Fussy, Slow Weight Gain, Excessive Spitting Up - HELP!

[Mom@Work@Home]

I'm not sure if this is a medical issue, a breastfeeding issue, or just the way my daughter is, so I'm posting here to start!

I'm concerned about two things with DD (exclusively breastfed 11-week old):
- Slow weight gain since birth (3-5 oz per week)
- Excessive spitting up since ~2 weeks old - averaging 5 times after every feeding, so 30-50 times per day!

Other things which I don't think are 100% normal:
- Consistently green bowel movements which are still frequent (after every feeding). DS had slowed down to 1 per day or less by now. They also seem very runny to me.
- Seems very uncomfortable while having bowel movements
- Rash on her cheeks
- She is hardly ever content. She can be fed & changed, but still very fussy while being held. It's not like she's in pain & inconsolable, just uncomfortable & fussy.
- She falls asleep okay, but she will wake often surrounding spitting up, gas, or bowel movement episodes

I'm thinking it's either colic, reflux, too much foremilk, or an allergy. Thoughts?

[Path2Felicity]

This seems like a food allergy or sensitivity issue to me. Food sensitivities/allergies often cause colic and reflux. My DD was diagnosed with reflux until we figured out that she had a very sensitive tummy and started avoiding foods that were triggers of her tummy upsets.

Try avoiding dairy and soy and see if that helps.

[Aka mommy]

Originally Posted by Path2Felicity

This seems like a food allergy or sensitivity issue to me. Food sensitivities/allergies often cause colic and reflux. My DD was diagnosed with reflux until we figured out that she had a very sensitive tummy and started avoiding foods that were triggers of her tummy upsets.

Try avoiding dairy and soy and see if that helps.

Yes to this. My oldest had GERD due to my hyperlactation. I was thankful it wasn't an allergy but we tried elimination diet before I found out it was my production issues.

[Asiago]

Maybe too much foremilk consumption? Perhaps try block feeding from one breast several nursing sessions in a row so that she ingests more hind milk.

[Friendlee]

Aw poor baby! I would definitely say either reflux or allergy...or allergy causing reflux. What sucks is that it's tough to determine what in your diet could be causing this. Seems like it would be wise to try eliminating some of the likely culprits like dairy, soy, etc. SUCH a bummer. My breastfed babe didn't gain a single ounce for 4 weeks and also had excessive spit up (not quite as much your babe though). At 6 months she still hasn't outgrown the spitting up and I think that issue suggests a reflux problem. She only pooped about twice a week at that age though. I am thinking that the bowel issues you're dealing with are more reflective of food allergies. ???

[dislocator3972]

That sounds exactly like my DD. After months of searching out food allergies and sensitivities, I finally realized that it was all oversupply. When my supply started to even out (around 3mos) things got better, and by 6 months my DD seemed almost normal. (haha)

My supply is still a little high, (DD is 7 months) but not that my daughter is bigger she can handle it better. I really wish I had listened to everyone who told me to try and handle my supply first before I tried all the allergy fixes. But I was convinced that if I let my production drop, her weight gain might slow further, and I didn't want to harm her.

Getting your production to drop will probably give you a quicker answer (whether it be yes or no) than allergy/sensitivity tests. You have to wait for 10 days ~ 2 weeks before you can judge a dairy sensitivity.

I hope you figure everything out!

[treetop]

Wheat or gluten is a possibility. Gluten can be passed through breast milk. The rash on the cheeks makes me think it is an allergy.

[annarose999]

This is exactly what brought me to the MDC messaging boards just a few months ago! for me allergy had nothing to do with it. i was on a strict allergen free diet for 6 weeks and i still had a colicky baby. i finally settled on oversupply and poor foremilk/hindmilk imbalance. someone on the boards suggested i block feed one breast per 24 hour period. it was the most uncomfortable experience but once i started dd was almost immediately better. her poops turned seedy and yellow like everyone says they should be, her gas lessened and her spit up was almost non existent. after a week or two i switched to 12 hour block feeds and everything came back almost immediately. i waited another two weeks then dd went through a serious growth spurt and i just fed her everything i had for about three days. after that i've been able to feed both breasts daily switching breasts every other feeding. it is important to say that while i was block feeding i pumped my other breast to make sure i didn't slow down production.

good luck!

