>Currently she now understands about the rareity of true Lactose
>Intolerance.  She knows her
>baby wouldn't be thriving the way she is if she really did have this
>problem and it would have
>been from birth.  Diane, I did present her options as the 4 step plan you
>emailed to me
>as it seemed to make sense not to muddy the waters by doing everything at
>once.

Why am I never current with lactnet?  Just saw this post and realized it's a
response to a note I sent privately.  I'll summarize it here for all of you.

Joan Fisher (Ottawa, Canada) has a 4-step procedure for handling "colitis"
or "secondary lactose intolerance" or "severe oversupply" or "overactive
let-down" or green diapers or blood-in-diaper or whatever you want to call
it.  She presented this at ILCA a few years ago, backed up with a number of
case studies from her own practice.

When a baby presents with any of the above, she moves step-by-step through
this list, moving to the next only if the previous doesn't help adequately.
(My apologies, Joan, if I'm misinterpreting any of my notes.)

1) Manage oversupply.
2) Eliminate dairy.
3) Have another look at any medications either mother or baby is taking, and
any foods mom ate/drank heavily during pg.  (For one mother, the culprit was
Kool-aid.  When she took that out of her diet, baby's symptoms cleared.)
4) Have mom pump and treat expressed milk with lactase drops (common brand
is Lact-Aid, available at most large drug stores), adding 3 drops per ounce.
 Let stand at room temp for a few hours before feeding, or refrigerate
overnight before feeding.  Don't return to direct breastfeeding until stools
are yellow and blood-free.

At this point, a number of us said we've had success giving lactase drops
directly to the baby before bfing, but it takes a lot more drops - probably
about 6 per anticipated ounce.  This might make a less drastic step to
insert between 3 and 4 above, but some babies probably need the thorough
lactose breakdown that comes with allowing the milk to stand.

I had one mom whose baby needed 16 or more drops before nursings, and still
had a "rumbly tummy" most of the time.  She said he was most comfortable on
the days when she worked part-time and he was given a bottle of
well-broken-down milk.  But the drops allowed them to continue nursing until
he outgrew the lactose problem, which took a number of months.  He
ultimately nursed until he was 6 or so, after she'd been urged to wean to
solve the problem.  This was the only mom I've had, though, who used and was
pleased with the effect of directly-fed lactase.  He'd been fine at the
start, by the way, until given a bottle of formula on two separate (and
unnecessary) occasions (boy, was she mad!).

Another LC said one of her moms discovered she could turn the bleeding on
and off according to the number of pre-feed drops:  too few and he bled.
Don't know the ultimate outcome there.

Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

             ***********************************************
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