Hi Sucharitha,

Thanks for writing to me personally.
I understand your problem and appreciate your concern for your baby.

1) So is he lactose intolerant for sure or it can be cow milk allergy too?

The history and stool for reducing substances are suggestive of lactose intolerance. But a stool pH would have helped in confirming the diagnosis. There is no real harm in trying breast milk once since a confirmation of diagnosis is not made and also primary lactose intolerance is very rare. Your doctor correctly suggested to wait for one week (this will give time for secondary lactose intolerance to subside) and try and restart breast feeding (which I repeatedly suggested is ideal for your baby). So wait these few days and may be by Wednesday or Thursday restart breast feeding. A stool pH if the symptoms recur along with stool for reducing substances will confirm the diagnosis. (Hope he will be happy with breast feeding and it was only a secondary lactose intolerance because of some infective loose motions he had).

2) Continuing on soy milk is not good for baby boy so what is the best option for me. Will opting for a hypoallergenic formula be better then soy one. Or since he is not allergic to soy, are there any lactose free formulas that i can use?

Yes you can try Simyl MCT Milk powder or Pregestemil milk powder. But hope he will stabilize with your breast milk which is ideal.

3)I am trying my level best taking medications, proper diet and pumping every 3 hrs to revert to breast feeding. I had to pump only this week and can't latch him on as I am going on a dairy free diet and want to test trial on my baby to see if he can toleretae breast milk after a week. However in case if he develops the same above symptoms even with breast milk, then i have to go for lactose free milk alone and thus depend on formula with no other choice. So please suggest whats best formula to put him on under such situation. Right now on Zerolac he is settled well, feeds regularly and smily. But since its soy based, I am worried he won;t get enough nutrition. Please understand i can get the formulas from US so please help me to choose the the best one.

Yes I can understand the effort you are putting in. In a world where all the mothers are trying to avoid breast feeding (by giving all the wrong explanations despite our best efforts to promote breast feeding) I really appreciate your effort to try and breast feed your baby. I hope you will be successful in your attempts. (Please spread the message of breast feeding around you. You will be doing a lot good to the society)
Try and be as sterile as possible during preparation of feeds these few days. (Another episode of infection will result in lactose intolerance and we will have to delay breast feeding as we can get confused if this is primary or secondary)
Do not use a bottle to feed your baby now. (This will cause nipple confusion and he will not latch on to breast later). Use a spoon and glass. As of those formulas from United states I may not be of much use because I do not have personal experience using them (to be XXXXXXX to you). So I may not be really useful in helping you in that aspect. But why should we think that he will not be comfortable with your breast milk. Hope for the best.

Continue to ask queries as and when required.
Take care.

Dr Y V Siva Sankara Murty
M.D.(Pediatrics)
Associate Professor of Pediatrics

---

Hi XXXXXXX,

Yes Simyl MCT powder is available now.

Be confident of breast feeding your baby. You can do it. You are not getting enough milk now just because your baby is not sucking at your breast. Once he sucks at the breast enough milk will be produced because of the basic harmone prolactin that is produced. You may also take Tab Metoclopramide during the initial period to enhance milk production.

I suggest you should not try any change over of the formula now. You should first try and breast feed after 3 or 4 days and give the add on of formula after every breast feeding initially. If he develops a reaction then change over to simyl MCT. If there is no such intolerance then you can entirely stop the formula after the initial transitional period.

Hope this helps.
Take care.

---

Hi XXXXXXX

Please ask as many queries as required. I will be more than happy to answer them.

Yes formulas containing DHA are always better than with out them.

But with breast feeding you need not worry about all these. It is the BEST.

Do not worry about using Tab Metoclopramide. We use it routinely. Those complications are rare. (I am not supposed to prescribe any thing using this medium. So please use it as prescribed by your doctor)

Hope this helps.
Continue to ask further queries as required.
Take care.

---

Hi XXXXXXX

Do not worry about that.

Did you start breast feeding your baby?
Are there any problems associated?

Now regarding your blood in the milk that is pumped out...

That could be because of vigorous pumping. It could also be because of improper latch (If you started breast feeding already). Is there any pain in the nipple. A soar nipple can also result in such a problem.

If you started breast feeding please continue the same. You need not worry about that blood. It will subside slowly. If the bleeding continues for a long time you may have to consult your doctor.

If you have sore nipple please write to me. (pain and tenderness at nipple)

Correct the latch if you already started breast feeding.

Continue to ask further queries as required.

---