Oh wise ones - I need your input!!!!!  I am working with a mother who is
breastfeeding her 3rd baby.  The first two were each breastfed nearly 2
years - mom's very committed to breastfeed.  The problem is that this
baby, currently 1 month old, as well as her first two babies, is very
gassy, screamy, fussy A LOT OF THE TIME.  This mom has lots of milk - I
first suspected foremilk-hindmilk imbalance and excessive lactose load
so I recommended feeding the baby on one breast only for a chunk of
time:  3 hours.  This didn't help.  Next I recommended breastcompression
to increase the hindmilk while maintaining feeding for a chunk of time
on one breast.  No improvement.  She suspects it's diet-related, which I
guess is never my first thought:  I'd prefer to think breastfeeding moms
don't have to do a lot of dietary manipulation to make breastfeeding go
smooothly.  But now I'm reconsidering.  Should I recommend lactase drops
next, or diet elimination of dairy - or both.  I know the elimination
has to be done for at least two weeks - she does add WCM to cereal  and
loves cheese and yogurt - is there any dairy that's acceptable?
Probably this is a stupid question, but if it's usually the cow's milk
protein that is the offender, is goat cheese okay?  rice milk?  soy
milk?  The mainstay of her diet is dairy - so this may make a big
difference, but also represents a huge hardship.  Any recipes I can
offer for substitutes?  How does she get enough calcium?  The
Ca-fortified OJ is a no-no, isn't it? Did I miss something obvious- is
there something else to try before majorly changing her diet?  Also, as
if I've not picked your brains enough already, her only other qualm is
that the baby wants to be on her all the time.  When baby is fussy,
screamy, gassy - going to breast makes him happy (he's gaining 2
oz/day!) but is this continuous nursing adding to the problem????  She
needs a break from him to attend to her needs and to her other two
children, so my usual advice of wear him in a sling 24/7 is not working
for this mom - as soon as she detaches him or puts him down he wails!  I
hear her getting frustrated.  Now what?????  Thank you!!!!!!janna
zempsky, cpnp, ibclc in west hartford CT where it's sunny for a change,