Minnie wrote about a baby with gas pains and discomfort when nursing and 
crying for long periods between feeds.  I would suggest first, as always, look at 
how baby feeds at breast; gulping, clicking, noisiness with feeding could 
indicate shallow latch (despite appearance), tongue restriction or incoordination 
of tongue use, high palate, etc.  Functional difficulties should be thoroughly 
ruled out first.  Posioning baby more upright, allowing more head extension 
and a very asymmetrical latch might help.  Lying down to nurse, side lying or 
having baby prone across mom can help baby handle faster flow if that's 
possibly a problem.

If it's mom's diet, she has quite a bit of possible allergens, mainly dairy 
which she likely needs to free of totally for 2-3 weeks.  I'd tend to start 
with dairy and have mom take digestive enzymes, at the same time.  She could have 
her OB or internist prescribe pancreatic enzymes ala Dr Jack Newman's 
recommendation on several websites, or use health food store ones and consult with 
nutritionist about which brands are most beneficial.  The fact that this baby 
had an insult to his gut with formula use (likely bovine milk based) and 
continues to suffer with mom's diet perhaps, points to a likely dairy intolerance.  
Remind mom, along with large doses of empathy and support, that the Mylicon, 
etc are only bandaids and don't get to the root of the problem.  I worked with 
one mom whose baby was tongue tied so suck was part of the problem but post 
frenotomy, her diet was addressed.  After lots of elimination and her rapid 
weight loss, she finally admitted she was a "sugar junkie" and elimination of all 
her sweets, addition of a good acidopholis/bifidus supplement for both mom and 
baby and they resolved the fussiness; it was a "silent" yeast overgrowth.  
Granted this took weeks to resolve but mom (and baby) felt it was so worth it.

Barbara Latterner, BSN, RN, IBCLC


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