Do I really have a foremilk/hindmilk imbalance? UPDATE: Apparently, yes (see post#14)

[Thalia]

My babe is seven weeks old and has a few symptoms of foremilk/hindmilk imbalance:

green stools (not all the time, but fairly frequent)
gassiness (crying from pain while pooping/farting, pulling off the breast at the end of a feeding, lots of farts)
foamy poop (occasionally)

She nurses every two hours during the day. I usually have her nurse on one side until she pops off or falls asleep (15-20 minutes), and then switch her over to the other side and do the same.

At night she'll often stay on one side and wake up to nurse from the same breast after 3-4 four hours of sleep. She usually wakes up a couple of times a night. Mornings seem to be her best time, so I'm wondering if this nighttime unintentional block nursing has some thing to do with that.

I don't have a super strong let-down, or at least I don't think I do. It usually comes in a few minutes into nursing. I usually have 2-3 let downs per breast. I've never seen her choke or pull off with a mouth full of milk.

She seems to be gaining weight well (although I don't know for sure, she hasn't been weighed in a while). She was on target at her 2 week appointment and ten days later when I brought her in to see the ped after the gassiness started. She was 8 pounds 1 ounce at birth, 8 pounds 12 at 2 weeks and 9 pounds 6 ten days later. She's getting chunky thighs and a double chin and little folds all over so I assume she's still putting on weight well.

Could I really have a foremilk/hindmilk imbalance? I don't feel like I have a big oversupply, or a forceful letdown, which I seem to remember coming up pretty frequently with this issue. And I don't pop her off after 10 minutes, either. Help!

[delphiniumpansy]

Why don't you try nursing her exclusively on one side for 2-4 hours each side before switching sides and see if it improves things? Can't hurt. I had an imbalance and that solved things for me.

[meggles]

Hey Thalia

My dd had some of the issues your dd is having, and it turned out that she couldn't tolerate my eating dairy products! Anything made with cow's milk (goat's milk was fine) made her very painfully gassy and would cause green poop off and on. You may want to look into eliminating some things from your diet, if you haven't already. Good luck!

eta: Gripe water (the organic kind) really helped us, too.

[Electra375]

Foamy poop is not an imbalance, it's an intolerance to what you are eating.
Top causes
#1 Dairy
#2 Gluten (wheat, barley, rye and oats)
#3 Corn

Try dairy first, changing to goats milk can help, but some are sensitive to goats milk as well, it's the dairy protein and not "lactose intolerance", lactose is a sugar that requires and enzyme to digest it, raw dairy products have this enzyme in them usually, pasteurized have killed off everything good about dairy.

I went DF with child #2 and it only helped a little, I didn't know at the time he was intolerant of Gluten, he's Celiac. My #4 is intolerant of gluten, I can eat dairy so long as I stay away from gluten. He's Celiac too.

And the tell tail sign was the mucousy poos, frothy, and then burning acid like rash.

[Thalia]

Hi Meggles!

Thanks for the input, everyone. I did a total elimination diet when the symptoms first started at two weeks, and it didn't seem to help. Sigh. So I'm trying to see if anything else will help. How long does it take to see results from block nursing?

She had a week-long course of antibiotics when she was first born, so I'm also looking into seeing if probiotics might also help.

[Electra375]

Oh yes, Enzymes, Probiotics and Ph levels can help when diet fails to be the obvious cause.

I've got my baby on Enzymes and Probiotics now to avoid reflux meds and it works!

[RoadWorkAhead]

How long did you eliminate for? It can take 3-4 weeks for dairy to leave the system completely. And what did your TED include?

[Thalia]

I eliminated everything except lamb, turkey, pears, rice, squash, and sweet potatoes. But only for two weeks. I didn't see any improvement at all over those two weeks, though. I would think it wouldn't be an all or nothing thing, but maybe I am wrong.

How long does it take for block nursing to show improvement? We are going on 36 hours so far with 4 hour blocks and if anything she seems rather worse.

[Electra375]

How did you prepare the foods you were eating? Were you adding back ingredients you thought you were eliminating? Such as cream of chicken soup/ mushroom, that contains wheat starch.
Did you eat anything at all inaddition to those foods? 1 slip can mess up the complete trial. 2 weeks should have been long enough to see some improvement.
At this point, I would still keep dairy out and go with Enzymes and Probiotics -- see a chiropractor who sells Standard Process. My baby put 10oz on in the first week we were on these supplements (MultiZyme, Zypan, Lactic Acid Yeast).

[Thalia]

I roasted the squash, sweet potatoes, turkey and lamb, cooked the rice in a rice cooker, and had canned pears. I didn't add any other ingredients.

I started an infant probiotic formula yesterday. I'm still block nursing and my supply seems okay, so I'm going to continue that for one more day and see if it helps.

So many things to sort through.

[Electra375]

Originally Posted by Thalia

I started an infant probiotic formula yesterday.(

This is dairy based, please stop. Formula also can really irritate an already irritated digestive track. The proteins are broken down in this brand. It's the only brand my son who is now only dairy semi-intolerant can handle at all and I only use it b/c I have supply problems.

I though he might be getting over his dairy problem, I gave him Enfamil yesterday mixed w bm feeding. BIG mistake... He isn't able to handle it. It makes him fussy and green liquid poos.

