I heard Dr. Goldman talk about the issue of food allergies in bfg babies a
year ago, and someone asked the same question about how is it biologically
reasonable for some babies to do better on a hypoallergenic (sic) formula
than on mothers milk.  He stated that in evolutionary terms, the time frame
from the kind of diets consumed by our primitive ancestors to modern diets
rich in cooked and processed foods is a revolutionarily fast change.  Some
of the problems we see in these babies may result from the fact that our
systems haven't fully evolved to cope with the variety and type of foods we
now consume.

A friend of mine who is a neonatologist here in Austin forwarded to me some
info on using pancrease to  treat mothers whose babies have food protein
intolerances and GER.  The moms take something like Ultrase with meals, and
the enzyme helps them digest better. This somehow improves the baby.  I am
not sure I understand the mechanism, and if any of the MDs on the list have
refs on this I'd like to see more discussion.

I have a client now (saw her with baby #1 for over-active letdown type
issues).  She has a little girl with Turners Syndrome.  The baby has had
lots of problems including a heart condition, hip dysplasia, and of course,
the low tonality typical of Turners girls that often affects feeding.  The
challage with Turners (at least in my mind) is to maximize the growth
potential, since the condition is going to limit it.  The time for the most
rapid growth is in early pp.  So we've had this baby at breast with and
without shields, mom pumping, etc. and growth is excellent:  at least 1
oz/day for 2 months now even with all her other problems.  However, baby has
GER and suspected protein intolerances that has produced flecks of blood in
the stool.  Pedi GI has continued to support the bfg plan, and supported my
suggestion to have mom go off dairy.  She also started the mom on the
pancrease meds.  Mom has been off dairy for 2.5 weeks and on meds for 1
week.  Baby is now on zantac.  There was an improving trend.  She challenged
yest. with some stored breast milk pumped while she was still on dairy.
Baby reacted with return to fussiness and distress.  Mom is going to donate
all the pumped milk to the local milk bank (bless her) and will stay on
current regimen of dairy elim, pancrease, and zantac.  Bfg will cont.

So this appears to be a workable regimen for the baby with GER and suspected
protein intolerances that may permit many (most?) to remain on human milk
feeds.  I think going ahead with RAST testing to try to discern other
reactive foods may be reasonable.  It is so hard to guess which food(s) may
be implicated.  One of the most atopic babies I ever saw reacted to rice
cereal!

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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