BF baby green poop and poor weight gain - what does this sound like?

[Kuverty]

This is my second thread trying to establish what's the problem with my LO. GPs so far been useless and just tell me to do nothing. Btw we've seen there different ones so far - is that even normal? Would prefer for DS to see the same one every time rather than the receptionist assigning us with random ones.

I hope someone would be able to help.

DS initially had bad reflux like symptoms, crying all the time, spitting up, vomitting etc.
Reflux meds didn't help. Tried Colief and that brought relief in terms of his crying - he is like a different baby, content and much more peaceful!

Yet ever since giving Colief his weight gain became very poor. He has a good number of wet nappies and makes big green poops now.

His feeding is just horrendous - he latches on for about 5 minutes or less, then detaches, latches on again etc. Fusses and cries, arches his back. I put him to the other breast and he'd do the same thing again.

He drools and spits up quite a bit though much better since introducing Colief. He gets very burpy and gassy even though he seem to eat little.

Having done some research online this sounds to me like a foremilk-hindmilk imbalance with his gut struggling to digest tons of fore milk. Colief helps as it assists with lactose rich foremilk's digestion (my theory.)

For the life of me I can't get him to try a bit harder to access hind milk, and can't even express it for him as hates bottle. I don't know what to do. It's all been very frustrating and I start to seriously regret even staring to breastfeed. It was horribly hard to get the milk going with crippling pain each time he latched on, and now this. DS is 11 weeks old.

Any tips for getting him to drink hindmilk at all? Does my theory sound feasible - any alternative POVs? How do I fix this? Has anyone been through this and managed to cope?

Thanks.

[Sunshineandlaughter]

Agree too much foremilk - causes wind and green nappies

Do you have a lot of milk? Sometimes babies cN fuss if let down too fast.. try feeding lying on your back/reclining.

Don't switch boobs - keep putting him back on same boob until it's empty.

Check in his mouth - are there any white patches inside his cheeks or on tongue (thrush)?

Have you had your latch checked recently to make sure it's still ok?

[3boys3dogshelp]

He sounds just like my ds who was dairy intolerant. He was better within days of me cutting all dairy out of my diet.

[peripateticparents]

I'd try 3dogs suggestion; cut out dairy and soy Completely for a week and see if it's made a difference by the end of the week. (Speaking as a mum of a multiple allergy boy)

[Taytotots]

If you can find a certified lactation consultant (www.lcgb.org/find-an-ibclc/) thry would be able to advise you what the issue is. It can be hind milk fore milk but might be other things as well like a toungue tie. Sadly gp s often don't have much training in bf so they might not be in the best position to advise. This is a good read www.analyticalarmadillo.co.uk/2010/11/green-nappies-what-do-they-mean-when.html?m=1

[SuperRainbows]

Could you express some foremilk just before he feeds

[Mysterycat23]

You can absolutely request a specific gp when you call for the appointment. The issue is finding one you feel comfortable with!

There are lots of different bottles out there. Medela calma mimic the breast as baby as to work to get the milk out. We have them for expressed milk and they're fab, LO took to them v quickly with no nipple confusion.

If you have a lot of supply then try block feeding to bring supply down a bit. Also gently massage the breast while feeding to encourage the fatty milk to come out. Just be gentle in all this and if you get lumps or engorgement gently express a bit off to keep boobs healthy.

I'm not qualified btw this is just what I did as I had oversupply and we had excess wind issues. Googling the causes of the first green nappy we had led me to the above. I also started making LO wait longer between feeds (2 to 3 hours instead of 1 to 2 hours) so he would take a full feed instead of just snacking on foremilk. Supply went down slightly and he's usually emptying the breast at each feed now.

No issue with weight gain here though, did the above at about 4 weeks of age.

Babies can get constipated with few signs and still producing poopy nappies so something to raise with gp if block feeding etc. doesn't help.

[SmokyMountains]

This could be one of several things. I know nothing about dairy allergies etc which sound a good possibility from the other replies.

