Dear Lactnetters,

Sorry I seem to be writing a lot today.  I couldn't help responding to this
one as I've seen this clinical situation a few times.

1.  A 5lb weight gain in 2 months seems pretty good.  I wouldn't be worried
about nutrition.

2.  Spitting up is one of the commonest symptoms in a healthy baby and is
almost never caused by breastmilk per se.

3.  I am not sure of the significance of "sugar in the stool" and would need
clarification.  Lactose intolerance in the neonatal period is almost unheard
of and usually presents in older children with gassy diarrhoea.

4.  Changing to a breastmilk substitute, in my experience, results in more
rather than fewer feeding problems.  I would be reluctant to make this
recommendation given the presentation of a healthy child.

5.  There is anecdotal evidence that lactase supplementation can be given to
breastfeeding infants and it may be worth contacting the companies if a case
of lactose intolerance is truly proven in a breastfeeding infant (usually by
a pediatric gastroenterologist in view of the rarity of the diagnosis.

I hope that this helps.  It is from personal experience rather than
evidence-based.

Khalid

Khalid Aziz
Memorial University of Newfoundland