Help me figure out the cause of these "symptoms"

[@llli*m11612]

My ds is 8 weeks old now and I'm more confused than ever.
I have already seen an lc, my pediatrician and a lll leader/group. No one seems to be able to help me pinpoint the problem if there is one.
I am mostly concerned about the screaming and coughing. I also would love to know if the green and mucosy poops are a concern or just within normal.
Baby
1- Sometimes fussy in evening and sometimes SCREAMING as if in pain in the evening (otherwise generally happy)
2- Coughing at breast at different times and away from breast seemingly when spitting up and swallowing back down (spits up without swallowing rarely)
3- Green poops occasionally, mucosy poops occasionally (no visible blood) Very gassy sometimes uncomfortable with it, but i:'m thinking it's within normal infant range.
4- Sometimes fussy at breast, choking, gagging and bobbing.
5- Mild (?) lip tie, I question posterior tongue tie
6- Horrible skin. Dry spots, cradle cap, baby acne on face and trunk, prickly heat rash looking area on chin but no diaper rash.
7- Thrush- I think it is gone now. Treated with gv for 4 days and now baby probiotics
Mommy
1- OS/OALD I have his 3yo sister nurse to relieve sometimes and I take him off for first let down sometimes.
2- I eat pretty healthy, whole foods mostly, but I love sugar. I avoid soy for the most part, but couldn't say it is fully absent from my diet.
3- I had mastitis when he was @2 weeks old. Treated with abx
4- I had thrush following abx I think. Itchy nipples but no pain. Treated with gv and apno.

Things we've tried
1- Dairy free diet for 10 days then a trial
2- Dairy free diet for 2.5 weeks then accidental hidden dairy trial (1 piece of cake)
3-Block feeding. This regulated my supply so I went back to switch feeding and my supply skyrocketed. This return of OS seems to have coincided with a return of the green mucosy poops.
So, dairy allergy, lip/tongue tie, is/oald, silent reflux or just normal?
Sorry this is so long. Help please

[@llli*maddieb]

Since the most severe issue sounds to be the rash, have you considered an alternative cause of the rash? Rashes can cause discomfort, and may have nothing to do with your diet or breastfeeding.

Suggestions: Changing detergent to some free and clear option/adding extra rinse cycles/trying different fabrics? I am sure there are otc rash skin treatments but that is outside my knowledge. In my experience with rashes when cloth diapering, changing the washing routine to include more rinses and being careful about detergent solved the problem. Anyway, that is an area I would suggest exploring. Also, how often do you bathe baby and with what? Frequent bathing is a common cause of dry skin and rashes.

The other truly concerning thing (to me, anyway) is the coughing. Is there a fast letdown? the other area to consider perhaps is painful reflux?

For both fast letdown and reflux, frequent nursing and holding baby more or less upright most of the time seems to work wonders. Of course, in some cases, reflux responds to medications. Nursing in a reclined position can help to. With my middle child, my letdown was so strong part of the time- especially if it had been a while since the last nursing session- I held him almost completely upright WHILE nursing (his head straight above his tummy and legs) so he could handle the flow.

Did you ever try probiotics?

[@llli*m11612]

Thanks for your thoughts. It is interesting to me that those symptoms stood out the most to you. Those are what the doctors keep telling me are normal and to just wait it out. These are the sane docs that recommend scented soaps and chemically enhanced products though so I guess I shouldn't be surprised.
All his clothes are cotton. I do use a free and clear detergent, but will try switching to another. I do use an extra rinse cycle. We all have sensitive skin in my house.
We bathe him with water only except for an organic, unscented baby soap once every other week or so. We delayed his bath too so he hasnt actually had that many baths. I actually wondered if bathing more often with soap would help.
Yes forceful let down and likely silent reflux. He does pop off at the first let down so we let that bit go into a towel. He tends not to like when I lie back too much. He turns his head down and seems to get lost. He also chokes more if his chin isnt tucked which he has a hard time doing when i'm lying back. So I do as tipped back as I as i can. He let's me know what position he wants to be in. He seems to do well when we're side lying at night. Idk if it is the position or him being sleepy. He doesn't latch well side lying when alert.
I will try the detergent change.
Anything stand out to you about his position preferences?