[Kmama2]

Originally Posted by Mom@Work@Home

I'm not sure if this is a medical issue, a breastfeeding issue, or just the way my daughter is, so I'm posting here to start!

I'm concerned about two things with DD (exclusively breastfed 11-week old):
- Slow weight gain since birth (3-5 oz per week)
- Excessive spitting up since ~2 weeks old - averaging 5 times after every feeding, so 30-50 times per day!

Other things which I don't think are 100% normal:
- Consistently green bowel movements which are still frequent (after every feeding). DS had slowed down to 1 per day or less by now. They also seem very runny to me.
- Seems very uncomfortable while having bowel movements
- Rash on her cheeks
- She is hardly ever content. She can be fed & changed, but still very fussy while being held. It's not like she's in pain & inconsolable, just uncomfortable & fussy.
- She falls asleep okay, but she will wake often surrounding spitting up, gas, or bowel movement episodes

I'm thinking it's either colic, reflux, too much foremilk, or an allergy. Thoughts?

DD had the green runny poop issue and it was defiantely too much foremilk. I did block feeding and it improved alot. If you need more info on block feeding I can post more in it. It helped alot. Both of my kids have had reflux and spit up excessively like you mentioned... 30-40 + times a day. It chose not to medicate them and they both improved around 4-6 months although dd spit up until 15 months and ds is still spitting up after every feeding at least once or twice at 6 months.
Also 3-5 oz a week is a good weight gain. Ds gained 5 oz over a month from months 4-5. I know your baby is younger but I think 3-5 oz a week is fine.
I would start with the foremilk/hindmilk thing and then move to allergies and colic... I think you will notice a big improvement as your baby getts older and isn't so flat. Do you elevate the crib mattress, keep her elevated after nursings etc??

[Megan73]

Average weight gain for a BF baby your daughter's age is 5 to 7 ounces a week. I wouldn't blockfeed - it will reduce supply.
It could be run-of-the-mill colic and either a supply or feeding issue (eg. tongue tie, latch problems) but my suggestion would be to talk to your doctor about reflux (it can definitely lead to poor feeding and poor weight gain), which can be treated with meds, and to a lactation consultant - definitely a IBCLC - who can see how much milk she's transferring.

[DevaMajka]

Are her poops mucousy?
I've read that green poo can be a foremilk/hindmilk imbalance or allergies/intolerances. But mucousy poo is generally an allergy or intolerance issue.

Allergies can contribute to slow weight gain too.

[Mom@Work@Home]

Thanks for sharing your ideas & experiences everyone! I know that she is still gaining, but what I am worried about most is that she is falling in the percentiles. She started out at >85%, but is now approaching the 15% line (on the WHO chart).

FYI - We have been seeing her ped. and he is thinking of giving her reflux medication (Prevacid) as the next step. But from what I've read, the meds are more to address the pain caused by the acid & will not stop the spitting up. I think I want to explore other options first.

Originally Posted by Kmama2

Do you elevate the crib mattress, keep her elevated after nursings etc??

Yes as much as possible. Her change table pad and crib mattress are both propped up a bit. At night she sleeps beside me in this - Fisher Price Newborn Rock ’n Play Sleeper

Originally Posted by DevaMajka

Are her poops mucousy?
I've read that green poo can be a foremilk/hindmilk imbalance or allergies/intolerances. But mucousy poo is generally an allergy or intolerance issue.

Yes, I guess they are mucousy. (TMI Alert!) They almost look like there is snot in them. If you take two poopy areas of her dirty diaper, put them together and then pull apart, there are strings or strands bridging the gap. I don't remember DS ever having this.

[Path2Felicity]

I would strongly suggest that you look into the possibility of food sensitivities. Reflux is usually a symptom of a problem, and antacid medication can be really harmful for babies.

[ThankfulMama]

Sounds like classic intolerance symptoms to me. Generally, the first course is to remove all milk (dairy) and soy.
Best wishes!

[DevaMajka]

Originally Posted by Mom@Work@Home

Yes, I guess they are mucousy. (TMI Alert!) They almost look like there is snot in them. If you take two poopy areas of her dirty diaper, put them together and then pull apart, there are strings or strands bridging the gap. I don't remember DS ever having this.

In that case, I would definitely look into food sensitivities!!

Ds had mucousy poop, which went away on an ED.