Good references:
Anveden-Hertzber. 1996. Eur J Pediatr 155:464-67. Proctocolitis in exclusively breast-fed infants.
Studied 9 infants between 1-8 weeks of age. Decreased cow's milk protein intake in mother. Symptoms were relieved in 6 of the 9 infants in 4 weeks. One resolved without restrictions.

Machida, H. et al. 1994. Allergic colitis in infancy: clinical and pathologic aspects. J Paediat Gastroenterol Nutr 19)1):22-24.
Mothers of 7 infants restricted milk products from diet. One infant had immediate cessation of bleeding, while the other six had gradual resolution of bleeding. More than 20 eosinophils/HPF appear to be an excellent criterion for diagnosis of allergic colitis. They recommend continued bf and monitoring of the hemoglobin and albumin.

My limited clinical experience with this(n=2) is that we don't wait enough time for the gut to heal. The above articles talk in terms of 4 weeks. If the baby is not ill or losing weight, then continue breastfeeding despite the bleeding. When the infant becomes very ill and is losing weight, that is where other interventions need to be started--use of the protein hydrosylate formulas.  The problem with these is that by the time they are instituted, the baby is old enough and smart enough to say"these taste horrible" and refuses. Then what do you do?

Another problem is that this condition is then complicated by temporary lactose intolerance because the damaged gut is not producing lactase. 
Again I think that we have enough bases to say that if baby is not ill or losing a lot of weight, get the mom off cow's milk protein, be patient, monirot baby(and close our eyes when we change the diaper.)
Carol L'Esperance, RN, MSN, IBCLC

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