Foremilk/hindmilk imbalance? But not all symptoms are there

[Ophelia]

DD is almost 3 months old.  I keep wondering about this.  At first, I'm pretty sure I had/have overactive letdown as the poor thing would sometimes pop off choking and sputtering, but that has gotten better and she usually doesn't do that anymore.

But since about 2-3 weeks old, her poohs turned from mustardy yellow to brownish yellow and not as seedy.  I look at the symptoms on this site:

http://www.breastfeeding-problems.com/foremilk-hindmilk-imbalance.html 

- Green frothy explosive stools (hers seem more brown but I could be wrong)

- Gassiness

- Diaper rash due to acidic stools

She only has the above out of all those listed.  Sometimes her poohs are thicker, but not always.  Sometimes quite watery.  I don't know how much gas is normal.  She does get red around her bum (DS had this too, but from gluten.  I can't tell if it's truly a food issue with DD.  I'm already off gluten, dairy (it affected her), soy, fish, and nuts).  I don't remember the poohs being this color with DS, I think his were mostly the yellow mustard color.

Gaining weight is not a problem with her, she seems to be quite healthy and chubby.  Generally poops twice a day.  I will put her on the same breast at the next feeding (IE left breast twice, then right twice, etc. except at nighttime where I switch sides every time she wakes up which is about 3 times per night).  But maybe I am not block feeding enough and need to do it at night also?  She nurses about every 2 hours or so.

I have breastfeeding textbooks and mention the imbalance but not so much the symptoms.  So I'm kind of at a loss.  Does anyone have more info on this?  Thanks!

[CheriK]

Wanted to say that I have a Kieran, too (9 year old).  Love the name ;-)

I haven't heard of the site you're referencing, but some of what they say isn't what is recommended.  At one point they say that breastfeeding too often causes an oversupply of foremilk, and that you shouldn't allow baby to comfort feed.  No evidence of either of these; breastfeeding MORE frequently rather than less is often recommended w/ oversupply as baby is less likely to be overwhelmed by high milk volume & is more likely to be able to access the higher fat hindmilk. Feeding on one side for 12-24 hours is almost never necessary and should only be considered in extreme situations, and herbs or medications to lower supply are also almost never necessary and probably shouldn't be used unless recommended and followed by a breastfeeding professional.

Some respected sites for breastfeeding resources online are the La Leche League Intl. website at llli.org (they're the first & have been doing this for over 50 years; they also have an online forum like this one w/ Leaders as moderators) and kellymom.com (evidence-based, collected by an IBCLC).  Both have info on overactive letdown & oversupply; kellymom in particular has a very detailed and accurate section on foremilk & hindmilk and what those terms actually mean.  They also have comprehensive lists of the symptoms you might see, including gasping/choking/pulling off during letdowns, spitting up frequently, gassiness, "colicky" behavior, fussiness during feedings or breast refusal, green stools with mucous, water, and/or blood.  Most babies will be growing quite rapidly - greater than 2# weight gain per month.  If baby is showing other symptoms of oversupply but weight gain is average or below, then it's a good idea to get an evaluation from an experienced breastfeeding counselor because symptoms of oversupply overlap and are often confused with those of food allergies/sensitivities, and reflux.

Most babies will have more than one symptom of oversupply.  Is your baby unhappy or uncomfortable?  It didn't sound like it from your post.  Oddly colored poops in and of themselves aren't typically a cause for concern.  If baby has signs of GI upset accompanying them (mucosy, watery, or bloody poops), difficulty at the breast due to fast milk flow, then possibly taking steps to reduce your milk supply are appropriate.  But if the only issue is poop color, I wouldn't be too concerned. 

[Ophelia]

Thanks!  Yes, I definitly trust kellymom out of the .com sites.  However, I could not find the information I was looking for as far as output and frothy/bubbly poohs.  I also don't know if the pooh is supposed to be thicker and creamy like, or very watery.  She has both but tends to be watery most of the time so I can't tell if this is normal or not, plus she gets the red bottom frequently (almost a RROD - red ring of doom) so something is obviously not 100% right.

Correct, she generally seems comfortable, no stomach pain, etc.  Not fussy in between feedings (in other words, not inconsolable and I can usually figure out what she's fussing about, usually wet dipe or has to potty).

I am checking out the articles on the LLI site.

[tibeca]

That red ring of doom is an allergy symptom. All you said above could also indicate a food allergy. Depending on how much this bothers her, I would range from doing nothing to an elimination diet.

[PatioGardener]

If baby is happy and gaining well then I tend to ignore poop colour. (Unless it is bright red with blood.)

My guy has always had green poops but is happy and growing well.

[Ophelia]

Thanks, I'm just not positive it's RROD - it could be.  I'm already off gluten, soy, dairy, nuts, fish, and also likely sugar soon.  I talked to my IBCLC/mentor and she mentioned possibly yeast...which I have had trouble with the whole pregnancy and now have it externally also :( so the need to probably cut out all sugars.

Edited by Ophelia - 4/29/11 at 3:02pm