max started "fighting" the breast and having
>difficulties nursing. he latches on and seems eager to nurse, but then pulls
>off, cries, fusses, etc...

Usually something offensive that mom is injesting.

>in addition to breastmilk max is given rice cereal quite diluted with
>breastmilk, and fruit. he is generally constipated (this i find puzzling)...
 max seems gassy.

I have seen many babies, especially so young, react to solid foods with
constipation.  One little boy would get constipated with even 2 tablespoons
of cereal. I recommend eliminating all solid foods.  He is obviously not
"ready" for solid foods and his little body is saying that. He could just
not be feeling good, and be more sensitive than in the past to foods in
mom's diet.

>max did not have any signs of colic when younger, but "threw up a lot,"
>according to mother. someone told her about reflux,

As you know, reflux is the cause of "everything" these days, definitely
over-diagnosed.  If Max threw up a lot, it could have been due to food
sensitivities.

>so in which direction should she go? I am leaning towards allergy - try
>elimination diet ideas, especially eliminating everything from max's diet,
>then trying eliminating things from hers.

I would go with food sensitivities in mother and baby, simultaneously
eliminating.  She would probably have to do something to boost her milk
supply since he has been substituting other foods for a while. (Blessed
thistle and/or fenugreek) I would advise mother to eliminate *all* dairy,
any iron supplements (including her prenatal vits.), baby's vitamins if he
is taking any, artificial sweeteners, and probably whatever fruit he has
been eating.

I would recommend a calcium/magnesium/zinc supplement because of the
elimination of dairy.  She would need 1500 mg of ca and the accompanying
mag/zinc that is included in such preparations.

Perhaps she couldn't fit into her work clothes and has been dieting using
artificial sweeteners, or otherwise changed her diet.  Perhaps she has
begun using birth-control drugs.

Patricia Gima, IBCLC
Milwaukee
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