Colic, "overfeeding", and symptoms of lactose malabsorption in the breast-fed baby: a possible artifact of feed management?

Curtailing the time for which a baby feeds at the first breast, in order to encourage intake from the second breast, may maximise milk production by the mother. With escalation of this situation a point may be reached at which the infant, because of the constraint of his stomach capacity, is unable to consume sufficient calories at a feed, since foremilk is lower in calories than hindmilk. The result will be symptoms of hunger (crying, fretfulness) and maybe even failure to thrive. The low fat content of the diet may cause rapid gastric emptying. This in turn may lead to lactose reaching the small bowel in concentrations that may tax the infant's lactase potential, with resulting diarrhoea. A simple change in breastfeeding patterns may alleviate some instances of undernutrition or diarrhoea.