6 month old, upset tummy...doc told me to start formula.... and reduce bf..LONG

[pipoca]

Hello. I need some advice.
I live in Spain and the health care system is paediatrician led (no hvs etc). DD is 6mo (ebf) and since mid September has been quite unwell. It started as a heavy cold, then another, conjunctivitis and then what appeared to be a really nasty tummy bug. She started possetting a lot more, like most a feed each feed and doing enormous gurgling slimy green poos after each feed. Also farting a lot and seeming to be in a lot of discomfort. She looked pale and ill and, altho continued to gain weight, it slowed from 150-200+g a week to no gain or 50g for a cople of weeks. Woke almost every hour some nights wanting to comfort suck (where before only woken 2 or 3 times, had a good feed and gone to sleep)
We went to the paed who diagnosed a nasty tummy bug and suggested sachets of a probiotic thingy to be mixed with sterile water and syringed in. DD seemed to improve for a week or so.
Last 2 days the poos seem much runnier again, altho bright yellow, not green and at night she is clearly in a lot of pain, waking every hour, writhing around before farting and relaxing eventually. possetting a lot again too.
Saw paed today who says the bug has stripped the gut of friendly flora/bacteria and that she's now "senstive to the lactose in the bm". i asked if she meant CMP and I should cut out dairy, she says no, it's the lactose.
Her advice is to give DD some lactose free formula (she's even given me free samples) and then bulk her other milk feeds by mixing them with her puree (we've started BLW, wasn't going to puree) and only have 2 full bm feeds a day.
As far as I understand it, lactose intolerance is very rare, especially in bf babies and surely if it's that then reducing bm won't help, she'd need to be fully FF on lactose free stuff. I don't want to stop bf if I can help it, as apart from the health benefits, I'm buggered if I'm getting into a position where she still wakes all bloody night but I also have to make up bottles at night.
Soooo......should I cut out dairy or is it just a tummy bug (that she's had for 3 weeks plus, got a bit better and is now worse again) and I should just bide my time?

gosh.
i came on ready to tell you that your doc was talking bollocks, but actually it sounds like an interesting case.

it IS possible to get what is referred to as secondary lactose intolerance following a nasty tummy bug, which potentially your child may have. in which case the doctor is right, lactose-free formula would be the way to go but like you say you would have to cut out ALL breastmilk

her symptoms certainly match with a food intolerance and I was going to ask if the symptoms had started when you began weaning, to see if it was food related

I am not sure what I would do in your position tbh and I hope someone else with more experience of this will come along and advise.
I guess I might start expressing and try the lactose-free formula. if her symptoms improve/stop then you will know it is that.
if nothing changes then you can hopefully go back to breastfeeding.

i would also stop weaning for a little bit until she is better.

Gosh, how frustrating.

Lactose intolerance is REALLY rare as an actual permanent problem. It's more common, though, after a tummy upset as a temporary thing.

There is a treatment that can be given before a milk feed which will counter the effects of the intolerance while the body sorts itself out. This would be worth investigating.

ahh carrots is right... colief? that helps the body digest the lactose?

thisisyesterday sorry, X post but I am sure that there is a treatment that you can get which means you don't need to stop BFing.

Arrgh again.

www.nhs.uk/Conditions/lactose-intolerance/Pages/Treatment.aspx
lactase substitute?

We've only been weaning for about a week as her tummy was in uproar. We've been doing BLW and she's had (in this order, one item a day):
slices of orange
banana
homemade wholemeal bread toasted with philadelphia
spaghetti
roasted butternut squash
cauliflower cheese
broccoli.
Broccoli was yesterday and last night was terrible..maybe cos broccoli is windy?
I can never express more than a few drops unless very engorged to not sure I could keep up supply that way alone. Not sure if she'll even take the formula, she wouldn't last time I tried (when v sleep deprived) and the lactose free stuff i think tastes quite unpleasant.
organic what's this thing you give before feeds called? Poss doesn't exist here, paed certainly didn't mention anything like that.

yes, i think that's what colief does

i'd completely forgotten about it.
would definitely be worth a try

TBH I don't know but worth looking into colief as yest suggests. Or Google?

Sorry at work :)

Am in Spain, so no colief, but will go to the pharmacy later and see if there's a version of it here. Have got a version of what I think it infacol in the UK (active ingredient simeticone??) to help with wind, but only got that this morning so not sure if it'll work.
Off to google lactase intolerance after tummy bug.
Don't want to stop bf particularly as it's so convenient and especially at night.

