Hi everyone! We are new here...and have a few questions. My daughter is 5 weeks old, and we have had lots of issues with breastfeeding (mastitis, thrush, latch problems) which led to her not gaining weight- was still below birth weight at 4 weeks. Because of this and my seemingly low milk supply, we have unfortunately had to supplement with formula :/ . At 3 weeks, while I was on antibiotics for the mastitis, she began having green, watery, and mucousy poops. This was BEFORE we introduced any formula. Went to a breastfeeding medicine specialist and she seemed to think that a dairy protien allergy is the cause for the diarrhea/mucous/reflux-like symptoms and due to my family history of allergies. BUT she hasn't had any mucousy poop since I finished antibiotics and we started supplementing. She is also much more satisfied after feeding (I nurse until she's done and offer a bottle when she still shows hunger cues, per Dr's recommendation) and hasn't been fussy at all, whereas before she was screaming constantly. Still pretty gassy and reflux-y, but a much happier and fatter baby.
So, my question is this: if a dairy allergy (and not the antibiotics) are the culprit, then wouldn't she be allergic to the milk in the formula? The first 3 ingredients are milk, lactose, and whey protein derivatives! Wouldn't she still be having the fussyness and mucous/diarrhea? I'm totally open to eliminating dairy from my diet, but it seems pointless if there is dairy protein in the formula...of course the goal is to EBF once we have all our issues worked out.
Sorry this is SO long! Thanks for reading, and thanks in advance for help!
Re: dairy allergy?
Absolutely yes. If she has a dairy allergy she would react to the formula as well.
Green mucousy poops does not necessarily indicate an allergy.
Check out this link.
Are you pumping to replace what you give her in the bottle? If you plan to get off the formula and get your supply up you need to stimulate your breasts so that your body knows more milk is needed.
Re: dairy allergy?
Oh, thank you so much for asking this question! This is one of those things that drive me absolutely crazy, when someone convinces a mom that the teeny tiny bit of milk protiens that go from what she eats, into her blood, and then into her breastmilk are the issue, (sometimes it is, of course, but really, not that often) and then put baby directly on a milk-based formula! Arrrrrgh. What is doubly maddening is that when formula is introduced early, that actually can cause a dairy sensitivity. Anyway, when formula (actually, bottles) seem to solve everything, actually what happened in my experience is the mom had forceful letdown (totally solvable) that was causing gas, spitups, green poops or whatever the supposed issue was, and neither dairy nor anything else in the mothers diet had anything to do with it. Of course, by the time the dust settles and mom figures this all out, her milk supply has been affected. I am not saying this was your situation, just I have seen that a lot. Certainly, anti-biotics can cause gastrointestinal distress and that is certainly the possible culprit in this case!
What is a "breastfeeding medicine specialist?" I have no idea what that is. A lactation consultant? A medical doctor who is very knowledgable about breastfeeding? Or what?
If your milk supply IS low, it is likely not too late to do something about that. First, nurse a lot. (is latch OK now?) Pump (or hand express) after nursing especially if you are supplementing. You can look into galactagogues. As far as weaning off formula, how that goes depends on how much you are supplementing at this point. You may need to work with your baby's pediatrician and/or a lactation consultant to wean off supplements as you build supply-assuming you have to build supply. Kellymom has an article with a protocol for weaning off formula but it's a very individual thing.
Breastfeeding is usually not all that complicated. But moms need helpful, evidence based information when they have issues, bad information or just incomplete information can and does cause MORE issues. Please surf this website and kelllymom.com for accurate breastfeeding info online. I highly recommend the book The Womanly Art of Breastfeeding (8th edition.) Another great book is Making More Milk but you do not need that one unless you have some highly unusual low milk supply issues. Most importantly, trust your instincts. You are the expert on your baby!
Have you contacted your local La Leche League? You can call ANY La Leche League Leader in or out of your area, so if the first one you contact is not your cup of tea, call another. It can really help to talk through what is happening with an experienced mom who has been there. LLL meetings are great resources too. And free! Of course the moms on this forum are awesome as well.
Re: dairy allergy?
Thanks for the input! Guess I should have clarified that the pediatrician is the one who put her on formula, and the breastfeeding Dr suspected the dairy allergy. Dr Rebecca Saenz is her name- she is an IBCLC and an MD. Some of her work is actually cited in The Womanly Art of Breastfeeding (great book, I borrowed it from my LLL leader).
I guess I'm sortof relieved that it is probably not dairy allergy. Must have been the antibiotics then. I don't think i have OALD or OS, because of her not gaining weight, and also there is never any spraying, choking, etc. She has been fussy at the breast lately, but I (and Dr Saens) decided that was because of a combination of flow preference and the thrush making her mouth uncomfortable. I have been using the paced bottle feeding techniques in the Womanly Art, and I have a Dr Brown's natural flow bottle- both have helped some. I should also mention that I have been using a nipple shield on the right side only because baby will start to nurse and get mad, start crying, and refuses to latch again without it. Not sure why that is...?