[@llli*mommal]

Everything you desrcibe seems very normal to me.

1- Sometimes fussy in evening and sometimes SCREAMING as if in pain in the evening (otherwise generally happy)

Textbook for an 8 week-old baby. Evening fussiness (a.k.a. "the witching hours" or "evenings-only colic") tends to begin at around 3 weeks of age and peak around 6ish weeks of age. My kids were like clockwork: they would be cute, cuddly, good nursers all day long, and then around 7-9 pm, they would switch to inconsolable, painful-sounding screaming. They didn't want to nurse, they wouldn't go to sleep. Nothing could calm them for more than a few minutes at a time. The best thing about evening fussiness is that it goes away, usually by 3 months.

2- Coughing at breast at different times and away from breast seemingly when spitting up and swallowing back down (spits up without swallowing rarely)

Normal, as long as the baby is gaining weight at a normal pace and doesn't seem to be in extreme amounts of pain. Spit-up, when the baby is a generally happy spitter and is gaining normally- that's a laundry problem, not a health problem.

3- Green poops occasionally, mucosy poops occasionally (no visible blood) Very gassy sometimes uncomfortable with it, but i:'m thinking it's within normal infant range.

Normal. Green is a normal color for baby poop, mucus is not an issue when the baby is otherwise healthy, and babies are generally gassy and uncomfortable with the processes of excretion. Imagine if you had never pooped or passed gas until 8 weeks ago- my guess is that you wouldn't be too comfortable with the process! Learning to coordinate all the muscles of the digestive tract so as to poop/pass gas with ease is actually a skill that people have to develop.

4- Sometimes fussy at breast, choking, gagging and bobbing.

Normal. Nursing is another skill that babies have to work to perfect. Young babies have trouble controlling mom's milk flow even when that flow is moderate. They need to develop bigger mouths, stronger muscles, more coordination- all things that come in time!

5- Mild (?) lip tie, I question posterior tongue tie

Is this causing you aIn while nursing? If not, then it's probably within the range of normal and you don't need to do anything about it. Ties often stretch out, and generally become less problematic as time progresses.

6- Horrible skin. Dry spots, cradle cap, baby acne on face and trunk, prickly heat rash looking area on chin but no diaper rash.

Normal for an 8 week-old. Baby acne is caused by the last flush of maternal hormones in the baby's body. It will go away. Avoid soaps and fragrances, and use a soft filter on your camera when you're taking cute baby pics. Cradle cap can be removed with olive oil and a soft brush: just put some olive oil on a cotton ball and rub that on your baby's head. After it's soaked in for a few minutes, brush the hair with a soft brush, and the cradle cap will flake right off.

7- Thrush- I think it is gone now. Treated with gv for 4 days and now baby probiotics

Not normal. Keep an eye on it; thrush can be very stubborn. Discomfort from thrush may explain some of the fussiness and digestive upsets.

1- OS/OALD I have his 3yo sister nurse to relieve sometimes and I take him off for first let down sometimes.

Normal. You're just 8 weeks in. Be patient with your body and letdown speed will eventually ratchet down. Also, your baby will get better at nursing, allowing him to handle fast letdowns with ease.

2- I eat pretty healthy, whole foods mostly, but I love sugar. I avoid soy for the most part, but couldn't say it is fully absent from my diet.

Since everything about your baby is pretty normal, I wouldn't avoid anything. Except sugar. That's not what you want to be eating when thrush is in the mix- yeast loves simple sugars!

3- I had mastitis when he was @2 weeks old. Treated with abx

Probably irrelevant at this point, though the antibiotics could be to blame for the thrush. Yeast overgrowth often follows a course of antibiotics, since antibiotics knock out your body's good bacteria along with the bad ones.

4- I had thrush following abx I think. Itchy nipples but no pain. Treated with gv and apno.

Keep an eye on it, and avoid sugars if you can. Taking a probiotic and eating probiotic foods (e.g., kimchi, sauerkraut, kefir, yogurt) won't hurt and may help.

