I have been working with a mom from my nursing moms group who has a 17week old baby. She called me Tuesday evening very upset that her pediatrician recommended putting her baby on formula due to his extreme fussiness and other behaviors. The mom was very upset and is not ready to wean or give her baby ABM. The pediatrician suggested that the baby is suffering dairy allergy and advised cutting out dairy for a "few days". The pediatrician told her that if the behavior was not improved by Friday that they would need to try the ABM. I advised the mom that it can take 2 weeks or more on a dairy-free diet, including all "hidden dairy" to see results if the fussiness was due to a sensitivity to cows milk proteins. Mom is willing to do this and has been dairy free since Wednesday. She and I are both thinking that her problems may be due to more than dairy (or maybe dairy is not the culprit at all.) She has given me permission to consult with the experts here and to share with you the emails she has sent me. The mom writes: >>>Thanks again for the info. I am going to try to eliminate all dairy from my diet, but I came across some info about overactive letdown on one of the links below. I think you would agree that I have an overactive letdown.? I'm sure you are probably aware of the symptoms: baby is gaining weight rapidly - often more than one ounce a day; normal development; frequent wet diapers and frequent, explosive stools - often green; gulping, choking, sputtering at the breast; arches, pulls off the breast and cries; frequent, brief feeds; seems to feed more contentedly at night; never appears satisfied; makes grunting noises during sleep; may spit up a lot. All of these symptoms are right on the mark. I know you gave me a couple of things to try, which I honestly only tried a couple of times. When I try to put him into a different position (upright), he starts crying and will not latch on until I put him back into the cradle hold. The option to express some milk prior to feeding him is going to be difficult since I'm usually home alone. If he's ready to eat & I try to put him in his bouncy while I express, he is going to start crying which will just increase the gas in his tummy. Similar scenario if I take him off the breast once my letdown begins & I compress it with a towel. He is not a happy camper when I do this. I am leaning toward OAL as being the culprit and will definitely keep trying these methods, but do you have any other suggestions? As a side note, I also read that breastmilk is made from what's in the mother's bloodstream, not what's in her stomach, and most foods the mother eats do not cause any problems in the baby. It did say the one exception to this would be dairy, but that dairy sensitivities usually manifest in bloody stools and skin problems rather than gas. He's never had bloody stools or skin problems. What do you think?<<< (The mom did say that baby sometimes has mucus in the stool but no blood and he does not suffer from eczema) and the mom writes again: >>> It's me again. A couple more questions. I read that if you do have an OAL it should correct itself as the baby gets older. That hasn't been the case here. Do you know anything about that? I read about another method of trying to reduce the forcefulness of the letdown. Use the same breast for two feedings within a four hour period. Do you think that would mess up my milk supply? (For instance, I would feed off the right breast for two feedings in a row; then feed off the left for the next two feedings. He usually wants to feed within 2-3 hours of his last feed, so I figured this might work.) Your opinion is greatly appreciated. Thanks again!<<< and today... >>>Thank you so much. Please present my case to anyone who will listen. I am at my wits' end. It is like we are starting all over from scratch. I want to breastfeed sooooo badly, but if it doesn't get better soon I fear that I am going to go to formula just to get some peace around this house. It is getting pretty bad. Yesterday, I tried feeding him while lying back on the couch, but he got frustrated. My breasts are very soft and his little face just gets buried in them. It's like I would have to try to hold his head up or something. Maybe I'm not doing it right. I'm going to the store this morning. I'll pick up some cabbage leaves and try that. I will try ANYTHING!!! Thanks again for all your help and let me know if your group can come up with anything.<<< I had advised to mom to try applying cabbage leaves to the breast for 5-10 min prior to nursing to see if that helps with the MER. Other things that might be helpful to know - The baby sleeps very poorly (no more than 30-45min at a time during the day and wakes every 2 hours at night from 8pm to about 530am when he is up for the day. He nurses about every 2 hours during the day and never seems satisfied (continually rooting, fussing and sucking on his hands), even though weight gain is great (9lbs 4oz at birth and 15lbs at 17weeks) and mom has abundant milk supply. The mom reports that the baby grunts alot as well. He does exhibit many of the signs of an overactive MER. It is also possible that she has an over-supply, but I would think that would have resolved by 17weeks. Mom has weighed the baby pre & post feed and has seen a 5oz increase on several occasions. He has reflux as well and has been on Zantac since about 8 weeks. I am not convinced that this problem is due to dairy allergy/sensitivity. What do you all think? I feel bad that I have been telling the mom that the fussiness would improve as the baby got older, but this is not resolving. Thanks for your input and suggestions. Mellanie Sheppard IBCLC hopeful 2004 Arlington, TX USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html