I did rent a hospital grade double electric pump and have been trying to pump between feedings, which has been difficult because by the time she is done nursing for 45 mins to an hour, she is usually not satisfied, so I have to make her bottle. She usually takes about 3 (!) oz after nursing. Then, I have to hold/rock her to sleep for another 30 minutes or so, or she will wake up as soon as I put her down. Long story short, a feeding is easily a 2 + hr ordeal...by then its pretty much time to feed again, and if I did manage to get in a pumping, I only get maybe 1 oz total. Then I have to give her MORE formula.after nursing because my breasts seem nearly empty and she gets very frustrated trying to nurse. Plus, I have to eat and sleep sometime :/ That's the discouraging, exhausting cycle.
I think what makes me the most upset is that I know breastfeeding is not supposed to be this complicated. I feel like I have read the entire LLL and kellymom websi
tes a million times. We drove 3 hours to Mississippi to see Dr Saenz, I had my LLL leader come over and check baby's latch. I feel like I've exhausted every resource!
And in the back of my mind, my fear is that I just won't be able to produce enough and will have to keep on giving my precious baby that nasty formula :/
Re: dairy allergy?
What if you gave any needed supplements via SNS so baby continues to stimulate your supply at the breast so you don't have to pump?
Re: dairy allergy?
That might work! Where would I get one of those?
Re: dairy allergy?
The Lact-Aid www.lact-aid.com is the one I prefer, but Medela has one you can order or get from an LC.
Re: dairy allergy?
(oops posted this novel before seeing pp. I have two Leader friends who both prefered the Lact aid as well. Just fyi.) There are two basic kinds of at the breast supplementers. Medela sells one called the supplemental nursing system-sns. There is also the Lact-aid, sold by-Lact-aid, I think. I don't think they sell any thing else. Your best bet is likely to purchase online/via phone, unless there is a local LC who sells them. You could also try to rig up a home made one just to see the concept seems like it may work for you before investing further.
Video of baby nursing with a lactation aid: Go to last video on page: http://www.positivelybreastfeeding.c...man/videos.htm It looks like it may be a “home made” at the breast supplementer.
Link to lact-aid website: http://www.lact-aid.com/ Link to medela sns: http://www.medelabreastfeedingus.com...ing-system-sns
Sometimes, when there are multiple issues, you want to work on everything 'at once', other times, it is helpful to break it down.
It sounds like the major issue in the early weeks was lack of weight gain, which may or may not have been due to low milk supply. You have solved that, (I assume it is solved) by supplementing. It may not be the solution you preferred, but it is a good solution sometimes! Rule number one is feed the baby.
Other issue was/is thrush and painful latch. OK. Are those things improved? Can you nurse comfortably at this point? It’s important that keeps being worked on if necessary.
The next major issue to deal with, I think, is increasing your milk supply and reducing the supplementing-If that is possible. For the moment, let’s assume it is.
Have you done a milk transfer weigh in? Where you weigh the baby, then nurse, then weigh baby again-on a very good sensitive scale? If you did one a few weeks ago, you might want to do another. This test is limited in its helpfulness, it’s really just a snapshot of that particular nursing session. However, in a case where it seems like baby is not getting ‘enough’ from nursing, it might be informative.
Even if baby got nothing from the breast, which is unlikely, 3 oz seems like a lot for a 5 week old to take in a single feeding. We know babies will drink more than ‘enough’ with a bottle. I think even using the low flow nipple and the paced bottle feeding, baby may be overfeeding a bit on the bottle, which is probably not a big issue, except it undermines your confidence, which IS a big issue. On the other hand, baby may be trying to make up for lost time a bit-so, not sure. This would be a question for your LC. I just think that much of what you are reporting-baby seems hungry after nursing, baby is fussy, I can only pump 1 oz, my breasts feel empty after nursing-none of that would sound like anything abnormal except that there was the (very real and alarming) weight gain issue. So it’s important, I think, to look at babies gain now, look at how much you are supplementing, and compare-you know what I mean? I think you need reassurance that your baby is getting some milk when nursing, and perhaps an estimate of how much, so you know how far you need to go-and how much you are able to pump and how much baby takes from a bottle are usually not great indicators of these things.
This is getting long. I will just say-please remember that every DROP of your milk is beneficial for baby. Every minute spent at your breast is beneficial for baby. And whatever or however they are fed, babies benefit the MOST from being in the safe and warm & loving arms of mama. Yes, sometimes moms cannot make ‘enough.’ At the breast supplementers are used a lot by moms who have adopted, some of whom may never make anywhere near ‘enough’ to exclusively breastfeed. But still, they breastfeed as much as they can. And they hold their babies and love them if they cannot. Some moms who have severe difficulties do find it simply becomes too much. You will know when & if that time comes for you. But never feel bad about feeding your child however you could! Because every drop and every minute, and especially, all that loving touch, which never has to stop, is good. Give yourself a big hug and pat on the back for all you have done! Your baby knows.