Things we've tried
1- Dairy free diet for 10 days then a trial
2- Dairy free diet for 2.5 weeks then accidental hidden dairy trial (1 piece of cake)
3-Block feeding. This regulated my supply so I went back to switch feeding and my supply skyrocketed. This return of OS seems to have coincided with a return of the green mucosy poops.
So, dairy allergy, lip/tongue tie, is/oald, silent reflux or just normal?
Sorry this is so long. Help please

My guess is "just normal". Obviously you are a well-informed mom who researches a lot, and sometimes that approach can lead you down a lot of dark paths. But you don't need to go down them! When your baby is basically healthy and growing normally, pretty much everything on your list can be brushed off as part of the quirkiness of the newborn stage.

[@llli*maddieb]

I think those stood out to me because of how you describe them. Of course, some amount of pimples/rashes/dryness in infant skin are entirely normal. Horrible skin? idk. It just sounded bad as you described it. And the coughing just made me think of reflux, and since reflux had not been mentioned I thought I would mention it. Overall, I agree with mommal that nothing on your list sounds all that unusual or serious, and also is likely linked to fast letdown. Fast letdown is only a problem to the extent it is a problem, and unless baby is refusing to nurse due to it, it is not really a problem.

As far as his position preferences, that sounds totally normal. With my middle guy I talked about before, I would almost sit straight UP so he could be more directly up and down. Laid back is utterly adjustable. It does not mean mom is laying down. It just means she is not sitting straight up like a typist, or hunching over baby killing her back. And baby can be in any position at all. Side lying is a great position. There are no wrong nursing positions. Whatever works.

What do YOU think is the most serious, unusual issue? Your instincts are probably the most reliable thing here. No one knows baby as well as you!

[@llli*m11612]

Thank you both.
It is hard for me to trust my instincts. I tend to be a worrier and knowing this about myself I often disregard my initial concerns. However, I don't think it is a good idea to do this regarding my babies. So, I try to follow all concerns without becoming too concerned if you kwim.
Being an infant is hard. They have to learn everything. It must be a miserable situation sometimes. I keep trying to tell myself this, but I would just feel awful if there was something I missed that i could have done to make it easier for my little guy.
I thought it would be easier with my second child. I had thought despite postpartum hormones i would be less anxious and more informed so no sweat. I am less anxious until the screaming starts and my instincts kick in as nature intended. Then it's blood, sweat and tears trying to fix it. Or milk, muscle and tears. There are just too many variables to try to figure out why some nights are better than others. We all have good and bad days anyway.
I will try a different detergent, olive oil for the cradle cap and I'll try to cut down on sugar. I eat sweets when I feel stressed or deprived so this may be easier if I'm not trying to do an elimination. Also, we did both start on probiotics.
Thanks again. I think I have been wanting to hear that it is all normal. I'll just keep nursing, dancing, bouncing, jiggling, walking, going outside, standing near the shower etc in the evening. It will be much easier without the anxiety of thinking something is wrong (like I've "poisoned" him with dairy). I really don't mind and it doesn't last forever.

[@llli*mommal]

I think that we modern mamas should take a page from our cavewoman ancestresses. When Modern Mama's baby is fussy or having weird poop, she freaks out and starts googling- there must be a cure for that or an app, there has to be something she can DO!!! Pumping? Dietary eliminations? Hypoallergenic lotions? Amber beads, a new sling, a macrobiotic diet, a machine that replicates the sounds of the womb...? Cave Mama, on the other hand, has no recourse to Dr. Google. She just rolls with the baby weirdness because she has no other choice. She holds him as much as she can and nurses as much as she can because she knows babies can't cry when they're nursing. Aside from that, she has more important things to worry about, like foraging for food or making sure the sabretooth tigers don't get into the cave again. It's hard to be anxious about a baby's poop color when hunger and sabretooths are consuming your mental resources.

I'm not saying that you should disregard your concerns about your baby's poop and behavior. Rather, I think you should weigh your concerns against your baby's "whole baby" picture. If your baby is generally healthy, generally gaining weight well, not giving you evidence of constant, severe pain, then you know that he's doing well, and those weird things you're observing are just quirks. But if he's always miserable, not gaining well, not generally healthy- then you need to look deeper. But not until then!

