My breastmilk causes gas?

[@llli*hippehpanda]

My son was born with high levels of billirubin, so his pediatrician had me supplementing his feedings with formula to help cleanse his liver. Once his levels lowered and we got to go home I kept up with the formula because my husband and I are always out and about and I was worried I wouldn't always be able to breastfeed while we were away from home.
The formula he started on though gave him awful gas pains and constipation so we switched to a sensitive with lower lactose and partially broken down proteins which did wonders for his stomach. We were all very busy for a couple of weeks and I ended up feeding him a lot more formula than I liked so I started pumping even after he had finished with a breast to bring back up my supply and make sure he had some breastmilk during our busier days.
That was when I noticed that his gas came back when he eats a lot of breastmilk (8-12oz) without some formula in between. He has the same amount of pain if I feed him the breastmilk from a bottle or let him nurse, but he doesn't have it with the formula feeds.
I know that breastfeeding is much better in general than formula feeding, and when he eats too much formula he has a hard time pooping (his bm is thicker, like peanutbutter).

When I feed him it is only off of one breast at a time, and I pump the other breast for longer than he nurses to make sure I get plenty of hindmilk in his bottles. It seems like if I only give him breastmilk in the early mornings and late at night he can deal with the pain, but I worry that there is something wrong with my milk.
I was lactose intolerant until I hit puberty, is it possible that my milk has too much lactose for his sensitive tummy?
Any suggestions for what I could do to help him feel better?

[@llli*sassypants]

Oversupply can cause gas, which looks similar to lactose intolerance.

My son was a seriously gassy baby and he was a spitter. I had some oversupply issues and resolving them helped with the spit-up but not so much with the gas. We tried gas drops, baby massage, probiotics (helped with his constant runny poops), I cut food out of my diet, we even went to a chiropractor. In the end he just had to outgrow it. Maybe learn some tummy massage techniques to help get the gas out in the meantime.

[@llli*mommal]

Welcome to the forum!

I don't think you're dealing with lactose intolerance. That tends to be a problem for older children, adolescents, and adults, not for young chldren, because production of lactase (the enzyme that digests lactose) peaks in infancy and declines later in life. As the PP pointed out, sometimes a baby will suffer from lactose overload due to mom having an oversupply of milk (moms with oversupply produce milk which has a higher proportion of lactose-rich watery milk), and lactose overload can produce symptoms similar to lactose intolerance. Basically, the baby produces a normal amount of lactase, but her diet is so enriched in lactose that it overwhelms the body's lactase production,

When you pump, how much are you able to provide? If you have oversupply, we can give you ways to fix it.

There are other potential explanations for your baby's fussiness besides problems with lactose, including:
- preferring the taste of formula (I don't know why this happens, because formula tastes nasty, but some babies do seem to like it)
- preferring a certain flow speed of milk
- a normal developmental stage
- not being accustomed to the sensations of digesting breastmilk- it digests faster than formula and has a mild laxative effect, which is why breastfed babies don't get constipated

I know it must be tempting to "fix" this problem by giving baby formula. But I suggest soldiering through and continuing to nurse, because problems like these are almost always very temporary. And temporary gassiness is a fair price to pay for the health benefits of breastfeeding.

Would you like to nurse exclusively, mama? It seems like you've fallen into something a lot of people call a "booby trap", which is that you're in a situation where your baby-feeding experience is being needlessly complicated by bottles, formula, and pumping. It's almost always much, much easier just to nurse the baby and let nature sort out problems like oversupply. Breastfeeding isn't always easy- it's like learning to dance when you and your partner (the baby) have never danced before. But when you introduce a pump and bottles, it's like you're trying to dance with 2 partners instead of just one! Much harder, many more opportunities for missteps. Anyway, if you'd like to nurse exclusively, we'd love to help you do that. If not, we can probably help you work bottles and pumping into your routine in a way that's less likely to cause problems.

[@llli*maddieb]

I know that breastfeeding is much better in general than formula feeding, and when he eats too much formula he has a hard time pooping (his bm is thicker, like peanutbutter).

Well, you can see with your own eyes that formula is an issue. Formula is SO hard to digest compared to breastmilk. The proof is in the pudding, so to speak!

