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Thread: Frothy, painful, and frequent stools (long)

  1. #1

    Default Frothy, painful, and frequent stools (long)

    Hi everyone. My 4 week old daughter has been having an increased number of stools for the past 2 days. I wouldn't be so concerned except for 2 changes we've noted: her stool looks frothy and she seems to be in a LOT of pain. I know some amount of discomfort is normal, but this is obviously a painful cry.

    She is breastfed and has started having stools almost every hour.

    I'm just finishing up my course of antibiotics for mastitis, and I know that could be messing with her GI tract, but I also read somewhere that frothy stools could indicate too much lactose caused by a foremilk/hindmilk imbalance. (I did read the sticky thread on the subject already, and I think I understand the concept).

    I have read a lot of info on this forum about OS & OALD, and I don't believe I have either one. I only leak when I get up for the first feed of the morning if she has slept for longer than 3 hours or so. In her initial latch, I can hear her gulping and swallowing, but she never chokes and she seems to handle the flow just fine. After a few minutes, I can't hear anything. When I pump, I get a total of 2.5 oz combined.

    So my question is this (whew!):
    IF these frothy painful stools are caused by a foremilk/hindmilk imbalance, how do I ensure that she is feeding long enough to reach the more satisfying hindmilk? She falls asleep at the breast every single time, usually between 10 and 20 minutes, but then she wakes up still hungry. At that point, I will usually offer the other breast. Should I latch her back on to the same side? Maybe that's why she's been having 8 hour nursing sessions.... am I switching breasts too quickly and she is only getting the foremilk from each breast??

    Thanks in advance for reading my long question!

  2. #2
    Join Date
    May 2006

    Default Re: Frothy, painful, and frequent stools (long)

    I can think of 5 possible explanations for green poops:
    1. Insufficient milk intake (stools will be scanty, watery, and thin)
    2. Oversupply (a.k.a. foremilk/hindmilk imbalance; stools will be copious, watery or frothy, may contain blood or mucous, and baby is likely to be excessively gassy)
    3. Antibiotics
    4. Illness (GI bug)
    5. Allergy (stools likely to be greenish, mucousy, and may contain blood)

    Since you're on antibiotics, I think that is the best explanation for the green, frothy, extremely frequent poops and accompanying discomfort. So before you go worrying about foremilk/hindmilk and lactose, finish your antibiotics and see if anything changes. If baby's poops return to a more normal color/consistency/frequency, then you've confirmed the hypothesis that the antibiotics were to blame. I'd offer baby a good infant probiotic right now, as well, and see if that makes a difference.

    Now, if baby's poops stay greenish, frothy, and frequent and she continues to be uncomfortable well after the antibiotics have left both your systems, then I think it makes sense to evaluate the oversupply and allergy possibilities. If you have oversupply, it's probably relatively minor because you're not leaking excessively, baby isn't struggling with a rapid letdown, feedings are not extremely short (often they will be under 10 minutes), and pump output is not excessively high (though if you are getting 2.5 oz right after nursing that is on the higher side).

    Now, on to "foremilk/hindmilk imbalance". Even though it makes for convenient shorthand for a real issue, I HATE this term. It implies that something is wrong with your milk, and implies that there are two discrete types of milk (foremilk and hindmilk) when in fact there is only milk. The milk that comes out at the beginning of a feeding is typically relatively low in fat, watery, high in lactose, and refreshing. As the feeding progresses, the milk gradually becomes higher in fat and relatively lower in lactose. A baby who consumes only the so-called "foremilk" may be gassy and uncomfortable and have green poops, but she will also get plenty of milk, plenty of fat, and will not be "unsatisified" by her intake.

    In short, at this time I would not change your nursing pattern or go to single-sided feedings. Give this a week and see if it's still a problem.

  3. #3
    Join Date
    May 2011
    Shakedown St.

    Default Re: Frothy, painful, and frequent stools (long)

    with mommal. My guess would be antibiotics or a bug (quite possible due to antibiotics) - my son has had really explosive , watery poops due to both of those things.

    If you don't have an oversupply, then I really doubt there is a foremilk/hindmilk imbalance; that is usually a consequence of a major oversupply. I had a pretty significant oversupply (I could pump 8-10 ounces after nursing) and overactive letdown and my son only nursed about 5 minutes per feeding, and he still only had foamy green poops on occasion. I think the fact that he nursed very frequently (every 1-2 hours) helped a lot with that.
    K. Sophia - Mama to my little lactivore, the amazing Mr. X (11/10).

  4. #4
    Join Date
    Jul 2010
    New York

    Default Re: Frothy, painful, and frequent stools (long)

    I am sorry you came down with mastitis. The first 6-8 weeks after giving birth are hard enough.
    please don't add more anxiety or stress to your self by doubting the quality of your breastmilk.
    Your body is healing and adjusting and your LO will be healthy and thriving if you are healthy and well rested.
    i am glad the antibiotics are helping you. Your LO will be fine.
    your the one who is probably sore and in some pain. I know how debilitating mastitis makes you feel.
    Started my family in 1986
    Finally done in 2001

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