> The mom has already started eliminating milk products from her diet
> and is motivated to do what she needs to to keep on breastfeeding. Should
> she also eliminate peanuts, eggs and soy from her diet?

If she can do it without it being too much of a hardship for her, yes,
might as well.

> If eliminating milk products helps,does she need to be off milk products
> until she stops breastfeeding (for many months)?

No, it might be worth reintroducing milk products, slowly, after a few
weeks, in small amounts at first.

> Also, concerning starting solids - what do you suggest? Rice cereal and
> applesauce?

A breastfeeding baby of 6 months often will not eat rice or any other
cereal, at least not more than once.  I think that applesauce is fine,
potato, yam, meat, almost anything which is not likely to cause
allergic symptoms.

> And, this baby has been on Zantac and Reglan since age 3 weeks for GER.
> Should the medicine be stopped?

It might be worth going off medication altogether.  Who knows if the
medication is not the culprit here.  In any case at 6 months it might
be worth going off medication because reflux gets better with age.

> If not isn't the Reglan causing the
> gastric emptying to increase which you commented may be related to the
> blood and mucous. Please explain why slowing down gastric emptying may
> make a difference to the blood and mucous.

As above with the reglan.  It is fascinating that physicians are so
reluctant to put mothers on metoclopramide (Reglan) for more than a
couple of weeks, but here we have a young baby who has been on it for
over 5 months.  Physicians don't believe it, but I think that lactose
malabsorption can cause bloody stools.  The irritation caused by the
lactose malabsorption can cause bleeding.  Thus, slowing down gastric
emptying often results in the lactose being better absorbed.

This whole case seems like the problems of an overabundant milk
supply.

Jack Newman, MD, FRCPC