume of milk as he grows by hand expressing?
Any thoughts and input gratefully received!

Andrea Simmons
LLLL, St. Louis MO