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Thread: Toddler/Baby Tandem. Green diarrhoea.

  1. #1

    Default Toddler/Baby Tandem. Green diarrhoea.

    Hello. We have a son (12 weeks old) and a daughter (23 months). My partner is still breast feeding our daughter as she has been convinced of the benefits of continued feeding. Our son was tracking the 91st percentile consistently and doing one custardy stool per day, until about three weeks ago.

    Our daughter got a cold of which our son exhibited some symptoms. His stools instantly turned a very wet consistently and became extremely frequent i.e. diarrhoea. Since birth he has often seemed agitated (regularly tensing up and throwing his limbs about angrily), but has remained otherwise in good spirits throughout. Initially we put the diarrhoea down to the cold and expected it to pass within a week, however it didn't.

    After a week we went to see a doctor who said it would only become a concern after two weeks. Shortly after this his stools turned to green. We went back to the doctors after two weeks and had a stool sample taken for which we expect the results on Tuesday. However the doctor expects a negative result with no sign of infection. Inspecting his stool and seeing him in a good mood, she seemed confident it was the result of too much fore-milk.

    However we have already been aware of the potential to miss out on hind-milk so my partner has been trying to intentionally make sure he gets a balance and to cut our daughter's consumption back. After the doctor stated her opinion she has been trying to up the balance of hind-milk further, but this doesn't seem to be improving the stool colour, consistency or frequency. She believes it is still getting worse.

    He has dropped to the 75th percentile but is still gaining weight

    We have also come across threads where other mothers who are tandem feeding have experienced similar troubles and the opinion seemed to be that there isn't much you can do about it but wait. However we are concerned that he is missing out on nutrients at this crucial stage of development.

    We thought it might be best to quickly ween our daughter so that the milk is tailored exclusively to our son's requirement as his need is greater. But are reluctant to give up on the benefits for our daughter. This will also be tough - she loves her milk. And besides we have no idea if this is how it works.

    We also have no idea how much of a problem this is for our son. It certainly doesn't seem at all healthy and is regularly causing a sore bum.

    Any input would be much appreciated.

    Cheers

  2. #2
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    Default Re: Toddler/Baby Tandem. Green diarrhoea.

    So the 12 week-old's green poops and sore bum started around the same time that he got his big sister's cold, correct? If so, I don't think you need to think about any more exotic cause for his poops and diaper rash than the lingering digestive upset from being sick.

    If your baby is getting a lot of foremilk, that is not a problem. All milk- both foremilk and hindmilk- contains everything a baby needs to grow and develop. A baby will do perfectly well on a diet of so-called foremilk alone, provided he gets enough of it. So you don't need to worry that your baby is missing out on nutrients, UNLESS his growth slows to a point at which it can no longer be termed normal.

    When you say your partner is trying to "up the balance of hind-milk", what does that mean, exactly? What is she doing to adjust your baby's intake? The reason I ask is that many of the interventions which are suggested for "adjusting" the foremilk:hindmilk ratio are harmful to milk supply or to the baby's intake. So let us know how you are trying to manage this and maybe we can help you figure out if you're using the right technique.

  3. #3
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    Jun 2009
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    Default Re: Toddler/Baby Tandem. Green diarrhoea.

    I agree with mommal entirely. Also, I have personal experience tandem nursing a baby and toddler. I also ran a toddler LLL meeting for years and talked to many tandem nursing moms.

    So if I am understanding, there was no problem until both kids got sick. Right? So I agree probably no reason to look any further for causes to your problems. Also, then suddenly the 12 week old got diarrhea? It is pretty hard to tell if an exclusively nursing baby has diarrhea. Frequent, watery poop is normal for a breastfed baby. What about the poop is making you think it is diarrhea?

    In any case, the way to treat diarrhea no matter what is causing it, is to manage symptoms. Manage symptoms means, make sure baby does not become dehydrated while the body rids itself of the virus or bacteria or whatever. A baby can be perfectly happy and healthy through a bout of diarrhea as long as baby is not becoming dehydrated. Also symptoms of the frequent, watery stools can last many weeks. You know what is the perfect thing to prevent dehydration? Breastmilk and lots of it.

