Hi Wise Women:

A mom called me and related that her 5 month old, who is gaining 
beautifully, has repeatedly been found to have occult blood in her stools. 
She brought her to a GI doc initially because of visible blood.  That went 
away, but they kept testing for occult blood and finding it.  Mom has been 
on an elimination diet - no dairy, wheat, eggs, soy, etc for 3 weeks now. 
No dairy for two months. Still blood in the stools.  GI doc is saying that 
it may be reflux causing blood from esophagus to work its way out in stools. 
Doc wants to do an endoscopy.  He says if the blood is coming from an 
intestinal irritation caused by allergy, he wants her to stop bfeeding and 
put the baby on Neocate.  Doc is concerned baby will develop anemia and also 
will be "set up" for more allergies later in life if endoscopy shows it is 
indeed related to an allergy.  Mom wants to keep bfeeding.  She has been 
doing research and suspects that oversupply (baby sometimes has green, 
explosive stools) may be causing irritation and thus the occult stool blood. 
Baby fusses at the breast and pulls away during the feed often when he needs 
to poop (or maybe from reflux?, but they've tried Zantac and the behavior at 
the breast persists).  Baby has taken one breast per feed from 2 months of 
age on.  I gave her the advice to limit feedings to one breast in a 4-6 hour 
period, then switch to the other breast.  I also suggested she get a second 
opinion and gave her the names of medical liasons in our area affiliated 
with LLL who are willing to take calls from parents.  Baby is not anemic, 
growing very well and meeting all her milestones.  Any ideas?.

Thanks,
Julie Rosen, LLLL, CD, PCD, LCCE
Teaneck, NJ 

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