Use Adult or child probiotic and take the powder out of the capsule and put a little on your finger w some Expressed breastmilk or water. Better yet, search for Lactic Acid Yeast by Standard Process, it is a probiotic.

[Thalia]

I'm sorry, I should have been more clear: I don't mean baby formula, I mean an infant probiotic _mix_, i.e. a combination of different probiotics. She doesn't have any weight gain problems and hasn't ever had formula.

The probiotic I'm using is Baby Jarro-Dophilus. The ingredients are as follows: B. breve M-16V* 25% 750 Million, B. lactis Bi-07 (formerly B. infantis) 15% 450 Million, B. longum BB536* 15% 450 Million, B. bifidum Bb-02 15% 450 Million, L. casei R0215 15% 450 Million, L. rhamnosus Lr-32 15% 450 Million. It does have a small amount of casein in it, so when I cut out dairy I'll have to find something else. I mix it with expressed breastmilk and feed it to her with my finger.

[Electra375]

Thanks for clarifying.
My baby is FTT, so we've been through the ringer. He was tested for intolerances through a sigmoidoscopy to test the mucousal lining of his colon. It's been a ride and not a good one.

I bumped into a Chiropractor on my way to find out about a compounded script. This Chiropractor set me up with the above mentioned supplements and we've been doing great every since -- still as close to 100% GF as you can be and mostly DF for me.

Every day is a challenge. My milk supply dropped during ds illness and never recovered on it's own, my AF came back too. The docs wanted him on formula, the semi-elemental type, the type that tasted so gross he would not drink it.

I've seen the foamy green poos enough in 2 of my children to know for us it is Gluten Related and cutting dairy out with gluten while the gut heals is the only cure. Then slowly add back dairy in limited quantities is usually okay. I guess the docs didn't think I could or should limit my diet, well, what other choice is there?

IF my baby tolerated formula (any kind), I probably would have considered stopping this insanity of pumping and fortifying a long time ago. And now due to my supply issues, I am having to give at least 1 bottle of formula a day. He does not tolerate 2. If I end up being short, I feed him more food. I'm tired. I'm sore. I'm hanging by a thread, the thread that every ounce of bm is one less ounce of formula.

Time to go pump...

I hopey you figure out what is making those foamy poos. The green is dairy, most definitely. Is there a rash that goes with it?

Look at making your bm more acidic, I know that sound strange, but it helps with the digestion in the stomach for some reason.

[Thalia]

Electra375: you really have been through the wringer. What a good mama you are to your little one!

The good news is the combination of probiotics and blockfeeding seems to be working. She's still having the occasional foamy poop or green poop, but her distress while eliminating is much much reduced. She's starting to fall asleep at the breast again instead of ending every feeding by crying, and when she poops on her little potty (we do EC) about half the time she's smiling. She still has some times where she seems to be having some pain, but it's getting better.

I wish I had started the probiotics sooner. I should have realized that the antibiotics would have the potential to wreak some havoc on her little system, but it took almost a month for it to really show up, so I didn't make the connection.

I think the block feeding is working, too. I had pumped recently to make a bottle for DD's grandparents to give while we went out for a few hours, and the difference in the milk compared to before we started block feeding was huge. Much more cream and much less watery foremilk. I was shocked. I had no idea there could be such a difference. She had been gaining so well I never suspected she was getting that much foremilk. I called the lactation consultant at the hospital and she said that DD's symptoms could definitely be caused by her getting too much foremilk, which would then zip through her system too quickly. We're doing about four hours on each side now. My breasts took about one day to adjust and now they feel fine, and I don't think it's affected my supply (except possibly reducing the amount I leak).

I've been eating dairy for the past week, so it doesn't look like a (serious) dairy intolerance at this time. She doesn't have any rash now, although she did last week, and off and on before. She did have a rash when I did my two-week elimination diet.

I don't know if we are out of the woods yet, but I really appreciate all the replies.

[chlobo]

What probiotic are you giving her? Is it dairy free?

[prettypixels]

Here's an article about foremilk/hindmilk imbalance that may be helpful; it does indeed cause green/frothy poops, although I'm sure other things can cause that as well.

http://www.wiessinger.baka.com/bfing...e/gulping.html

[Thalia]

chlobo: the probiotic is Baby Jarro-Dophilus. I listed the ingredients earlier in the thread. It is not dairy-free.

prettypixels: thanks, that's a great article-really describes the issue well.

[Thalia]

Just wanted to give another update. DD's poops are much more yellow now, and I'm seeing bigger curds in her poop, too. Someone told me the curds are fat that is eliminated because it's not needed, so I hope this means she's now getting all the fat she needs from the hindmilk.

She's also switched from having a smear of poop in her diaper almost every time we change her to just 2-3 BM's per day. They seem more concentrated and less watery, too. That could just be because she's getting older, but it may also be the changes we've made.

The other big change I've noticed now that we are using the probiotics is that her poop has that buttermilk smell that I had always read about. Before this her poop didn't smell like anything at all. Now I can smell a distinct buttermilk smell. I think it's because the good bacteria are now breaking down the breastmilk properly.

Anyway, thought I would update in case anyone has the same isssues and ends up reading this thread.

[Electra375]

Great news!!!
Ah, yes, that distict bf poo smell... It really is distictive, yet not offensive (except to men).

[Hippiemommie]

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