    Rashes are usually caused not so much as by frequent poops (which again are normal) but how they are dealt with. My suggestion there, if you are using commercial baby wipes, stop except for outings. Also, try not to wipe. Instead, soak a soft cloth or paper towel in warm water with (if you think it needed ) a tiny drop of mild, unscented baby soap in the water. Soak the cloth or paper towel well and then gently soak baby's bottom clean, instead of wiping. Or just get a bowl of water or fill the sink and soak baby's bottom clean in that! Gently pat dry and apply a good coat of a reliable barrier ointment such as Aquapher or similar to speed healing.

    We thought it might be best to quickly ween our daughter so that the milk is tailored exclusively to our son's requirement as his need is greater. But are reluctant to give up on the benefits for our daughter. This will also be tough - she loves her milk. And besides we have no idea if this is how it works.
    Please let me assure that this is NOT how it works. Mother Nature is pretty smart and knows how to handle the entirely normal situation of a sibling nurslings. The nursing mother's milk will be exactly what the infant needs. It will not change in that sense because a toddler is nursing. Luckily this milk is also entirely healthy and beneficial for the toddler to have as well.

    A toddler nursing makes a mom have more milk, which is also exactly what happens when a mom is nursing twins. So again, not a problem.

    I also wonder if the frequent poops are not diarrhea at all, but caused by mom making more milk. Why would that happen? because again, mother nature is smart. Sick kids nurse lots, which increases mom's milk production, which means the baby or/and older child who is nursing are less likely to become dehydrated from the illness!

    Here is the one poop issue that is related to tandem nursing. It is that the toddler who is getting lots of milk after baby is born may begin having soft, kind of breastmilk-like poops. This is NOT diarrhea and is perfectly healthy. In fact this is a great protector against constipation which is a common toddler issue. So while there may a change in poop look for the toddler, it is not hurting them.

    As mommal says, "Too little hindmilk" is a fake problem. It is a myth. A baby can and will gain just fine with more "foremilk" as they do with more "hindmilk." Your doctor is right that IF there is any "problem" it would be too much foremilk. What she left out is the issue is actually "too much foremilk all at once." Sometimes, some babies have a little issue digesting their meals easily if mom is making so much milk that the baby gets "too much foremilk all at once" when baby nurses. This is not a problem most of the time, but sometimes, it can cause some very minor gastrointestinal discomfort and frequent, watery poops. it is not causing any permanent harm but it can be a little uncomfortable for baby.

    If this is happening, the usually most effective way to fix it quickly is to encourage baby to nurse very frequently. Baby will get less milk each time, and that will help. Also the breasts will have less time to "fill up" which is what causes the "too much foremik" problem. Your partner may have been told to block nurse. This is a technique for reducing milk production and is not the right approach if there is any concern at all about baby's gain.

    Oh and fluctuations in weight gain percentile are entirely normal. A baby who is in the 75th percentile is still gaining faster than most babies. Sick babies who are in trouble do not gain weight like that.
    Last edited by @llli*maddieb; April 16th, 2017 at 09:45 AM.

  4. #4

    Default Re: Toddler/Baby Tandem. Green diarrhoea.

    She has tried putting our daughter (23m) on first to drain foremilk and then cutting her feed a bit shorter before putting him (12w) on. She has also tried blockfeeding even to the extent of giving him exclusively one side for the whole day and her the other. Niether approach seemed to yield a noticeable difference.

    So would you consider foremilk identical nutritionally to hindmilk, just more dilute?

    I feel confident diarrhea is the appropriate word for it. Before her cold he would do normally one yellow stool with the consistency of thick custard. We knew this was less frequent than usual but assured it was just the low end of normal. Then suddenly it shot up to about six times a day, often leaving little more than a wet stain on the nappy with little to no solids. Others can be more mucus-y. About a week in they started getting greener and now they're consistently bright green and we're approaching three weeks. They normally come out with a lot of wind. What are your opinions on the colour?

    We already use only cotton wool and water, then dab off with dry cotton wool. My partner doesn't like to use much barrier cream so we only use it to treat soreness rather than preventatively. Recently soreness has become less of a problem so that's one improvement.