But just to add on another idea incase, my DS had a missed anterior tongue tie. It meant he couldn't access the hind milk as he wasn't able to latch on properly. He fussed when feeding, was on and off the boob all the time and was clearly frustated when feeding and did green poos. He was also a very windy baby as he took in air due to his poor latch. Did lots of winding which did seem to help as did infacol. But he didn't settle well, and couldn''t gain weight properly. He had it cut at 8 weeks and at that point was still 12% below birth weight.

Two midwives in the hospital, my community midwife a health visitor and the gp all missed entirely the fact that he had a tongue tie despite actually examining his mouth (it was a very thin and almost see through but stopped his tongue moving properly). I went to see a specialist breastfeeding midwife who picked it up in about 2 mins, referred me to the clinic at Kings in London, and the consultant said it was a 50% anterior tongue tie but when they are thin like this they are missed constantly, so if this is something you haven't had checked by someone with specific training and knowledge, it might be worth ruling it out.

I found it very hard and scary that my LO wasn't putting on weight and was clearly unhappy despite me feeding him pretty much nonstop. for you xx

[Aliveinwanderland]

How are you giving the colief if he won't take a bottle? I thought it had to be mixed into milk?

I agree to try and cut dairy from your diet. It does sound like too much fore milk. Have you tried block feeding?

[BreatheDeep]

I'm not qualified or anything but it sounds like tongue tie to me. This can cause the fore milk problems as the latch isn't efficient enough to get to the hind milk. Have you had the latch assessed by a ibclc qualified lactation consultant?

[Kuverty]

@3boys 

I tried eliminating all milk products previously - I remember first few days it seemed to have helped him but later it was back to same old. That was before he started producing green nappies though.

@mysterycat

I might try the mendela calma bottle - literally yesterday I bought a lansinoh moma one and he seem to have taken to it much better (that's not to say he actually eats from it properly but he accepts it in his mouth, bites on it and thus occasionally takes a gulp or two - managed to get an oz of formula into him that way today.) What is block feeding btw? Is hat similar to cluster feeding? Before I'd feed him every three hours or so but was worried about poor weight gain so started to feed more often. Can't win!

@SmokyMountains

Sorry to hear about your DS tongue tie it must have been so stressful not to have him gain weight properly all this time. I can't even imagine what I would have done in that case, completely freak out for sure. I did think maybe tongue tie but DS is able to stick his tongue out (not very far out though) and been gaining weight beautifully up until 8 weeks of age (though his feeding has been similar to how it is now for at least 7 weeks back.) I will try and have this checked though just in case - thank you for suggesting and sharing.

@aliveinwanderland

I express about 10 mls before some feedings (not all mind you he gets something like 5 drops a day only in total) into a plastic container, mix in one or two drops of Colief and give it to him via plastic doser/ syringe - these are the instructions on the box for breastfed babies.

@Breathedeep

Tongue tie suggestion again - something for me to seriously consider. I had a myriad of breastfeeding specialist look at my feeding also at the hospital and some weeks after. They were all in awe what a great latch he had etc - though I'm not sure if any of them was a proper qualified latch consultant or just midwives and volunteers (they don't exactly approach you disclosing full credentials.) Will look into this thank you.

Btw - I find it so annoying that so many so called "specialists" just listen and look at you and are completely unable to help. So many times I'd come to see GPs and had to suggest things for them to check/do as otherwise they just smile and say some patronising stuff like "oh he's just not have his growth spurt yet and worrying mommy!" Unless the child is literally throwing up blood or something I feel like they'd fob you off to no end. How obvious the symptoms have to be for them to come up with any diagnosis whatsoever? Sorry just a rant! I'm from Germany and used to being able to list symptoms and have doc's investigate until they reach a diagnosis. This includes specialists referrals and tests. In fact we are going over to visit grandparents soon and I reckon I'll take DS to docs there. No hard feelings towards the NHS my after care at the hospital was wonderful and everyone is amazingly kind, but the lack of help with this issue is driving me up the wall :(

[Sunshineandlaughter]

Did you check his mouth for thrush?

[Sunshineandlaughter]

Block feeding is feeding continuously on one side - do this for a few feeds - don't swap sides.try and feed only every 2-3 hours as well

[Sunshineandlaughter]

And feed lying back - slows down your flow which might be the problem here

[sleepydee9]

Sounds very much like excess lipase and/or milk imbalance. It takes a bit of tweeking but expressing generally makes it worse and block feeding on one side can really help. Analytical Armadillo and Kellymom used to have information helpful about this. I've never found HV or GP to be useful with anything related to breastfeeding, have you tried LLL?

