Hi Tania,

Sounds like this mom was on the right track with block nursing.  More
frequent feeding is a good idea too, particularly if she uses one breast for
several nursings in a row.

From BAMS (please read all the way to the bottom):

Lactose is a sugar abundant in human milk (and a very important contributor
to brain growth).  The enzyme lactase, which is produced in the small
intestine, processes lactose by breaking it down into glucose and galactose.
Lactose intolerance usually refers to the reactions (bloating, gas,
abdominal pain, diarrhea, nausea) that occur when a lack of lactase leaves
lactose unprocessed in the gut.

Primary lactase deficiency does not occur in young babies but occurs later
in life in about 70% of the world's population (with the exception of those
of northern European ancestry).  Lactase production gradually decreases as
early as age 3 or as late as adulthood.  It does not cause diarrhea in
babies.

Congenital lactase deficiency (hypolactasia) is very rare and becomes
obvious shortly after birth, causing dehydration, illness and lack of weight
gain.  The few babies with this condition cannot be safely breastfed.

Secondary lactase deficiency, which is most common in babies, is a temporary
condition caused by damage to the lining of the small intestine from
infection, celiac disease, other illness or medication.  Continued
breastfeeding is recommended both during infectious illness with diarrhea
and after; except in severely malnourished formula-fed infants, low-lactose
and lactose-free formulas have no clinical advantages (Heyman, 2006).

In addition to milk, other protein foods that may cause reactions in
breastfed babies are soy, egg white, peanuts, fish, wheat, nuts, corn and
pork.  Eliminating (or adding back in) no more than one or two foods at time
is helpful in pinpointing the cause of allergic symptoms.

A Finnish study examined the effect on bone mineral density of eliminating
cow's milk from a breastfeeding mother's diet and concluded that elimination
of dairy for a few months was not associated with loss of bone mineral
density.  [BTW, not breastfeeding puts women at higher risk of osteoporosis
than does breastfeeding].

Pancrease MT4 is usually taken by those with cystic fibrosis to help break
down their food more completely.  The treatment involves taking two tablets
with each meal and one with each snack (Schach & Haight, 2002).  By breaking
down the offending food more thoroughly, allergens are less likely to pass
intact into the mother's milk and cause a reaction in her baby.

In one preliminary US study on this treatment, 16 breastfeeding mothers
whose babies had bloody stools eliminated dairy, soy, nuts, strawberries,
and chocolate from their diet and began taking Pancrease MT4 (Repucci,
1999).  In 13 of the babies, bloody stools resolved and colic symptoms
decreased while the mothers continued to breastfeed.  This could be
suggested as an alternative to switching a breastfed baby to hydrolyzed or
elemental cow's milk formula.

Bloody stools are not always caused by allergy or sensitivity.  A Finnish
study of 40 babies between 1 and 6 months old with bloody stools found,
after elimination and dairy challenges, that only 18% had a cow's milk
allergy (Arvola et al., 2006).  The researchers recommend elimination diets
whenever a baby has bloody stools, since this resolved the symptoms of some
of the babies, but they noted that in the vast majority of cases, this
symptom was not an indicator of a serious health problem.

No negative outcomes have been associated with mothers continuing to
breastfeed when a baby has bloody stools  (Sicherer, 2003).

Ingrid Tilstra
La Leche League Canada Leader
International Board Certified Lactation Consultant

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