Breastfeeding issues conflicting advice...

[Taranta]

I've posted about a couple of BF related issues recently, am continuing to have problems, and am getting conflicting advice from HV and GP.

DS is now 4 months old, still very unsettled/unhappy a lot of the time, cries a lot when waking up, sleeps for only short periods (nights from 8pm usually 4hour stint then 1-1.5hr long bursts of sleep interspersed with feeds till 5.30ish) only naps for 30 mins here and there daytime.

For the past month he's been increasingly difficult to settle and waking more frequently, farting a lot, and been pooing up to ten times a day, very runny and often greenish. Following some BF issues I have worked up from mostly FF to mostly BF (all but pre-bed time feed) but for the past month his weight gain has slowed considerably, to a few oz per fortnight. HV has instructed me to add in more formula feeds - she says the runny nappies and grumpiness and frequent feeds during night are caused by my milk being too low calorie, that I've tried hard, but now I need to accept i need to move back to supplementing. GP, who saw DS during one of his spectacular meltdowns, puts his crying down to him being a fussy/windy baby, and the runny nappies to teething. They are however checking his poo for lactose intolerance...
I don't know who, if either of them, have the right idea about what the problem might be.
I don't have a problem with formula, but I was so thrilled to be so nearly exclusively BF DS after the problems I'd had so this is a real fricking knock back if i go the HVs way. The fact that I was feeding him myself and he seems to love it made it worth the almost weekly blocked ducts in my mastitis-recovered right boob. I don't want to decrease if I don't need to, but I don't want DS to be going hungry and with an upset tum because I selfishly want to feed him all by myself.

What would you do?

Oh I know what you mean about the lack of mental acuity and the dairy-free challenge - I felt just the same...It can take 2 weeks for dairy-free to have an effect.

Your DS sounds lovely, bless him.

On the ranitidine and domperidone front - ranitidine in particular is weight-sensitive and in any case can stop working after a short while even if the dose is increased: something to do with the body circumventing it and just making more of the acid-producing apparatus.

If dairy exclusion makes no difference, you could always ask for a trial of a PPI drug like omeprazole or lansoprazole oro-dispersible. My preference speaking as a parent was for the latter, as it's properly dispersible and therefore easier to administer. It also tastes of strawberry rather than omeprazole's distinctly bitter gritty taste and texture. If you do get prescribed it, it has to be given on an empty stomach at least 30 minutes before any milk or food, and the micro-beads in it shouldn't be crushed.

So, I've come back from the paediatrician with a couple of tub of neocate, and their decision to halt the reflux drugs as the thinking is it's been allergy-prompted reflux. Got dietician appointment next week but had a chat with them and it look like I've got to start trying to get a little bit of neocate into his system somehow... Any tips Narmada, and others? I know lots of you will have been here before...

Please read this article. Hope it helps:
www.medic8.com/healthguide/allergies/cows-milk-allergy/lactose-overload.html

Thanks Susemyoli, but that's not what's going on in my DSs case. Sure he has some of what are listed he as symptoms of 'lactose overload' but he is quite underweight and I do not have an oversupply issue. More the opposite.