Gas is entirely normal in young babies. Breastmilk is so much better from a health standpoint than formula that even if your milk DID cause your baby to have gas, which I doubt, it would still be FAR better for baby than formula, sensitive of otherwise. When a baby has a dairy sensitivity via breastmilk, (which can happen, but rarely) it is the protein from milk that is the issue, not the lactose. If you want to try eliminating dairy from your diet, that is something to try but really, if the issue is just gassiness I would not bother.

Too MUCH of anything per feeding can cause excessive gas, so big bottles full of formula or bm are generally not a good idea. Babies notoriously overfeed from bottles. Babies have tiny tummys and only need a couple of ounces per feeding, (more or less depending on age which you don't mention) as long as they are being fed with the appropriate frequency. And as pp says, forceful letdown can cause gassiness, but this is easily remedied without bottles.

[@llli*hippehpanda]

He's 8 weeks tomorrow, which I know tends to be too young for lactose intolerance but my mother said I wasn't much older than that when I developed it. Which is why I thought it may be the culprit.
His pediatrician was the one to recommend he also receive formula and so I am hesitant to take it away from him also I recently went back to work and with the formula I know my mother will have plenty to feed him during the day while she watches him for me.
He nurses for around fifteen to twenty minutes per feeding and usually only one breast. When I pump the other breast I usually get about 2 to 3 ounces. His formula feedings tend to be around the same size around every three hours.
The past couple of days I've been trying to only feed him his formula during the afternoon when he tends to be awake and we're playing and active. His gas seems to be a little less painful for him but still forceful enough to wake him from his naps.

[@llli*mommal]

Have you considered the possibility that you were misdiagnosed when you were a baby? The fact that you can tolerate lactose now, as an adult, when your lactase production is probably lower than it was when you were an infant, suggests that this is the case. There are certain situations that can mimic lactose intolerance, like when mom has a milk oversupply, or a dairy protein intolerance (remember, lactose is a sugar, not a protein- the fact that your baby did better with the "sensitive" formula could suggest that he has a protein issue), or an illness which disturbs the baby's gut.

It sounds like your pediatrician suggested formula to help clear a bilirubin issue. So at this point there's no reason to use it unless you really want to. Your pumping output sounds excellent, and it sounds like you could easily get enough milk to feed baby exclusively on breastmilk.

[@llli*maddieb]

It's entirely up to you if you wish to feed your child formula instead of at the breast. But I have to take this opportunity to clear up the idea that ‘lactose intolerance’ prevents a baby from being safely breastfed. This is a myth that will not die and it just is not true. In some very, very rare cases, a baby has a medical condition where they really cannot digest the lactose in breastmilk or most formulas. If a baby has thse exceedingly rare conditions, no, they cannot be breastfed. But these should be called by thier proper names to avoid confusion.

In extremely rare cases, (1 in 60,000) a baby has a condition called galactosemia, an inherited metabolic disorder where the liver does not produce the enzyme that metabolizes galactose. By the third day of life, such babies develop severe jaundice, enlarged liver, vomiting, and lethargy. This is an exceedingly rare and very dangerous condition. Baby would be tested for this condition (and many babies test false positive so you might need more than one test) and if your baby had this condition you would be told absolutely NOT to breastfeed at all. Such babies cannot safely have human breastmilk or most formulas.

Another condition-congenital lactase deficiency (hypolactasia) is also obvious shortly after birth, causes dehydration, illness, lack of weight gain. Again, it is exceedingly rare, and again, these babies cannot have breastmilk, or most formulas.

Some babies do experience temporary lactose intolerance (secondary lactase deficiency) due to gut injury from illness, medications, or infection, and some premature babies (less than 34 weeks gestation) have a temporary developmental lactase deficiency, and the current medical recommendation from the AAP for those situations is for the mother to continue breastfeeding. The AAP also concluded that except in cases of severely malnourished FORMULA FED infants, low- lactose and lactose-free formulas have no clinical advantage.

All of the above info about galactosemia, hypolactasia, temporary lactose intolerance and AAP recommendations is from Breastfeeding Answers Made Simple (Mohbacher, 2010), a lactation text book.

[@llli*juno]

When I started eating healthier food, I was gassy and uncomfortable. It was because my body needed to get rid of the other things it had stored when I ate the bad foods. My body was detoxifying itself. Perhaps that is the problem your baby is having. When he eats breastmilk, his body rushes to rid him of what formula has left behind.