My first clinical question!  Actually, I have been asked this to post this
case on behalf of the Lactation team of our local Health Region (not on
Lactnet).  This client has them stumped, and they would appreciate any
thoughts you have.
I will monitor the list for replies, but replies could also please be sent
directly to:
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Thanks,
Janice Reynolds
Saskatchewan, Canada

A 27 year old mother of a first baby, has struggled with her 9 month old
since 6 weeks after he was born. He breastfeeds frequently (every 2 hours in
the day and every hour at night) and is gaining well, but he is very gassy,
very fussy and has episodes of screaming at nights since he was 6 weeks old.
He is relatively happy and content in the day. There is no evidence of an
oversupply or an overactive letdown. His latch is good. Mom has a good
supply and her baby handles the flow well. Stools are yellow. She has tried
eliminating dairy, eggs, wheat and nuts from her diet for 7 days with no
improvement. She feels, however, that he is reacting to foods as she thinks
his episodes of screaming are more severe and frequent if he takes wheat
products or is she eats certain foods (for example, pizza). He is eating
some fruit, vegetables and chicken. She has eliminated all cereal from his
diet. She is seeing a pediatrician next week for a complete medical checkup,
but is feeling exhausted and frustrated. We are feeling that he is receiving
more lactose than his gut can handle, but are not certain of the cause. Any
suggestions?

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