QUESTION: Our son has been diagnosed with some allergy at 1 month of age. We found this out due to blood in the stool. We went to our family doctor, an emergency room, and Riley's (a children's hospital) emergency room. My nursing wife was instructed to take all milk, eggs, corn, soy, nuts, and fish out of her diet. She tried this for 4 days and the blood in the stool remained. In addition he started to get hives only seconds after latching on. These lasted approximately 30 minutes. Due to the 4 day trial period, they put my son on a special formula called Alimentum.

My wife continues to pump in hopes of still getting to do this cherished ritual that she enjoyed with her first child. We found new hope when we read your one article stating that it could take up to two weeks to get milk out of her system. The questions would be, what does she need to do to continue nursing. If she starts on a non-milk diet for two week then re-introduces nursing would this be ok? Should she leave all those extensive things out for two week or do they leave the body and breast milk quicker. If she does this, what can she take for a calcium supplement and should we keep the Formula only diet up for the entire two weeks?

Thanks greatly for your help in this troubling matter. We are anxiously awaiting a response.

My heart goes out to you and your wife. I know this is hard on you all; however you are not alone. Unfortunately, this is not that uncommon of a problem. I am curious about the onset of the problem Ethan experienced. Until this occurred, was everything going OK? Was he a happy baby or was he colicky?

Also, did you wife perceive her milk supply as being "very abundant?" Ethan's weight gain was certainly way above average, so I would guess so. Also, were the stools streaked with blood or would you say there was "a lot" of blood? Did it occur with each stool?

Blood in stools in an infant is almost always associated with a dairy allergy. It is the bovine protein that causes the problem. And, yes, it can take two weeks for it to clear out of your wife's system. It is important during that time to read labels and be aware of "whey" (the watery part of milk). Also, beef needs to be removed from her diet because of the bovine protein. Yes, she should leave out the other products to begin with--eggs, corn, nuts, soy, and wheat. These are the most common allergens. She can begin to reintroduce these foods slowly once the stools become blood-free. As I said before, it is the dairy products that are the most likely cause. Calcium supplements are available at any pharmacy. Green leafy vegetables are high in calcium also.

One theory about the blood in stools is that lactose malabsorption causes this. Dr. Jack Newman, a well-known Canadian pediatrician, who is extremely knowledgeable about breastfeeding has this to say, "The irritation caused by the lactose malabsorption causes the bleeding. Thus, slowing down gastric emptying often results in the lactose being better absorbed." Dr. Newman teaches a technique called "Breast Compression" to help a baby get more fat at a feeding. You can read about this as well as his other articles about breastfeeding at the following website. http://www.erols.com/cindyrn/drjack0.htm  

Another way to increase fat content is to pump off a little of the foremilk at the beginning of the feeding. Foremilk is lower in fat. Fat slows down gastric emptying. Feeding on one breast per feeding is another way to make sure baby gets a higher-fat feeding. While she is pumping, your wife can throw away the first ounce or more and that will result in a higher-fat bottle of milk. You can begin to introduce the breastmilk half and half with formula. Your wife can put just the milk from the end of her pumping sessions to begin with--it will be very high in fat. This means leaving out the first 2/3 or so of the pumped milk. If everything goes OK, then up it to 3/4 breastmilk, 1/4 formula, and so on.

How long has your wife been off milk-products? I would try the half-and-half after about 10 days, unless the doctors have advised otherwise. I'm curious as to what the doctors have said concerning this situation. Let me know how things go. I hope this has been helpful.

Cher Sealy, RN, BSN, IBCLC, LLLL

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