Mothering Forum banner
1 - 12 of 12 Posts

·
Registered
Joined
·
26 Posts
Discussion Starter · #1 ·
Hi. I'm totally new here. I've read a bunch of posts but still don't quite understand block nursing. If you don't want to read all of this skip to my question at the end


Background: My 4 month old has had poo problems since 10 weeks old. It started with blood in the poo, so I eliminated dairy. It went away, then came back a few weeks later, so I eliminated soy. At this time his poo got much greener and very mucusy, and he got really fussy. I gave the soy elimination a couple weeks but didn't see an improvement so eliminated eggs. For the past week he's still got green mucusy poop but now it is really watery and very frequent. He is back to pooping after each feeding. I think he's got diarrhea all the time now. Starting last night he is waking up crying because he has a diarrhea blowout. But before this he has been a very good sleeper -sleeps 7-8 hours at night without waking. He is also a very good, happy baby. He is not colicky or fussy, and doesn't have gas pain. In fact he seems totally fine until you look at his poo. Bloody on and off, very mucusy, and now really runny. We had two diapers with pink urine last week, but that hasn't recurred.

I think foremilk/hindmilk imbalance could be an issue, so I'm trying to block nurse. DD nurses about once every 4 hours. The first day I did this I simply used only one breast for each feeding, alternating each time. My unused breast got very full, but after doing this for just a day and a half they no longer got super full. So I figured the block nursing decreased my supply to where it should be. However, he still has green soupy poo and occasional spots of blood. I'm trying the total elimination diet, but also want to make sure he gets enough hind milk. Now that my supply is lower, DD is not satisfied after one breast. He has a very consistent pattern. He nurses for 6-7 minutes then stops. I burp him and then try to put him back on the same breast. He will nurse a little more but not enthusiastically, and I have to massage my breast to keep the milk flowing so he'll keep nursing. I know there is still milk because I can easily hand express some and squirt it right in his mouth. But he is just not interested. It's like the hindmilk is not as tasty to him or something. But as soon as I switch him to the other breast nurses well for about 5 minutes, then he is done and totally full.

So - should I restrict him to one breast for four hours or so? I worry about doing that because he will "finish" the one breast and want the other, but I won't offer it. Or given this pattern do you think I don't have a foremilk/hindmilk balance problem?

Please help! Thanks!
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #2 ·
I just thought of a few more details that might help.

1. I have plenty of milk. When I pump I get about 5 oz in the first 5 minutes. So that leads me to believe that when he nurses he gets 5 oz VERY quickly- probably faster than the pump does. Starting yesterday I'm no longer pumping. I do want to pump to store milk, but for now I can hold off in hopes that it will help.

2. I have a feeling that if I nurse him on one side only, he'll get hungry sooner that his usual 4 hours. So this might mean nursing more often (if I stick to only one side for 4 hours or so).

3. With the current pattern of nursing, which started after I did block feeding for 1 1/2 days, he started biting more. He always bites when he is done. So after 6-7 minutes on the first side he chomps down (no teeth yet, thank goodness). He's not trying to slow the flow, because at that point my flow is slow. He might be frustrated that it is not gushing out. If I keep trying to get him to nurse on that same side he keeps biting. But if I switch sides he nurses well (because milk is gushing) and doesn't bite until that side slows down and I think he's full, after about 4 minutes. I've been working on curbing the biting. I watch him and as soon as he gives me clues that he will bite down I unlatch him. He doesn't seem to mind unlatching at this point, since he is basically done anyway. I think he is learning not to bite.

I'm really hoping someone has some input!! In the mean time, I think I'll try block nursing on just one side for four hours.
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #3 ·
and one more thing. When I pump if I keep pumping for 15 minutes I get 8-10 ounces per breast. Is that a lot? Does that mean I have too much milk?
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #4 ·
and one more thing. Baby is otherwise healthy and gaingin weigth. He's 4 montsh old and 22 lbs. He started out big - 11 lbs 6 oz at birth. He's been in the 97th percentile in weight, length, and head circumference since birth. I'm not worried about him getting enough milk and gaining...