[@llli*dandelions]

I just wanted to echo what the others said (even though with a baby it's not comforting to hear that nothing's wrong). Most of this sounds perfectly normal, and something that time will fix (a Rx I always hate lol). Although I can't speak to the rashes or tongue-tie, this sounds very similar to what we dealt with:

1- Sometimes fussy in evening and sometimes SCREAMING as if in pain in the evening (otherwise generally happy)

Yep - we've had ~ half dozen nights total where LO was absolutely inconsolable. Screaming, arching away from me, ANGRY -- to the point that I paged the doctor, every time, because I was sure something was wrong. We never did nail this one down -- we used gripe water, skin time, baby massage to help with the gas, and just weathered the storm. By three months, it never recurred.

2- Coughing at breast at different times and away from breast seemingly when spitting up and swallowing back down (spits up without swallowing rarely)
3- Green poops occasionally, mucosy poops occasionally (no visible blood) Very gassy sometimes uncomfortable with it, but i:'m thinking it's within normal infant range.
4- Sometimes fussy at breast, choking, gagging and bobbing.

Oh the joys of OS/OALD. When LO was ~ 8 weeks I posted here because I was worried about MSPI (http://forums.llli.org/showthread.ph...ly-versus-MSPI). Subsequent to that post we went through periods where every diaper was green - VERY green. Sometimes for a week or two on end. LO would nurse fine at times, and other times would just get pissed -- arch away from the breast, cough, choke, get frustrated, etc. This all subsided around 3 months, and we're certain was linked to excessive lactose intake from the OS (not lactose intolerance, just that he wasn't getting the fat because the milk was always so dilute) and OALD. I started nursing him side-by-side in bed, and that was a life-saver for me, and we still do it frequently (he's just over 7 months now). It still takes just 5-10 min to pump 3-6 oz per side, and I still have a geyser during letdown, but as he got older, it mattered less. Before it would overwhelm him; now he sometimes plays with the stream, or will just let it out of his mouth if it's too much. I never strictly practiced block feeding, but if it has/had been less than ~2 hrs since he ate, I consider it the same feed and put him back on the same breast. (Or I'll express a small amount of milk to see if he got to the fatty stuff & decide from there.) I still do this. He almost never gets both breasts except occasionally before bed if he's still hungry after thoroughly draining the first one.

7- Thrush- I think it is gone now. Treated with gv for 4 days and now baby probiotics

When we had thrush, it was painful enough for me that I suspect you'd know if this wasn't gone.

2- I eat pretty healthy, whole foods mostly, but I love sugar. I avoid soy for the most part, but couldn't say it is fully absent from my diet.

I might suggest you try to cut down on the sugar for your own health, but everything I've read finds that milk content has little to do with mom's diet (which proteins show up are obviously tied to the diet, but if you drink a Frosty, for instance, it doesn't mean baby's getting a Frosty Jr. a couple hours later).

[@llli*m11612]

Thank you Dandelions- I actually think I did want to hear nothing's wrong. It can be stressful to not have a name for your illness, but if there is no illness. . .
I was on a dairy free diet for @16 months with my daughter and was not looking forward to it again. I don't want to miss something that's causing my baby pain, but I don't want to be chasing causes for normal infant behavior either.
It's no wonder parents seek out and spend money on gadgets, self help books, medications etc when you consider how well designed babies are to communicate their need through utter looks of despair, piercing screams and frantic body movements. The cave baby would not easily be ignored thus was safe. I am so grateful that we don't have to live in caves, that we have access to all the medical advances, technology and life saving knowledge, but sometimes that makes it easy to overintervene.
Maybe Webster's will add that word along with Dr. Google to their next edition.
PS. I'm still nervous about adding back in dairy. So, I'm going to wait a few more nights of him screaming to convince myself it wasn't that one piece of cake. I just have to see that it is part of his babyhood rather than something I did/ate.
Also, I know sugar is bad. It's my greatest vice.
Thanks again everyone.

[@llli*musicalmelaniee]

Hi there! Just popping in quite late to see if the original poster wouldn't mind updating how her baby is doing now? your concern over normal vs. health problem is similar to my concern for my 4wk old, so I'd love to hear how things straightened out for you! Thanks in advance