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.