Karen, I read your post regarding the babe with projectile vomiting after feeds with great interest. I found myself in a similar circumstance with my oldest daughter when she was an infant. She had projectile vomiting, followed by bloody diarrhea. After months of testing and frustration during which I was told to stop breast feeding and try each of the three most common protein hydrolosate formulas, we finally isolated numerous IGE mediated allergies. She is allergic to dairy, beef, egg, wheat, and peanuts. While I had removed dairy from my diet, I had not looked for other allergens; hence the symptoms continued. I found that the symptoms were present immediately and for the 2-3 days after I ate the offending food. I need to make 5 points that may benefit you in assisting this mother. 1. Dairy is tough to eliminate. Teach her to read labels of everything for it is everywhere. Look for not only casein and whey, but caseinate, lactalbumin, curds, yogurt, butter,artificial butter flavor, rennet, carmel, and lactose. The letter U circled followed by Parve on a label is a reliable dairy free indicator. Nice substitutions for dairy are Rice Dream frozen and liquid products. Fleishman's No Salt Margarine (green box) is also completely dairy free and relatively good to cook with. These are also pretty easiy to find in regular grocery stores. 2. Consider other allergens. The most common allergens are: wheat, egg, peanut, corn, and citrus. If the babe reacted to Soy formula, I would be particularlly interested in Soy and Peanuts in the mom's diet. While she may not be eating much Tofu, many "modified food starches" or "food protein" is in fact soy. Hence many prepared foods... An allergy to Soy does not necessarily translate to an allergy to peanuts, but there are chemical similarities. And peanut is a very common, very potent allergen. Is this mom eating the quick and easy peanut butter sandwich for lunch? Would she have to avoid the soy and peanut oils? Technically, not. The oils are supposedly protein free. However, "pressed oil technology" does allow some nut meat to pass through and thus there is protein present. Use with great caution and again read labels. An article in _everyone's favorite newspaper_ the Wall Street Journal on 8-14-95 discussed the increasing prevelance of peanut use in food juxtaposed with its seeming increased presence as an allergen in the population. They noted that peanut butter is even used as a sealler in the wrapping of some egg rolls! 3. Use a food/symptom diary and a two week diet plan to test this baby's response. _Have mom eliminate common allergens for her diet for two weeks._ If this is allergy related, babe should be GI symptom free by then. (Excema would take longer than 2 weeks) Gradually add in allergens: one per 3-4 day period with increasing dose over that time period so that on day four she is eating alot of the offending substance. If no reaction, no allergy. If the baby does react to minimal ammounts, avoid it altogether. If it takes 10 glasses of milk to get a reaction, then maybe she can get away with a piece of cheese now and then. 4. This is an issue of informed consent. There is no _perfect_ abm out here for babes with allergy. The protein hydrolosate formulas have been shown to contain whole protein chains. BREAST MILK IS ABSOLUTELY BEST, but must be free from allergens. People who think that the symptoms are not bad enough to warrent exclusion from the diet may be in for a rude awakening later in the form of illness, i.e. childhood asthma. Patients with gluten sensitivity (Celiac disease) who are not compliant with a gluten free diet have a much higher than normal risk of GI tract cancers and lymphoma's. Allergy is a equivalent to the body receiving friendly fire injury. Just how much injury can it sustain, before it wants to pull out of the fight? 5. There is much quackery out there regarding food allergies. I recommend a great textbook which presents a balanced, research based approach to dealing with this vexing problem. The text is FOOD ALLERGY; ADVERSE REACTIONS TO FOODS AND FOOD ADDITIVES published in 1991 by Blackwell Scientific Publications, witten by D. Metcalfe, H. Sampson, and R. Simon. By the way, I nursed my daughter till she was 4.5 years. Best Regards, Glenda Deahl, RNC, Still waiting for IBCLC exam results ;>