His thighs are so fat, that he doesn't fit in a bumbo chair and we had to take the tray off his swing because it won't snap down over him... LOL
 

·
Registered
Joined
·
5,249 Posts
Have you seen a pediatrician? Blood in poo is not something that's normally associated with foremilk/hindmilk imbalance, it's usually a symptom of something wrong with the baby's gut, not what's going in it. The fact that your baby is otherwise gaining weight and healthy is good, but blood in the poo really needs to be checked out.
 

·
Registered
Joined
·
4,169 Posts
ITA w/spughy here - blood in stools or urine is not related to oversupply or foremilk/hindmilk imbalance. It's a thing you need to discuss with your pediatrician as soon as possible (don't wait for the next WBV, call them).

It's summer, so it's possible that your LO wants foremilk just for hydration.

In regards to milk supply: how much is enough and how much is too much is a highly individual thing. I can think of a bunch of reasons why you might be getting the results that you are with the pump. Maybe your son is a very efficient nurser, and has stimulated your breasts to work that way (he is a big baby, and growing fast - that takes a lot of milk). The baby has flow control options that the pump doesn't - he can opt to suck less hard, the pump just goes - so the pump might be getting more out of you than a baby who can opt to lollygag a little. The green stools suggest an oversupply problem, but there is obviously something else going on. I can't tell whether it's in addition to oversupply or instead of.

My question is - why are you pumping? Do you work or are you returning to work soon? If it's just to have a stash, I'd say stop until you get to the bottom of whatever's causing the bloody stools, gas and so on. IF the problem is oversupply, pumping will make it worse. If the problem is related to foods in your diet, you'll have to toss everything you pumped before you eliminated the problem foods anyway.

I cannot say enough that the bloody stools really, really need to be checked out, as soon as possible.
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #7 ·
Thanks for your concern about the bloody poo. I've been to the pediatrician many times and a gastroenterologist. Both basically tell me that he is doing fine, so don't worry. I called about the pink pee and they said to save the next diaper that had the pink spot and bring it in, but it has not happened again.

At 6 weeks old when he first had blood in the stool the pediatrician told me to eliminate dairy. I did and it went away, but then came back a couple weeks later. So - I went back to see the pedi and she said to go to the specialist (gastro). She didn't want me to keep playing with my diet because that would be too hard on me. She did order stool samples and hemoglobin check. Stool samples came back fine (they checked for 4 different things, can't remember what), and hemoglobin was very good - better than normal for his age. So, in every way they can measure he is thriving. He just has green diarhea with blood spots in it. And that really worries me. The gastro doc didn't help. She said she could scope him, but didn't think it was necessary since he's thriving. That didn't really help me, so I eliminated soy for a week, then eggs. I haven't had an egg in over two weeks.

But I keep seeing blood in his stool. It varies - sometimes none, sometimes tiny specks, sometimes larger specs. But never more than the size of a lentil. Never big streaks. And I"m sure it is blood - they tested it at the pedi.

So....starting last week I went on a total elimination diet (only Turkey, lamb, squash, pears, rice, potatoes, and millet). It is day 5 of that diet and he seems about the same. I actually couldn't find turkey at the store and bought a big Capon at EarthFare thinking maybe it was a game bird of some kind. Then at homed I googled and found out it is a castrated rooster LOL. So my diet is as Dr. Sears describes, except range fed Chicken instead of turkey, and only white rice (not brown, since my brother is allergic to brown but not white rice).

With the nursing - I think oversupply is a problem. I started block nursing yesterday. I went 6-7 hours for one breast then switched. I had to pump off several ounces before starting a new breast, since it was totally engorged and I know he would have filled up with foremilk. I was excited that after doing this, he nursed longer and seemed full after the one breast. So maybe before he was getting filled up with foremilk. I think his poo is getting more yellow as opposed to green, so I'm a little encouraged. But it is still really runny and mucusy, and after 2 days of no blood he had a little bit in his diaper this morning.

