<< Have a client with a 9 week old who was diagnosed with this condition
(lactose intolerance) at 2 weeks old and required a blood transfusion and
temporary weaning onto a lactose free formula.>>

Val -
My husband is an adult gastroenterologist (I'm a LLL leader), so he and I
often get questions lactose intolerance vs cow's milk protein allergy.
Lactose intolerance in an infant is almost unheard of.  Riordan/Auerbach (2nd
edition, 1999) states: "Congenital, or primary. lactase deficiency is
exceedingly rare; some authorities question its existence."  My husband says
it is the most over-diagnosed problem in infants and under-diagnosed problem
in adults.
Why would this baby need a blood transfusion for lactose intolerance?  Is
something else going on here?
Is this baby allergic to cow's milk protein?  Foremilk/hindmilk imbalance from
switching breasts?  Over-active let-down?  Mom can try eliminating all dairy
(and maybe beef too) from her diet for 10-14 and see if there's improvement
and that would point to cow's milk protein allergy.
If mom has forceful let-down, then she can wait until initial spraying has
stopped before putting baby to breast.  She might want to try pumping first
and then putting baby to breast.  Let baby stay on one breast, and perhaps use
breast compression to be sure baby gets plenty of hind milk (more fat, less
lactose).  Some physicians recommend lactase drops, but my husband
investigated this and found they were never approved for giving orally to a
baby, and babies end up receiving many more drops than recommended for a
gallon of milk.
You may want to look at an article by Melissa Clark Vickers, LLL leader and
IBCLC at  <A HREF="http://www.lalecheleague.org/LVfinish.html"> LLLI: Finish
the First Breast First</A> .  There's another article you might read written
by a mother with over-active letdown.
<A HREF="http://www.lalecheleague.org/LVoveractive.html">LLLI: Overactive Let-
Down: Consequences and Treatments</A> .  Also get a copy of the LC series #13
) The Effects of an Overactive Let-Down Reflex by Frances Andrusiak, BA, MSW,
and Michelle Larose-Kuzenko, BA.
Cynthia D. Payne
LLL of Berkshire County Massachusetts