Fussing, Diarrhea, and Breastmilk--at my wits end!

[Bethusila]

My baby is almost 8 weeks old.  I EP, and at the beginning I had a lot of problems with my supply, so we supplemented with formula.  Over this time I have built up my supply to the point that we have been able to slowly phase formula out.  She's gone the last 48 hours with no formula at all, for the first time since she was 2 weeks old.

I don't know if it's related or not, but the last week she started becoming very fussy, which has escalated to the point that she is screaming and inconsolable off and on for 30 minutes at a time.  Then she'll nap or eat, and when that's done she's back to fussing.  Also, today she has had diarrhea all day, and I'm sure that doesn't help put her in a better mood.  My husband feels that the lack of formula is the correlation, and wants to start giving it to her again.  I just can't imagine why a baby exclusively eating breastmilk would NEED formula to settle her tummy?  Isn't breastmilk supposed to be everything she needs?

I have tried generic gas drops from Wal-Mart, but I see no difference.  I don't know if there's anything else that would help.  I feel terrible for her, she was so happy and easy-going until this past week.  Any suggestions or advice would be GREATLY appreciated!

[trumpcard]

Troubleshooting with you here so bear with me. How do you know that your baby has diarrhea? Is it possible that you are confusing the look of BF poop with diarrhea now that the formula is out of her system? BF poop is very runny but that is completely normal. If she really does have diarrhea than breast milk is absolutely better for her belly than formula. BM is much easier for her belly to digest.

With the fussiness I would look at your own diet to see if there is something in your diet that could be bothering her tummy. Mt DD was sensitive to dairy through my breast milk and it made her fussy and gassy. I dropped the dairy for a couple months and then slowly started adding it back and she has been fine since.

Good luck!

[Bethusila]

Well, I was under the impression that while BF poop was more runny than formula poop, it would have a "seedy" quality to it.  This is just complete liquid, and it's very thin.

I have heard a lot of people talk about dropping dairy from their diets while BF-ing, and while I'm only taking maybe 2 servings of dairy in a day at this point, I can drop it completely if need be.

Also I just had an epiphany...I started the mini-pill this past Sunday, which seems to have made me start my period today.  Would that have any effect on her tummy?

[trumpcard]

Yes, it can be seedy but as your DD is getting her digestion settled I imagine it could have different appearances. We had an unfortunate run-in with a stomach virus when my DD was 6 months old and I can tell you that I knew true BF diarrhea because of the smell. YUCK!

I am far from an expert but I also wonder if you may have a foremilk/hindmilk imbalance to get worked out as your supply regulates. That could contribute to the different appearance of her poop.

As for dairy, that was an easy food for me to eliminate and it helped DD very quickly. I tested it a couple times by adding it back in and her problems would return quickly. I would experiment with your diet and see if you can find out what is bothering her. 

I'm not sure about the mini-pill but I would guess that could contribute although I would imagine that some of the foods are a more likely problem.

Good luck, Mama. I hope some more, wiser people here can offer you some advice.

[tnh2007]

Hi Mama!  I'm sorry to hear about your challenges.

DD who is 6 months now, started having tummy trouble at about 3 weeks old.  She was having terrible tummy pains and gas.  Her poop wasn't really strange, but  has never gotten the thick, smooth consistency of my first.  Nothing worked for DD except for bicycling her legs and gripe water.  Those two things seemed to help, but it is just something that took some time to work out.  I did try eliminating numerous things from my diet, but finally realized that what I was doing didn't seem to be helping.  I think she was through that phase at about 2.5 or 3 months and now she is a really sweet, easy baby.  I know it is tough, but I wish you the best.  I really don't think that reintroducing formula for your lo will help, but I don't know.  I'm just speaking from my experience.

Good luck and hang in there.  You are doing great!

[Asiago]

You may also wish to post here in the breastfeeding forum, it may get more replies.

I found this info on the kellymom site:

 http://www.kellymom.com/health/meds/birthcontrol.html#sideeffects 

 

Any hormonal birth control may cause fussiness in the baby (not reported in the literature but often anecdotally by mothers). This may be due to the hormones causing a minimal decrease in the protein/nitrogen/lactose content of the milk. Some mothers have reported marked improvement in their baby's degree of fussiness once they come off hormonal birth control.  

 I also read on the site that oral contraceptives can cause a decrease in milk supply.

All of that said, perhaps the pill is not related to the fussiness.

As PP mentioned it could be a foremilk/ hind milk imbalance. Oversupply, as well as switching sides often. can result in too much foremilk being consumed.  This will cause indigestion as the foremilk goes too quickly through the small intestine for all of the lactose to be broken down.

