bright yellow in spit up

[amaayeh]

DD is three weeks old and I'm still nursing my three year old.  I seem to be producing a lot of milk and my newborn spits up quite a bit of milk every time we nurse.  She nurses, almost chokes, I pull her off to burp, she burps really well, and then it's followed by multiple spit ups of milk (sometimes curdled, sometimes fresh).  I try to block nurse the kids to make sure my newborn is getting plenty of hindmilk.  Her poops are nice and yellow, and she's having about 4-6 a day. 

This evening I have noticed some bright yellow streaks in her spit up.  This is new.  What might this be?  Do you think she is spitting up so much because of an allergy?  I have never had a milk allergy or anything so I have never had to eliminate anything from my diet.  I am worried, though, that my newborn has something else going on other than just oversupply.  Also, she does not take a paci and using me as a paci...and my three year old does, too.  :)

[MindfulBirth]

First.. good for you in tandem nursing your children!! 

Second, how is your baby's weight gain?  Is she exhibiting signs of pain or distress other than the spitting up?

Spit up in and of itself is a normal newborn behavior if not accompanied by other symptoms.  Its a laundry problem more than anything else.  If you feel it is an oversupply issue, try different nursing positions (baby sitting up more.. Biological Nurturing.. babe-on-top). 

As for the color.. don't panic just yet.  Your milk can change color based on what you have eaten and your milk composition changes (you are just now getting full "mature" milk) - both of which can slightly effect color.

[abiyhayil]

I sounds like reflux,

http://www.kellymom.com/babyconcerns/reflux.html

Warning signs of severe reflux:

• Inconsolable or severe fussiness or crying associated with feedings.
• Poor weight gain, weight loss, or failure to thrive. Difficulty eating. Breast/food refusal.
• Difficulty swallowing, sore throat, hoarseness, chronic nasal/sinus congestion, chronic sinus/ear infections.
• Spitting up blood or green/yellow fluid.
• Sandifer’s syndrome: Baby may ‘posture’ and arch the neck & back to relieve reflux pain--this lengthens the esophagus and reduces discomfort.
• Breathing problems: bronchitis, wheezing, chronic cough, pneumonia, asthma, aspiration, apnea, cyanosis.

 Breastfeeding Tips

• Aim for frequent breastfeeding, whenever baby cues to feed. These smaller, more frequent feedings can be easier to digest.
• Try positioning baby in a semi-upright or sitting position when breastfeeding, or recline back so that baby is above and tummy-to-tummy with mom. See this information on upright nursing positions.
• For fussy, reluctant feeders, try lots of skin to skin contact, breastfeeding in motion (rocking, walking), in the bath or when baby is sleepy.
• Ensure good latch to minimize air swallowing.
• Allow baby to completely finish one breast (by waiting until baby pulls off or goes to sleep) before you offer the other. Don't interrupt active suckling just to switch sides. Switching sides too soon or too often can cause excessive spitting up (see Too Much Milk?). For babies who want to breastfeed very frequently, try switching sides every few hours instead of at every feed.
• Encourage non-nutritive/comfort sucking at the breast, since non-nutritive sucking reduces irritation and speeds gastric emptying.
• Avoid rough or fast movement or unnecessary jostling or handling of your baby right after feeding. Baby may be more comfortable when help upright much of the time. It is often helpful to burp often.
• As always, watch your baby and follow his cues to determine what works best to ease the reflux symptoms.

[Bokonon]

I would lean more towards oversupply and forceful letdown, since she is choking while nursing.  Can you extend the blocks to try to tame the oversupply?

[llwr]

I had oversupply and forceful letdown.  Both girls would choke sometimes, pull off a lo,t and my 2nd would projectile almost once a day for the first week through about 3. 

For oversupply and forceful letdown, you can try to lean back or even lie on you back if you can manage it (a lactation consultant told me that, but I couldn't figure it out), or as PP said, baby sitting upright.  You can express a bit so they don't get the full force of actual let down and a bit less foremilk.  I was told also to only feed one breast per feed for a while for the oversupply.  I have no idea how that fits with tandem nursing.  I don't know how you feel about paci's, but she also said that my DD had a bigger need to suck than I could give her with as much milk as I had.  She did certainly end up LOVING that paci.

[gratefulma]

Hi, My son spits up just like that! He burps and then it is followed by tons of spit up (sometimes curdled and sometimes fresh) I block nursed for awhile... which helped.

I heard that the yellow or orange streaks that sometimes appear in breastmilk is hindmilk. This is ok to see and not to worry. My 3 month old spits up all the time, and everyone says its just a laundry problem.

I wanted to make sure it wasnt an allergy so I stopped eating dairy for 5 or 6 weeks... and there was not any change.

Does your baby seem uncomfortable? If she seems happy , I wouldnt worry about it.