Miller and Chopra and others recommend that total or partial breastfeeding should be encouraged in the PKU infant. In addition, these infants should have their phenylalanine blood levels monitored regularly. The symptoms of galactosemia are vague, especially since the newborn appears normal. However, soon after birth mothers report that their infants have profuse vomiting, poor weight gain, wasting and lethargy. Failing to identify galactosemia may have dire results while false-positive test results can lead to unnecessary weaning.
Practitioners often err on the side of weaning when there is doubt.
Thus, mothers should be encouraged to request an immediate retest with special handling. Such testing may be difficult in areas where there is no reliable way of protecting the sample from heat. There is no intermediate or partial breastfeeding option for these infants. They must be totally weaned promptly and fed a galactose-free formula such as Nutramigen. Note that this is a very different situation than PKU, so a clear diagnosis is critical.