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?

fairimum honestly, lactose is in all milk, not what comes through from what the mother eats. You are right that SMA LF is milk based and therefore not CMP free which would imply a LI in your children rather than CMPI - but then again, what you ate would not affect lactose levels in your milk when they went back to EBF.

carrot is right, fairimum....your consultant could have got it wrong or maybe has not explained it right. But lactose is definitely in all milk, there is no escape :) It's the biology of it - mothers's own consumption of it makes not a jot of difference, as that is not where the lactose comes from.

hello tiktok, what's your take on the possibility that this is LI brought on by a nasty (and it was very nasty) tummy bug. Would you agree I'm better to keep bfing than introduce lactose free formula? Do you know how long something like colief takes to work, assuming it works?

pipoca, you may find this paper interesting as does refer to lactose absorption problems due to either GI infection or allergy, the relevant bits are about 4 pages in and in the 'tree' diagram towards the end. Unfortunately a lot of the other material I've been able to find on the subject is from sources which, um, clearly have a great deal of input from companies that make 'special' formula.

pipoca, I'm not medically trained and my experience is largely with well babies. However, very occasionally I come across babies whose LI (secondary LI, as your dd's is) is so bad they really do seem to need to be given lactose-free formula as a temp measure - but I would think this is a judgment call, rather than anything cut and dried, e how bad is it? how long has the baby been suffering? can the baby have some breastmilk in the meantime?

(sorry pressed post message too quick)

so you need to decide how confident you are in the doc, and maybe think about ways of preserving your milk supply if you do suspend/reduce the bf.

Sorry not to be able to help.

I was given this advice by a doctor when my son developed a similar complaint. I had it checked by other Healthcare professionals and it was agreed that the doctor's advice was wrong. (fwiw, this advice can be correct for formula fed babies)

i also asked on here and was given the same advice as my health visitor, which was: keep on breastfeeding, cut out solids for a short period of time and let the bm help clear up the bacterial infection in the gut.

my ds had his tummy bug for a few weeks and then it went. a poo sample revealed nothing.

just my experience.

i know others for whom cutting out dairy helped.

I'm sorry I haven't ready the whole thread... My daughter developed secondary lactose intolerance / dairy allergy after illness and antibiotics that messed with her gut. She was 6 months old. I cut dairy out of my diet completely and it made her so much better. It can take a couple of weeks to see the results. When I was ready to stop nursing (12 months) she was still allergic so she was given a prescribed formula from the GP. My paediatrician was very very pro nursing and encouraged me to carry on.

tiktok she's not too bad during the day...sicks up quite a lot more than usual, farts a lot and seems in some discomfort but it's not as bad as it was before the probiotics last week. it all started 3+ weeks ago, very badly at first (she just cried and cried all day and woke throughout the night). It seemed to calm down after the probiotics and she woke less (but still 3 or so times a night) and seemed in less discomfort. Then it's been the last few days she's been back to writhing in pain at night and waking almost every hour.
The doctor's suggestion was to replace some feeds with LF formula, but I'm not sure a) if she'll even take it or b) if there's any point if the other feeds are bm.
I don't want to stop bf, because if nothing else I don't want her to still wake at night but me have to FF those feeds, with all the hassle that entails (and, yes I have done it before as DS was FF and it is a faff with a capital F compared to bf.)

I don't know about LI with BF as my daughter was CMPI and on Neocate from 9 weeks when it was diagnosed. However, I did a trial with normal formula and she seemed okay for a few weeks at around 11 months, then got a v&d virus, and developed secondary LI. She was pooing very watery frothy poos which smelt slightly sweet (the lactose in them I think) and got extremely dehydrated after about a week of it. (At the start I thought it was still the tummy bug then the poo got more watery and frothy etc) I realised she wasn't very well as her fontanel was sunken as were her eyes and she had no energy. I gave her lots of dioralyte (as per the instructions on the box obv) and she improved within hours. So I didn't need to take her to the Dr but had she not improved I would have done. I then put her back onto Neocate immediately and she improved very quickly. It does sound like LI from my experience of it...

That's not very helpeful for you I realise but just wanted to share my experience of LI following a tummy bug and just to watch out for dehydration signs as obv constant diarrhoea can dehydrate a little one fairly quickly.

tracked down the Spanish version of colief..but they'll have to order in from the warehouse for me, so won't get it til tomorrow. 23 frickin euros!!!! So, have tracked down an online supplier from the UK for 16 quid instead if it works and I want more of it.
Does anyone know if it's like CMP allergy and would take a while to settle or after 1 LF formula feed you'd see a difference? Am inclined to try the LF formula sachet the doc gave me tonight as I don't think it would impact too much on bf at 6 months to have an evening ff. Might help the awful writhing pains at night?

Well, interestingly my daughter (with CMPI) was better nearly immediately upon swapping back to the Neocate (amino acid based - no lactose or CMPI). She stopped having diarrhoea after a feed or two anyway. So you might well see a difference quickly. Again, that isn't much help and it's all based on my experience of LI and CMPI.

well as predicted she had a bit of the LF formula and then refused in disust. To be fair, it smelt gross, I'm not surprised she didn't like it. So I bfed her and she's gone to sleep. Will see how we go tonight and try the colief tomorrow.