>This baby's first month was fine.  Birthweight 6 lb 5, down to 5 lb 14, up
>to 9 lb 5 at a month.  Mom was especially pleased to have such a placid,
>well-gaining baby because her first had been colicky and slow-gaining.
>Then at a month, baby began spitting up, burping, gassy, fussy generally
>and especially at breast, green stools.  After 3 weeks of misery, she came
>to me.
>
>She began using one breast for every 2 hour period, nursing frequently, and
>cut out dairy.  Spitting up stopped, stools gradually became yellow over a
>5-day period.  But the fussiness continued.  Once in a while they'd have
>one or two absolutely perfect days, then back to fussy.

Diane, one suggestion would be to get an assessment from a chiropractor. If
the neck vertebrae are out of alignment from the birth, this affects the
efficiency of the digestive tract. What was the birth like? Not sure why
the first month would be fine, but the rest could fit the pattern: Initial
discomfort makes baby want to feed frequently for comfort and hence
stimulates oversupply, which leads to lactose overload and colic. Were the
green stools copious in quantity? Did anything, like immunisation, happen
just prior to the time the fussiness started? Change in mum's diet? Of
course, food intolerance could well be involved on top of this. Any history
that would make this more likely? Is it possible that baby is now suffering
with 'silent reflux'? This could be secondary to either neck misalignment
or intolerance.


>Now, 12 days after I first saw her, baby tends not to be *extra* fussy at
>breast, as she was earlier, but her general fussiness means she's not
>really settled at breast either.  She tends to sleep only in arms;  mom's
>nights are a wreck.

Is it that she wants to be upright, or is she OK with being horizontal in
arms? (Clue to ruling out silent reflux)

>Tonight she's going to start lactase drops as well, after dr and I talked.
>The rumbly tummy, the initial oversupply, and the *history* of green stools
>fit with transient lactose problems;  the current nice yellow stools sure
>don't.

I don't think this sounds like lactose intolerance - more like lactose
overload when she had the green stools, etc

But I'm at a loss.  Dr wants to try lactose-free formula.  I
>pointed out that that won't do anything the lactase-treated breastmilk
>won't do, but she's eager to get some respite for this mom, and is starting
>to look suspiciously at the breastfeeding.

Danger!! Why is it *always* the fault of breastfeeding??? I would imagine
the alternatives could only be worse, particularly from a long term point
of view.

For now, mom will be giving
>drops directly to the baby.  I'll talk with her tomorrow about pumping for
>a bottle or two, to provide the baby with really thoroughly-treated milk to
>see if that makes a difference.

As far as my understanding goes with this, these drops are not really any
good for giving to baby directly, ie not designed to be used this way. They
are designed to be put into a volume of milk and allowed to act over a
period of hours, eg overnight. In this case, even this doesn't sound like
it will help here - the baby is no longer showing signs of lactose
intolerance anyway, as you pointed out. Very frustrating situation.

******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************