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Thread: OS/OALD vs Cow's Milk Protein Question (XP)

  1. #1

    Default OS/OALD vs Cow's Milk Protein Question (XP)

    Hello, LLLladies!

    I'm (still) trying to figure out why my 9-week-old son suddenly started spitting up tons at ~5wks. The pediatrician, at our last visit, suggested a dairy-elimination for a month, so I'm about a week into that... but our symptoms could match up with OS/OALD, too, and I'm not sure how to differentiate (and my pediatrician isn't, either), so I'm hoping you can help me figure out if it's either issue, or something else entirely.

    * DS spits up a lot, as of ~5wks, when he did not really do so at all before. Like, after every single feeding, sometimes multiples times, up to a couple tablespoons (though usually around 2tsp-1tbsp). It's white and chunky, with definite solid bits.

    * About half the time, DS seems unhappy either before or after spitting up.

    * There's a family history of reflux problems/GERD on his dad's side -- my husband, his sister, and his father are all on daily maintenance anti-reflux meds per doctors' orders.

    * DS's diapers look perfectly normal -- they range from "pumpkin" to "mustard" in colour, with seedy bits. They have been green in the past, but haven't been more than "maybe greenish yellow" in several weeks, certainly since before the spitting-up issue started, except the one day I tried doing block-feeding for 24hrs (which promptly resulted in green poops). No blood, no obvious mucous. No redness on his bottom, etc, either.

    * He's a very heavy wetter -- even overnight, he needs about a half-cup of absorbency per hour to not have huge leaks.

    * He's gaining weight VERY fast -- 3/4 to 1 pound a week

    * He's very gassy (and often painfully so), frequently has VERY loud belches (you can hear 'em from a different floor of the house), and always makes a lot of grunting/straining noises between feeds (especially while asleep)

    * He often wants to latch ONLY to the nipple with no areola, often rears back/pulls off without unlatching, and sometimes makes audible gulping noises while nursing -- all three are especially a problem on one side, but do happen to the other as well

    * He often wants to suck but seems frustrated about getting milk when he does so; he'll take a finger or pacifier in preference to my nipple at those times.

    * I leak a LOT of milk -- 1-2.5oz per feeding typically gets caught in my Milkies Milk Saver (though I've also been known to overflow it; it can't hold more than about 2.5oz), and also leak when not feeding, too (though I can't measure that... )

    * I rarely-to-occasionally get little 'jets' of milk if DS unlatches early during nursing (I cannot feel let-down, but I assume that's it), and can also see 'jets' of milk in the flange when pumping.

    * When I pump (rare), I can get ~6oz in 15-20min total for both breasts, without prompting a second letdown... BUT, ~6oz is about how much he'll take if we do a bottle-feeding, too, so perhaps that's to be expected?

    * DS prefers to go 3.5-4hrs between beginning feeds during the day, and 5-6hrs at night; trying to feed him more often results in either copiously more spitting up or outright refusal.

    * I always let him completely finish the first breast, until he lets the nipple out of his mouth of his own accord (usually 10-30min, depending on his mood) and doesn't seem to want it back, then change his diaper, then offer the other side (he almost always takes it) and let him finish that side 'til he's content as well (another 10-30min).

    * I've never "felt" engorged except when skipping a feed (e.g., when DS decides to drop a night-time feed), but I've definitely felt hard lumps of milk in my breasts at times, and suspect I probably "store" a lot of milk. (I'm wearing UK 34K/US 34O bras, up from UK 32G/US 34I pre-pregnancy, which is an increase of six or seven cup-sizes. *weep*)

    * Since starting a dairy-free diet (including 'hidden' dairies per the list on kellymom, but maintaining my previous soy intake, which was fairly little) nearly a week ago, DS's spitting up and gas have both gotten worse, with a LOT of added fussing and crying.

    ...

    So, that's the state of things. Any ideas what this is likely to be, and the best routes to be sure and/or to fix it?

    Thank you very much!

  2. #2
    Join Date
    Jun 2009
    Posts
    5,419

    Default Re: OS/OALD vs Cow's Milk Protein Question (XP)

    Sounds like OS/OALD to me. For one thing, that is way more common than dairy protein allergy, for another, you and baby have many of the symptoms. Sinc os/oald is a pretty common issue, if it pumps like os/oald, spits up like os/oald, and gains like os/oald, it is probably os/oald. 6 ounces is a tremendous amount to be pumping or for a 9 week old baby to take in a single feeding, babies typically overfeed when bottle fed.

    Since you are a week into dairy elimination, you could go another week and see if there is improvement if you wanted. If there isn't, you can pretty much rule it out. Of course, if you start taking steps to help baby with the oald, which you probably want to do, that may improve things at the same time! You'll be able to tell which it is if you then add dairy back into your diet and see what happens.

    What have you done for the oald? An immediate issue I see is the long length of times between feedings and the encouraging baby to take both breasts per feeding. Just nursing a bit more more often and letting baby "finish the first breast first" even if that means he takes one breast per feeding should help. I see you say it causes more spit up to murse more but sometimes things need to get worse before they get better. To avoid refusal, try easing slowly into increasing sessions and offering but not pressuring.

    This article has more ideas: http://kellymom.com/bf/got-milk/supp.../fast-letdown/

    And your pediatrician may be interested in this about food based allergies and the breastfed baby:
    http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf

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