Dear Alicia and Lactnetters,
I have had a couple of clients with simillar case histories to the one you
are describing.  In the first case, the baby nursed well, stooled
prodigiously, gained well for about two weeks, then went into failure to
thrive, and gradually developed bloody stools by about 6 weeks of age.  Ped
put the baby into the hospital, and the poor mom was so freaked out that
altho she understood the idea of an elimination diet, she followed the ped.
gastroenterologist's recommendation and weaned her son to Nutramigen.
  The second case I've had was a baby who had exzema and wheezing from very
early on, though he thrived well on exclusive bfdg.  At around 5-6 months of
age, his mom ate a whole bowl of peanuts (while travelling and unable to
access other foods), the baby went into anaphylactic shock, was rushed to
the nearest ER, and succesfully resuscitated.  Mom cont to nurse him until
over the age of 2, she had to give up a huge number of foods, and not eat in
restaurants at all.
  This baby's allergist was skeptical that the baby could possibly be so
reactive to something in her milk, but tested the baby in his office, and is
now a believer.  The mom says that one of her biggest frustrations has been
that there is NOTHING in the literature about these types of cases, and to
that end, she really wd like me to write this case up and get it published.
Care to collaborate?
  I think your idea of using the frozen milk from the time mom was on an
elimination diet is a good one.
  Good luck, and let us know how it goes.  Perhaps (with advance permission
of course) we can get these mothers in touch with each other: mom to mom
support is so valuable, esp in unusual situations like this.
  Martha Johnson RN IBCLC
Eugene, Oregon

> ----------
> From:         Alicia Dermer[SMTP:[log in to unmask]]
> Sent:         Wednesday, March 17, 1999 6:57 PM
> Subject:      allergy to human milk
>
> Hi, everyone:  I'm coming out of lurkdom to ask a few questions about a
> severely allergic baby whose gastroenterologist is now suggesting that the
> baby is allergic to her mother's milk and recommending Neocate [Before
> everybody jumps all over this guy, he has been *extremely* supportive of
> continued breastfeeding up until now]. To make a long story short, this
> baby (her mother has a history of severe cow's milk allergy) had been
> doing well until her older sister brought home a stomach virus about 6
> weeks ago.  The baby developed severe chronic unremitting diarrhea with
> blood, which eventually responded to a severe restriction of
> the mother's diet (down to lamb, apple sauce and rice) for three weeks.
> At the doctor's recommendation, the mother started reintroducing foods,
> baby did fine when wheat was added, but relapsed when a few other foods
> were added.  Baby has slowed down on her growth but staying in the
> 10-25%'ile.  She is developmentally on target, and otherwise looking
> great.
>
> The mother had been losing so much weight on the severely restricted diet,
> that she couldn't go back to just lamb apple sauce and rice, so she had
> been sort of compromising.  In the past week or so, the baby has
> had episodes of green stools with blood-tinged mucus and marked fussiness,
> which don't seem related to anything in particular in mother's diet.  Baby
> has other signs of allergies including nasal congestion, and such extreme
> milk sensitivity that she developed an immediate rash on her cheek after
> her father (who had just eaten cereal with milk), had kissed her cheek.
>
> Other causes have been ruled out, including foremilk/hindmilk imbalance,
> baby is scheduled for a colonoscopy on Friday.  Mother is extremely
> reluctant to wean her baby to Neocate.  She did a Medline search about
> allergy to human milk and found only one reference, from the 1960's, I
> believe.  Her questions to Lactnetters are as follows:
>
> 1.  Is the incidence of actual allergy to human milk known or documented
> at all?  If anyone knows whether or not this even exists as a condition,
> please come forward with the scientific references. [I personally believe
> that this couldn't be the case with this baby *even if* there was such a
> thing as allergy to human milk, because the baby had normal stools when
> mother was on just lamb and rice -- still, I promised her I would ask].
>
> 2.  Are there any studies regarding long-term developmental and other
> effects of using Neocate?  How long has Neocate been around, anyway?
>
> 3.  Have any of you worked with moms who continued to breastfeed in this
> kind of situation?  If so, what was the eventual outcome if a mother
> continued to breastfeed while baby was having bouts of bloody diarrhea?
>
> The mother has a huge supply of frozen milk from the days of the severely
> restricted diet.  I had suggested that she start using that instead of
> Neocate, pump her breasts now and store the current milk for possible
> later use (once the baby is not as highly sensitive?).  What do you folks
> think?  Any other suggestions?  TIA, Alicia Dermer, MD, IBCLC.
>