Cynthia, I just wanted to add a few comments to the info from you and your
husband concerning lactose intolerance. As I read your comments holding my
aching head,  I smiled (sort of) when I got to the part about lactose
intolerance being underdiagnosed in adults. My mom became (realized? made the
connection?) she was intolerant when she was 40. My older sister figured it out
when she was 39. I finally noticed at 37 that every day I ate a bowl of cereal
in the morning, I had a terrific headache that afternoon and a terrific
bellyache the next day. My mom can eat yogurt and some cheese with no problem,
but milk will make her extrememly ill. My sister has sinus problems and some
digestive problems with too much of any milk products. I have "relatively" mild
problems with ANY milk product. Unfortunately, avoiding milk products is
difficult--both because of the prevalence in lots of stuff, and because I LIKE
cheese, ice cream, etc. I try to be good, but, uh, guess WHY I have a headache
this morning!!!

My daughter was a classic "high need" baby and today (at age 8) has some
problems with milk, but can tolerate the sweet acidophilous milk pretty well.
Looking back at her infancy, I suspect that many of her problems could be
attributed to a foremilk/hindmilk imbalance. There is a good article on this by
Michael Woolridge and Chloe Fisher from a 1988 Lancet called ike "Colic,
'Overfeeding,' and Symptoms of Lactose Malabsorption in the Breast-fed Baby: a
Possible Artifact of Feed Management?" (Lancet 1988; 11 (8605):382-84). They
describe a chain of events that starts with feeding from both breasts
(arbitrarily switching sides) which means baby gets lots of foremilk and less
hindmilk. Since lactose concentration stays pretty constant throughout the
feeding, and since baby will try to get the calories he needs, the more foremilk
he takes in, the more lactose he gets. He has lactase (enzyme) in sufficient
quantities to handle reasonable amounts of lactose, but too much lactose means
something like an artificial lactose intolerance-like problem. Solution involves
increasing the hind milk by letting baby feed from one breast till he comes off
(then offering the other) which fills the caloric requirements in less milk,
which in turn means less lactose.

I wish I had known all this 8 years ago!

See you in Chicago!

Melissa Vickers, IBCLC
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