I KNOW the answer here will be to provide Mom with sunglasses, but... I have
a 4 month old exclusively breastfed patient, whose mother is an OB-GYN. She
has had grossly bloody stools with fussiness off and on for the last two
months. Mom is vegetarian, and began by eliminating dairy, wheat, eggs.
Initially the baby seemed better (both poops and attitude), but in the last
week has had extremely bloody stools again. This time, however, she is
perfectly happy. She is gaining, content, developmentally marching along. Her
hematocrit is perfectly fine, and not dropping. Mom, despite her medical
background, is happy with watching for now, and is planning to now eliminate
soy from her diet. The gastroenterologist is concerned about possible
eosinophilic gastroenteritis, and would really like to scope her and do a
biopsy. He has also suggested a "breastmilk holiday" (ie, give her Nutramagin
for a while) to "calm things down."
My question is whether there are any studies, or academic papers showing that
we can ignore those bloody stools without worry. I can protect my own
patient, and watch and wait, but I would love to affect the
gastroenterologist's approach as well, to avoid future "sacrifices on the
alter of ignorance."
Perhaps I should provide the subspecialty consultant with sunglasses.
Also, is anyone aware of any good elimination diet plans on the Internet,
especially for vegetarians?
Anybody? Dr. Jack?
Jennifer Cox, MD, IBCLC (hurrah!)

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