Block feeding on one side for several feedings will help baby to receive more of the rich fatty hindmilk versus a lot of foremilk from switching breasts often. Even just allowing baby to set her pace and finish feeding on one breast completely before thinking about switching (which isn't always neccessary). Baby will let you know, watch her cues she'll let you know if she is still hungry.

Foremilk has a lot of lactose. Lactose is great for brain development, in fact human milk has more lactose than any other species due to the size of our large brains and the growth needed. However, when baby receives too much foremilk and insufficient hind milk, baby is getting too much lactose and not enough fatty hindmilk. The hind milk is the milk that is mixed with the fatty globules upon 'let down' and is very satiating too.

The fussiness and very watery stools (even more so than normal BM stool) may be indicative of too much foremilk, a change in breast feeding pattern may be a first step to see if it helps. Good luck, no worries you will figure it out soon

Link about balancing foremilk/hindmilk: http://breastfeeding.hypermart.net/toomuchmilk.html 

[Llyra]

Breastmilk poop is not always seedy. It can vary from yellow, to yellowish brown, yellowish green, or even orange. It can be runny, or seedy, or thick like peanut butter. So it being runny doesn't make it diarrhea. My kids' poop varied a lot, depending on the kid, the day, what I was eating, how often they were eating, how long they were sleeping between feeds, and sometimes for no reason I could see. But a lot of mamas inexperienced with exclusive breastfeeding will assume baby has diarrhea-- a breastfed baby poops so frequently, and it is often just really really liquid, liquid enough that it pours out the side of the diaper and up the back.

It is possible, though, that if the change is recent, and accompanied by a lot of fussiness, that she's come into contact with her first virus. In which case it's self-limiting, and you only need to just keep on nursing. But I can say from experience that true diarrhea, in the breastfed baby, is genuinely nasty, stinky, green, and disgusting stuff. You'd likely KNOW.

FWIW, too, two months old is a common stage for a growth spurt, which can lead to fussiness, sleeplessness, and a desire to nurse very, very often. This is normal, and the correct way to handle it is to follow baby's cues and nurse as often as baby seems to want.

A foremilk/oversupply problem would show up as frothy, really GREEN poop. A dairy intolerance usually shows up as green poop, sometimes with a little blood in the stool, and with baby seeming to be in pain.

[BabyFireFly]

My daughter's breastmilk poop was almost always liquid - sometimes foamy, sometimes more like a thick paste. I wouldn't worry about that too much.

The mini pill, which is is progesterone only ( the same hormone that is elevated in our bodies naturally while we BF) is not supposed to cause a reduction in supply - it has been studied for over two decades and proven not to. However, there are always concerns when it comes to subjecting an infant to an elevated amount of steriods. I have read a ton of stories from mamas who were on the mini pill and claimed that their babies were not just fussy, but down right screamers - after taking themselves off of the pill, in a few weeks the little ones started calming down. Many of those mamas reported that they were also negatively affected by taking the pill - headaches, tenderness, tearfulness, etc and decided to stay off the pill and go another route for birth control.

I would keep a food journal for a week - write down everything that you ingest (food/drink/supplements/medications) and see if you can link the fussiness to any of the things that you eat. I know there were certain foods that would make my LO more amp'd up at times.

[LaydieBugs]

I'd give it more time, to be sure.  She might still be working the formula out of the system, and getting used to the sensation of a smooth-moving digestive tract (formula slows everything down).  She may need to be fed more often too, are you feeding on demand?  When in doubt, feed?  

After formula poo, breastfed poo might not seem "seedy."  It is super liquidy, and does not smell bad ... it's actually a little sweet smelling, like overripe fruit.  Exclusively breastfed infants' cloth diapers can go straight into the washing machine without rinsing -- it's that liquidy. 

It helped us a TON that baby's Dad & I had allergy testing (blood testing, not scratch tests, the name had something about ELISA and IgG, or IgA ...).  I didn't totally cut out his Dad's big two (whey and chicken egg) and DS started having bigtime spit-up around 2 months.  A few weeks later he started seeming a little colicky. 

Hyland's Colic tablets helped a TON (the gas drops from Wal-Mart do nothing for us), and we still use them often when there is unsolvable fussing.  But when I finally cut out the foods to which his Dad is allergic, we made major headway. 

Diarrhea happened around 6 weeks I think ... we're talking explosive and foamy (we'd see the foam coming out the leg of the diaper), and green.  That seems to have been an oversupply issue which was resolved by block feeding (which reduces milk supply). 

Have you gotten a second opinion from a different lactation consultant, about whatever prompted you to use formula?  Perhaps it was a latch and not a supply issue?