Fiona:

I've seen hundreds of these babies and this is a classic "food sensitivity"
profile. This is what I would do. 1. Put mom on a dairy elimination diet
immediately. 2. Dairy includes: milk, cheese, cottage cheese, yoghurt,
butter, buttermilk, skim milk, non-fat milk, sour cream, creme fraish, ice
cream, ice milk, frozen yoghurt, pizza, kefir, non-fat milk solids,
buttermilk solids, whey, casein, sodium caseinate, calcium lactate. 3. Some
of these are "hidden" in processed foods so mum will have to read labels and
you may have different titles for these various things in Australia. 4.
Elimination must be done for 21 days. You will not achieve a baseline any
sooner. 5. Baby should begin to feel better within five days. A bit of
calming willl occur, the rash will go next but the mucous and green stool
will continue almost until the end as the bowel gets rid of the "toxins".
6. After 21 days, you may want to challenge by having mom eat a serving or
two in one 24 hour period, but I know of few mothers who are willing to put
their babies or themselves through a challenge. 7. If mum accidentally slips
up and eats a bit of dairy, she must start counting all over again. 8.
Usually by 6 months, a severely sensitive baby may tolerate a little dairy,
but some will never tolerate any. You will see. 9. Occasionally, a dairy
sensitivity is actually a sensitivity to cinnamic acid which is found in all
dairy, some citrus, watermelon and tomatoes. If this is the case, then mum
will also have to eliminate those foods. 10. Now, mum will have difficulty
with the restrictions at first, until she develops new eating habits. It
takes about 2 weeks before they settle in. Emotional support is really useful
to mums during this time, as well as suggestions for what to eat instead. I
would not advise substituting with soy until the baby has been off the dairy
for some time because 50% of babies who have troubles with cow's milk protein
appear to also have trouble with soy. (yes, this is research based). Goat's
milk is not acceptable because it is also a foreign animal protein.

The key here is to stay with the elimination diet long enough to establish
the baseline. Most of the docs I've worked with here think 4-7 days is
enough. I've put mothers on elimination diets for 21 days when doc had them
on previously for 7 with no results and gotten the situation completely
resolved on many occasions!

There are many ways to get calcium in so mum need not worry about that. She
can take a supplement, if necessary. Now, in the future, to prevent or
diminish potential in utero sensitization with a subsequent baby, mum can do
a rotation diet, only having dairy every fourth or fifth day. She can also do
a rotation diet as the baby gets older and the gut has "matured". (I would
really not do a challenge until baby is at least 6 months.)

If this strategy does not work there may be some other issue that needs to be
addressed, although the rash really nearly nails this case as a food
sensitivity problem.

Oftentimes the gut has been so damaged by the food sensitivity problem that
yeast can be a secondary concern as can lactose dumping. Strategies to
address these issues would be appropriate, although they may be hidden until
the baby improves with the elimination.

Hope this works. Keep me informed.

Alison Hazelbaker