    Thanks for your quick responses.

  5. #5
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    Jun 2009
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    Default Re: Toddler/Baby Tandem. Green diarrhoea.

    So would you consider foremilk identical nutritionally to hindmilk, just more dilute?
    Foremilk is certainly not "diluted" or in any other way inferior to hindmilk. All milk contains everything a baby needs to grow and develop normally. But foremilk and hindmilk are not identical. Here is what is understood about "foremilk" and "hindmilk."

    What is even meant by these terms? Foremilk simply means milk that comes toward the beginning of a nursing session. This milk tends to be higher in lactose (human milk sugar) and lower in fat. As a baby nurses, the milk gradually changes to what is called hind milk. This milk is lower in lactose and higher in fat. What we know is this is a gradual change that happens throughout a feeding, and feedings are normally very varied in how long they are. So it is not like we can say the first 10 minutes baby gets foremilk and last 10 hindmilk. We cannot say "pump for X minutes" and the rest will be hindmilk. We cannot even say "nurse toddler first" and the rest will be hindmilk. (Not that this was not a good idea, it's just that we cannot be that precise. And there is no reason to be!

    Nature/biology/higher power whatever you believe, this is what happens as milk comes out of the breast for a reason. The reason is that lactose is very important when it comes to life and growth and babies need lots of it. It gives babies energy. It rehydrates babies really well. This is why this is what comes at the start of a feeding. Of course babies need fat too. But there is lots of fat in the milk that comes toward the beginning of a feeding too.

    The babies who probably get the most foremilk compared to hindmilk are babies whose moms are overproducing- making more milk than baby needs. And these babies always gain faster than average.

    So this is why it is a myth that a baby might get too little hindmilk. If a baby is not gaining well, then they are either not getting enough milk overall, or they are ill.

    What I was saying about the "too much foremilk all at once" is that some babies sometimes have some trouble digesting all that lactose if they get a lot at once. This is NOT "lactose intolerance," again, babies need lactose and lots of it to live. In the very rare instance a baby cannot process lactose because they have a rare very and very serious disorder, they are very ill indeed and obviously so from the start.
    She has also tried blockfeeding even to the extent of giving him exclusively one side for the whole day and her the other. Niether approach seemed to yield a noticeable difference.
    Block feeding is meant to be used as a method to reduce milk production, because it works very well to do that. Block feeding has no other purpose or benefit, the only purpose is to reduce milk production. Some moms make so much milk it puts their health at risk because they become painfully engorged between nursing sessions, or it is so much that baby is refusing to nurse or having a very difficult time nursing because there is just way too much milk coming all at once. So block feeding is meant for only very specific situations where it is known that mom is making much too much milk and it is causing problems.


    I feel confident diarrhea is the appropriate word for it. Before her cold he would do normally one yellow stool with the consistency of thick custard. We knew this was less frequent than usual but assured it was just the low end of normal. Then suddenly it shot up to about six times a day, often leaving little more than a wet stain on the nappy with little to no solids. Others can be more mucus-y. About a week in they started getting greener and now they're consistently bright green and we're approaching three weeks. They normally come out with a lot of wind. What are your opinions on the colour?
    If you are confident it is diarrhea, diarrhea is caused by an illness. So it would have nothing to do with foremilk or hindmilk. But in my experience diarrhea in a baby looks like dirty brown water, at least at the worst. Then it slowly transitions back to normal as the gut heals, and certainly could look green and/or mucousy during that transition.

    My opinion is that a 3 month old pooping 6 times in 24 hours would be a normal poop pattern, stains also are normal, as is gas and some explosive poops generally speaking. Green is a poop color that can happen just normally, might signal a minor illness, might indicate "too much foremilk all at once" or be a sign of returning to normal after a bout of diarrhea as mentioned above.

    I agree no need for barrier cream in diaper area if there is no sign of a problem. But if there is something objectionable in the barrier ointment (some people want to steer clear of petroleum jelly based products) there are usually pretty good products available that are plant-based. If she ever used lanolin ointment for sore nipples, that works well as a barrier ointment too.
    Last edited by @llli*maddieb; April 17th, 2017 at 05:33 PM.

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