Arvola found that only a third of otherwise healthy exclusively bf 
babies with blood in stool had cow milk protein allergy, the rest had 
mild gi infections that went away within a month or so. The bleeding 
often stopped and started a few times on the way to healing. The babies 
with bleeding had fewer strains of beneficial gut bacteria than the 
healthy, ebf controls. Hopefully this information will be reassuring to 
this mom.

So, if there are no other signs of allergy (eczema, fussiness), then 
perhaps mom can expand her diet again. If she feels safer rotating 
allergenic foods so she eats each one only every 3-4 days, that is 
another possible strategy. If there is oversupply, working on that may 
reduce gut irritation (the lactase containing intestinal brush border is 
often damaged during a gut infection). And in one rat study, 
lactose-overload damaged guts were depleted of vitamin E, so perhaps 
having mom temporarily take some vitamin E (babies can overdose, so 
giving it to mom to make sure there's sufficient in her milk) might help 
the brush border regenerate too. Human milk's trophic effects on the 
brush border are particularly important at this time.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 5/30/2013 10:43 AM, Tania Archbold wrote:
> PTP
> ---Mother wrote:
>
> So baby has been having small visible blood spots in her stool since she was 5 weeks or so (she is now 14 weeks). That is when her stool started becoming green and full of mucous as well. I saw the pediatrician and she said to cut out dairy/soy/beef/legumes. I have been dairy/soy free for 2 months and also have cut out all possible allergenic foods for about a month now. I pretty much only eat chicken with no spices, vegetables, and rice. I have also stopped taking my prenatal vitamins since it has corn starch in the ingredients (not sure if i should keep this up since my diet is not very good right now) Also changed kate's vitamin d drops recently since the one i was giving her had corn in it too( that i was not aware of until recently). Anyway, the blood did disappear for about 2-3 weeks but then came back last week (blood present in a bout 6 diapers total for the week). Also her stool started becoming more green every time as well. The only thing i can think of is that i had some spices that had corn in it that i wasn't aware of before consuming and i also had a ginger ail. could that be the cause?
>
> The other thing i'm thinking is that it could be a foremilk/hindmilk imbalance. Baby has all the symptoms of this. green explosive stools, gassiness(occasionally), she used to spit up a lot but not anymore, frequent feedings, blood in stool, only gaining 0.6 oz per day now, diaper rash, bowel movement immediately after feeding(she has about 5-8 per day, mostly green, mucous for the past 2 months). The only time it started to become yellow was when i was block feeding. I stopped because i was afraid i was going to loose my milk all of a sudden. I tried to block feed for 4 hours but that didnt help, so i did it for 8-12 hours on each side and that seemed to make her stool more yellow. Do you think i should continue to block feed? and how long should i spend per side?
>
> Also, i have pumped a few times to see the consistency of my milk and it looks like a i have a lot of foremilk. Its pretty much blue with a thin layer of fat at the top(after separating from refrigeration).
>
> Anyway, i'm worried sick about my daughter because she is still having blood. And i read that too much lactose in the foremilk can cause irritation in her digestive tract and cause bleeding. So im wondering if its the imbalnace or a food sensitivity. The pediatrician did not even want to hear about my foremilk/hindmilk imbalance! She was actually very rude about it (did not want to discuss anything that has to do with my milk, insistent that the colour of stool is of no concern) and told me to switch to an amino acid based formula. I really don't want to stop breastfeeding and am desperate for answers. We will be getting a referral to <pediatric children's hospital> to see the specialist soon but i'm afraid he will say to switch to formula too. That's why Im writing you to see if you think there is any way i can continue to breastfeed or if you think i should just listen to the doctors.
> -------------------------------------------------------------------------------------------------------------------------------------------------------
> Tania again:
>
> This is a mother-baby pair I saw in the first week of life.  Baby had an undiagnosed PTT which she then had released at a very reputable clinic.
>
> I have not seen her in person since then.
>
> I have asked for details about weight gain and frequency of breastfeeding.
>
> I explained more about what happens with the fat in our breastmilk, and encouraged frequent feeding to even out the fat content the baby is receiving.  I suggested compressions to encourage breast emptying before switching to the other side.
>
> I will admit my knowledge of where to go with regards to the mother's diet once the main culprits have been eliminated is pretty shaky.
>
> Does anyone have any other ideas?  What other questions should I be asking?
>
> Tania
>
> Tania Archbold B.Sc, IBCLC
> www.mothersnectar.ca
> Mothers Nectar Lactation Consultant Services
> Guelph, ON Canada
> 519-400-7098
>
>
>
>
>
>
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