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Subject:
From:
Ann Perry <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 11 Jan 2004 12:38:39 EST
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I think this is one of the diagnosis that is thrown out there when a
clinician just doesn't know what is going on.  This is my observation.
I am frustrated when a mother calls and has been told that her baby is
"allergic" to her breast milk, therefore she either had to wean or restrict her diet
dramatically.
The fussy, colicky, spitty baby may have allergies but to leap to the
conclusion that that is the diagnosis is premature.  A much deeper investigation
needs to be done to determine this diagnosis.  What I find is on many cases that
the mother does have an over production and/or over active let-down.  There is
also the possibility that there is more than one issue in play, i.e.; over
production, and some allergies.
I think Linda and Jean have pointed out some great points. When one is
obtaining a history, you cannot just focus on the mother's complaints or what she
was told as a diagnosis but ask questions going back to the birth and early
days, get details of weights, when the problem behavior started, what has been
done so far including what seemed to work and what did not work.
When the term "Reflux" is used it is very broad, including mild spitting to a
severe pathological problem with erosion of the esophagus.  There is no one
cause of Reflux.  It could be brought on by allergies, formula, over filling of
the stomach either by bottle feeding or a mother with an excessive supply,
and other causes.  We need to look at what may be causing Reflux and not worry
if this is the correct term.
This has been discussed many times in the archives and it keeps coming back.
I really wish we had gastrointerologist who had knowledge about breastfeeding
working with other clinicians to take the diagnosis of "allergic to breast
milk" out of the diagnostic codes.
Ann Perry RN, IBCLC
Boston, MA

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