OK, a quick google came up with this, so if it is lactose intolerance brought about by a virus, maybe something like colief would work. Also seems to answer my question about cutting out dairy.

A breast-fed baby who develops lactose intolerance after a stomach virus should continue to eat breast milk. Breast milk contains immunological factors and other components that actually aid in the healing of the intestines, so providing these is more important than restricting breast milk because of its lactose content. The amount of milk a breast-feeding mother drinks has no impact on the lactose content of her milk, so you don't need to stop drinking milk yourself if your baby develops a virus-induced temporary lactose intolerance.

I posted cos I know they know F all about bf here in Spain and wasn't sure if she was talking shite or if there might be something to it. Will continue to google, any more thoughts on this most appreciated.

xx

Infacol works on wind by breaking up big bubbles into smaller ones thus allowing them to pass more easily. I'm very about it personally as their "scientifically proven" product had around 25 babies in the study and I worry about the effects of stuff in a BF baby's diet with no proven safety. BUT that's a personal worry and I have no evidence of a problem (at all).

So Infacol isn't going to help LI. As yest says, colief does contain lactase (just G'd it myself) and easily sent to you from here if required (I expect Boots online or similar will do it).

BUT this is supposition and I am not in any way trying to offer you medical advice. What I am saying is that LI is an option worth exploring :)

From what I understand breast milk will help repair the gut and replace healthy flora as it has live antibodies in it, and loads of lovely other stuff. FF is all pasteurised so the 'live' part is no more.
I would continue with the breastfeeding but stop the weaning for now. You need her tummy to be healed before you start adding extra foods in and another month delay shouldn't matter

"with no proven safety" V badly worded, procrastinating rushing at work as always. It's been used very widely and I've no knowledge of a problem which implies safety. What I meant was, anything added into the BF baby's gut concerns me but it may well be that infacol just goes straight through without interaction at all. It's just, from the info they've given me, not proven to do so.

FGS "implies there's a safety problem".

cutting all dairy from your diet will dramtically reduce the lactose in BM, my 2 and my neice and nephew are lactose intolerant, cant even have it in cakes etc but were fine when BF if i/sil didnt eat any dairy at all!

Yes, I'd heard that about the "dodgy" science behind infacol. There may well be a version of colief here, will try the pharmacy when it opens again after siesta.
Yes, from what I understand bf will help to repair the gut.
To clarify, this all started about 3- 4 wks ago and she's only had less than a week of weaning, so not a reaction to food. But poss a good idea to give up on BLW til she's a bit better.
Thanks for your ideas, keep 'em coming, they help me to sort out what might be the best thing to do.

When DS had... interesting nappies for a week or so I took him to our GP. One of the things she said it might be was temporary LI after a bug, but she was v reassuring that he needed his milk as usual. She did suggest we not offer him yogurts and the like until it cleared up though.

oooh, interesting fairimum, so, should I cut out dairy? The page I found before and linked earlier said no:
The amount of milk a breast-feeding mother drinks has no impact on the lactose content of her milk, so you don't need to stop drinking milk yourself if your baby develops a virus-induced temporary lactose intolerance.
I hope not as I've already had 2 cups of tea, pasta with mozarella and an icecream today

well not what we were told by consultant at the hospital who said to avoid all food with lactose in - i certainly knew about it if i had eaten something - had a cream cake once thinking it would be ok - we were up all night with DDs upset tummy :(

fairimum sorry but I have to contradict you here.

Lactose is a sugar which is in all milk. Even if mums have NO dairy in their diet at all, their milk will be packed with lactose.

You may be confusing it with cow's milk protein which is a different intolerance and CMP CAN be passed into mum's milk, it seems. Not sure if there's any scientific studies on this but it's absolutely clear from an immense amount of anecdotal data that a CMP intolerant baby will be a different baby if mum goes CM free. Like yourself :)

I don't KNOW if there are studies but there may be. Given that dieticians recommend CMP free diets by proxy for CMPI babies, I expect there actually is scientific data.

I think colief is sold here as Kerulac, so will try to get some after the siesta today.

oops posted too soon...how long before noticing a difference with colief, if it works?

both of my children are lactose intolerant have no problem with CMP - DD went on to SMA LF which still has the CMP with no problems etc - i am not saying it will eliminate all lactose but it will reduce it if you avoid it yourself, which is often enough to make the difference.

The lactose composition of her (breast) milk will remain constant, regardless of whether or not mother consumes milk
and dairy products.
from
www.allergynutrition.com/resources/FAQ/33/Lactose%20intolerance.pdf