At 04:45 PM 2/4/02 -0600, you wrote:
>Has anyone heard of the phrase "reducing substance"

I am hearing this phrase more and more, particularly from the Peds who are
annoyed, at best, with breastfeeding. When a mother calls me with this
"diagnosis" we begin to work with over-supply. It is usually resolved with
the standard protocol for oversupply/over-active/letdown.

One mother had a Ped appointment the day after her baby's having one fussy
night with loose stools and was advised to go on a full elimination diet of
dairy, including cassein and whey, for 4 weeks. She was told that if she
didn't do this the problem would become very serious, even life threatening.

Of course she followed the orders, but, on my recommendation, she also
worked on reducing her supply, which helped. When the 4 weeks were over and
the problem had resolved, she was advised that she must stay off the dairy
or go to soy formula, which would be a more certain way to avoid lactose.
The fact that the stool was now acceptable was proof that it was breastmilk
related.

Her Ped is one of two in town who have just recently stopped overtly
working to get mothers to stop breastfeeding. ("This breastfeeding stuff is
over-rated. My wife doesn't breastfeed and our kids are very healthy.") So
I am thinking that this is a new, more "evidence-based" approach to the
same outcome.

Whenever a mother calls with a reducing substance concern I am usually
correct in guessing who the doctor is.  I wonder if the makers of soy
formula or lactose-free formula have educated the doctors on the subject of
testing for reducing substances with lactose intolerance in breastfed
babies. This diagnosis has certainly grown more common.

Testing stool samples of breastfed babies and finding serious conditions
that can be resolved with formula would certainly "put breastfeeding in its
place."

Pat Gima, IBCLC
Milwaukee, Wisconsin
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