One of the topics I have found most fascinating and most controversial is
colic and breastfeeding. I was asked to do a talk on MATERNAL nutrition and
lactation and had planned to go through macronutrients, vitamins and
minerals in a classic nutrition fashion and got this idea that completely
changed my talk.  I asked IBCLCs in New York and California what the most
common maternal nutrition questions were from their clients. I have to say
I was very impressed with the response rate - what a great group.  The MOST
common question was about what foods should be eliminated from the diet.
The research I had to do for this talk forever changed my outlook on the
topic.

I learned from this talk that neither my own personal experience nor my
clinical experience are sufficient to really fully understand breastfeeding
problems and their management.

From my personal experience, my son's colic was completely alleviated by
stopping the 10 minute per side nursing that I had learned in the dark ages
when I did my doctorate and also by nursing him in a more upright
position.  I completely ignored the nurse practitioners advice to eliminate
dairy from my diet since no one I knew ever had dairy allergies.

From the clinical observations of the practice where I am doing my
training, I have observed many infants labeled "colicy" become much calmer
when a variety of breastfeeding management problems are addressed. I have
not YET observed a case of cow's milk allergies in a totally breastfed
infant.  I have observed reactions in infants fed cow and soy milk
formula.  One of the IBCLCs in the practice does have a daughter with cow's
milk allergies so there is an alertness to this problem.  The practice is
high-risk and high volume, but I'm only there part time.

Fortunately, Lisa Marasco sent me some nice references on dairy allergies
and I continued my plunge deeper into this literature.  While most of the
research pertains to formula-fed infants and there are a lot of problems
with how the breastfeeding groups are handled, I did find the research on
transfer of cow's milk proteins and allergies in the infants completely
convincing.

I also found many many other conditions unrelated to breastfeeding that can
cause colic with varying degrees of research to support the link.  So, my
conclusion is that it is really multicausal and it is important to look at
all the possibilities when dealing with colicy infants.

One of the things that interests me is that not all women transmit cow's
milk proteins through their milk.  If we understood the relationship
between what caused some women to transmit the proteins and others not, it
would give us some options in cases of moms (like myself before my
reeducation) who are resistant to eliminating dairy from their diets.  Do
any of you have any thoughts on what makes the difference in transmission?
I have heard one SPECULATIVE theory that women who have engorgement and/or
mastitis are more likely to transmit these proteins and that reducing these
conditions will alleviate the problem.

I also have a question for Cheryl Taylor White, about whether or not she
could help me out with references for her statement that "Dairy takes up to
six weeks to be undetectable in the Mom's system, but the others take
merely a few days." I hadn't run across anything that specific in my lit
searches.

Susan Burger, PhD, MHS

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