So - I guess I"ll keep to the TED and block nursing. I really hope he improves soon. I was hoping to at least see a little improvement by now.

Oh, and I stopped pumping for milk storage. I was pumping just in the morning to relieve engorgement, and figured I might as well do a full pump in the morning to stockpile milk. Now I only pump to relieve engorgement - so a few ounces before feeding him if I can wait that long. I noticed that this milk is really watery and has almost no cream at the top (after the bottle sits in the frig for a couple of hours), as opposed to a full bottle of pumped milk, which has a thick layer of cream on top.

Anyone else been through anything like this?

Am I worrying too much? I mean, he is "thriving" according to the doctors and I agree. But then I change his diaper and see the blood. I worry that whatever is causing it is doing long-term damage or something.
 

·
Registered
Joined
·
5,249 Posts
Geez, that's hard. It IS good that he's thriving and it sounds like you're being really methodical and conscious about it and that's great.

You've probably already done this, but I checked on kellymom.com and sure enough, oversupply CAN be associated with bloody stools - the block nursing you're doing should definitely help with that. It could also be associated with food intolerances - which you're working on - or a bacterial infection. Was his stool cultured for c.difficile or salmonella?

Can you keep us updated? I am learning a lot about this - I am training to be a post-partum doula and this issue has not come up.
 

·
Registered
Joined
·
4,169 Posts
Hey Brandi -

We had killer oversupply over here for a while, and I have a fair amount of experience with the foremilk-only bottles that you describe. The milk was watery (almost pale green), and no cream ever rose to the top. So that much is normal.

In terms of fixing it... argh. I had to sideline my pump completely. It was just contributing too much to the problem. I wound up pushing the nursing blocks pretty far - I was going 10-12 hours on one breast for a while. This is not recommended as the odds of plugged ducts and associated infection increase, but it was what we had to do. I treated the engorgement with ice packs, hand expression (which doesn't do as much to stimulate production as the pump), and hot showers.
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #10 ·
just a little update.

I'm block nursing using LONG blocks - about 10-12 hours per side. This seems to have worked to decrease my supply already. I got really engorged, and even had the beginnings of a plugged duct, but after a little pumping and then nursing that has gone away.

Anyone know if block nursing is something you do temporarily to decrease your supply - and then go back to regular nursing? Or do you keep nursing that way forever (or until something else changes)?

He had one diaper yesterday with tiny flecks of blood in it
BUT, he slept through the night (didn't wake up with a poopy diaper), so that is progress!
 

·
Registered
Joined
·
5,249 Posts
I think it depends - it does reduce your supply, but maybe the best thing to do would be to keep block nursing only in shorter blocks - maybe 2 nursing sessions per breast before switching. 10-12 hours sounds really long, were shorter blocks not working?
 

·
Registered
Joined
·
26 Posts
Discussion Starter · #12 ·
yeah, shorter blocks weren't working. I could just tell because my breasts would be so full every time he nursed if I switched every 4 hours. He normally nurses every 4 hours during the day, for a total of 5 times per day. So I was basically nursing from one side twice, then the other side. Before starting the new side I was pumping off up to 7 ounces to get the breast softer, and he would still nurse 15-20 minutes and get enough milk

But now it's the end of the fourth day of this and I just decided to switch every four hours, or basically nurse from once side then switch to the other side for the next session. I am going to do this now because I think the 3 days of 10-12 hour blocks really diminished my milk supply. I think I have enough now, but I might need a little more. Tonight He seemed really hungry. After nursing from one side for 15 minutes he was still fussy. I nursed him on the same side an hour later and he was still fussy. Finally I switched sides and had a lot of milk, and he was finally happy after nursing about 15 minutes.

So now I'm going to just alternate and see how it goes, and hope my supply doesn't go back up too much. If it does I'll go to longer blocks.

He still has the same symptoms, except he is having fewer bowel movements. I'm encouraged. He only had one (big one) this morning. He still has mucusy runny stool, and there was a tiny bit of blood this morning. But maybe this is progress...
 
1 - 12 of 12 Posts
Top