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Thread: Oversupply or Food Allergy - how to tell?

  1. #1

    Default Oversupply or Food Allergy - how to tell?

    Warning... very long post ahead... for those who have the patience to read through it, thank you in advance!

    My 7-week-old breastfed baby is very fussy in general, and very hard to nurse in particular -- every breastfeeding sessions feels like I'm fighting her to make her nurse, and she cries almost constantly when she's awake, whether nursing or not. She also by now has exclusively green poops. This is my fourth kid, but the first who has not loved nursing. I'm trying to figure out if the problem is oversupply or dairy allergy, and hoping for some help. Here's the evidence:

    Evidence for OVERSUPPLY:

    * I've had an oversupply with all of my kids, and clearly do now as well. (It didn't bother the other kids, though.)
    * At the beginning of every session, when my milk lets down, she cries and comes off the breast and my milk goes spraying everywhere. Then she won't get back on until I trick her into it by pulling a switcheroo with pacifier. Then she's often on and off for the rest of the feed. Usually less of a problem with the second breast, presumably since it already had a first let down.
    * Green poop, either normal consistency or slightly watery. This started at some time during Week 2 or 3. It used to be that she'd have sporadic yellow poops, or one yellow poop in the morning, but for at least the past week there hasn't been any yellow.

    Seems obvious, right? BUT --

    * First, she is gaining weight too slowly, to the point where she hadn't regained her birth weight by 2 weeks. We eventually got her to gain weight enough that the pediatrician wasn't concerned about her health, but it is still really slow. I understand that oversupply usually causes quick weight gains, and my other kids all gained super-fast during their first 6 months.
    * Second, her best feeding session is usually the first one of the day -- when I am most engorged and presumably my let-down is the strongest. (She also does pretty well during the last feeding of the day. The ones in between are all miserable, though.)
    * Third, her fussiness has gotten worse as time goes by, even as my engorgement and oversupply has gotten better.

    So -- evidence for ALLERGIES:

    * Green poop.
    * She is extremely fussy. Sometimes she will go a full day where I cannot put her down -- the only way she won't cry is if someone is holding her or if she's in the swing. And sometimes, even those don't work. I don't think she's ever been laid down on a flat surface for more than 20 minutes without crying. It seems like gas pains, too -- her stomach will get taut, and she'll be perfectly happy and suddenly start crying as if in pain.
    * Family history: My oldest kid was allergic to dairy until she was 2, and the third had a dairy intolerance that showed up through blood in his stool.
    * Her fussiness has gotten worse as time goes by, and I've been adding more dairy into my diet as times goes by (not by design, just because I've been able to do more of my own cooking and I love cheese).
    * This probably doesn't mean much, but I've been off dairy for the past 2 days and this evening is the happiest as I've seen her in a while.

    So... I don't know what to do. Either dairy elimination or block feeding, I guess, but which one should I try first? Which is the more likely problem? If anyone has any suggestions/wisdom/experience to share, I am all ears. Thank you!

  2. #2
    Join Date
    May 2006
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    Default Re: Oversupply or Food Allergy - how to tell?

    Welcome to the forum and congratulations on the new baby!

    Based on your post, I think you have more that 2 possibilities to consider. In addition to oversupply/fast letdowns and allergies, you also should consider tongue and lip ties and reflux. They could also cause some, arguably all, of the issues you mention. In fact, I think reflux is a very strong possibility because the baby has been slow to gain despite evidence of oversupply, she is hard to nurse, cries frequently when not nursing, and in particular seems upset when she is laid flat. Babies with reflux like to be held upright because gravity helps keep stomach acid in the stomach.

    If this were my baby, I would want to do the following:
    1. Talk to the pediatrician about the possibility of reflux.
    2. See a lactation consultant, preferably an IBCLC, for an in-person evaluation of breastfeeding. In particular, I would like to have an IBCLC do a weigh-feed-weigh measurement on the baby and show you how to do one. I would also want her to evaluate the baby for tongue and lip ties, and to help you with positioning.
    3. Feed her as often as possible. This should help with the slow gain.
    4. Do not block feed. It sounds very likely that you have some oversupply, and block feeding would reduce that. But it's possible to go too far with block feeding and when the baby is slow to gain, you do not want to reduce supply.
    5. Do a trial elimination of dairy, but don't wed yourself to the idea that your baby has a dairy intolerance. Allergy/intolerance issues are hard to diagnose with 100% accuracy. Anyone who tells you that your baby has a dairy intolerance or allergy based solely on stools or behavior is not doing their due diligence. The way you sleuth out a dairy allergy is methodically: you eliminate diary for a few days or a week, and then you have a big glass of milk and watch the baby's behavior. Then you eliminate and test again. And again. If the baby ALWAYS seems miserable after you reintroduce dairy, that's stronger evidence of dairy being a problem.

  3. #3

    Default Re: Oversupply or Food Allergy - how to tell?

    Thanks, but I don't see any evidence of reflux (she barely even spits up, nor does she wheeze) or tongue tie (I considered that early on, but she sticks out her tongue just fine). She also absolutely refuses to nurse if it's less than 3 hours since her last nursing, and even if I could nurse her more frequently, it would increase my supply, which I don't want -- as it is she can't handle my letdown.

    It's been 4 days of dairy elimination so far, and there is no question she is a lot less cranky -- relatives have even commented on it. I realize that's not proof, but the evidence seems pretty strong.

  4. #4
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    Default Re: Oversupply or Food Allergy - how to tell?

    Thanks, but I don't see any evidence of reflux (she barely even spits up, nor does she wheeze)
    Babies can have reflux without doing either of these things- it's called "silent reflux". I would keep this in your mind as a possibility, particularly if you continue your dairy elimination but don't see positive results in the weight gain department.

    My friend "C" had a baby who is a perfect example of a baby who didn't quite fit the classic reflux vs. allergy mold. She was an experienced nursing mom, doing everything right, nursing on demand both day and night, and yet her baby didn't grow particularly well. He didn't seem to have reflux, or any other symptoms- he was just small. Finally she ended up treating his reflux AND eliminating dairy- it seems that her kid had reflux which was exacerbated by a dairy intolerance- and he finally started to gain weight at a more normal pace.

    or tongue tie (I considered that early on, but she sticks out her tongue just fine).
    Nevertheless, I would have someone with tongue tie experience check for you. Just to cover all your bases!

    She also absolutely refuses to nurse if it's less than 3 hours since her last nursing, and even if I could nurse her more frequently, it would increase my supply, which I don't want -- as it is she can't handle my letdown.
    Actually, when you have oversupply nursing more frequently is one of the most highly recommended remedies. Because the baby doesn't really empty out the breast when she nurses, she's unlikely to increase supply in any really significant way. What she is likely to do is to empty is just enough that you're not feeling constantly full, and enough that your letdown at the next feeding may be a little gentler and easier for her to handle.

    It's been 4 days of dairy elimination so far, and there is no question she is a lot less cranky -- relatives have even commented on it. I realize that's not proof, but the evidence seems pretty strong.
    That's great! Fingers crossed that you have found the missing puzzle piece.

    I think I takes sense to stay willing to test your hypothesis- one of my major quibbles with the allergy/intolerance thing is how many moms are starving themselves, sometimes for no reason. Breastfeeding moms shouldn't have to live on bread and water diets, right?!

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