[user1489479761]

A few other people have mentioned this - but check the little ones mouth for thrush... it's a thick white coating on the tongue and/or inner mouth.

Thrush feels like blisters on the tongue to babies which could explain why he's suddenly started popping off (it hurts). If hes popping off and just getting a little if the foremilk this explains poor weight gain and green poos.

I've personally found my GPs hopeless at diagnosing and treating thrush (I have it and had a nightmare getting it treated). So you may want to find and visit a specialist lactation consultant. If it is thrush then I found this handout useful.. you may want to go to your gp armed with it if you think thrush is the problem

https://www.stgeorges.nhs.uk/wp-content/uploads/2013/10/48Community+services+Wandsworthh_Breastfeeding+with+thrush.pdf

First step for sure is to go see a lactation consultant. Diagnosing bf issues often requires specialist knowledge most GPs may not have

Good luck!

[SmokyMountains]

"How obvious the symptoms have to be for them to come up with any diagnosis whatsoever? Sorry just a rant! I'm from Germany and used to being able to list symptoms and have doc's investigate until they reach a diagnosis"

Oh I feel your frustration! It would save so much time and effort if they'd just refer to an expert already!

Sometimes it feels to me like they have been told every time they refer someone a kitten dies or something!!

I had terrible pain last year and various GP's kept trying to figure it out themselves and diagnosed it as a kidney infection, a reaction to medication, an ovarian cyst, a kidney stone and a hernia before in the end I went to A and E and a consultant figured it out from one blood test. It was gallstone in my bile duct. This was after 6 months of terrible pain first. Grrr

Oh also, still might not be a tongue tie, but we thought my DS could stick his tongue out fine...but after his got snipped it suddenly seemed to get a lot longer!.

[StiginaGrump]

OP there isn't enough info in your post for anyone to be able to suggest a feeding plan. Could you call one of the national helplines or go to a baby cafe or group run by an ibclc or a bfc.

In the mean time don't block feed as this will reduce weight gain. Swopping so you get 2 or 3 sides per feed would actually help transfer fattier milk and increase weight gain - you need personalised info though from someone who has all the info needed and who can check for tongue ties too.

[peripateticparents]

Good luck! Hope you find someone who can help. Our gp told us it was impossible for my ds to be having an allergic reaction. 8 months later he was diagnosed as anaphylactic to several things. Wasn't as bad as it could have been as I 'knew' even without official diagnosis, but I remember how sh*t the process of figuring it out was. Hope you get it resolved quickly

[SerialReJoiner]

My DS had tongue tie, but it didn't cause me pain or have any obvious latch problems. He was pooing bright green, frothy poos, sometimes filling a nappy three times in 30 minutes. He was gaining g, but slowly, and i had a few virtual head pats from HCPs when i expressed concern.

His posterior tongue tie was preventing him from accessing the fatty milk because he just ran out of steam and couldn't manage to feed for long enough. I did breast compressions during each feed, which helped him enormously. His poos turned own within about 12 hours of managing his feeds.

We got his TT snipped and he very quickly was able to get the milk out efficiently on his own.

If you want to check for TT yourself, just run your finger under baby's tongue to feel if there is a membrane tethering the tongue to the floor of the mouth. it often runs in families; dh and i have it too.

[AGnu]

Another who had an undiagnosed tongue tie. Both my DC had them. DS1 ended up having to see a paediatrician for failure to thrive at 9m. DS2 gained weight fine for the first 8-9 weeks but started to plateau, just like DS1 had. I pushed to see the feeding specialists at the hospital & the first one scoffed at my suggestion that he could have a PTT. I demanded to see the qualified IBCLC who snipped it & we had lovely yellow poos & no weight issues from then on! I'm expecting again & plan to ask to see the IBCLC asap after birth to preempt any issues.

[Kuverty]

@sunshine

He has a bit of thrush and I'm already giving Nystan - I have to admit I've been a bit lax about it as the thrush appears to be only minimal when I look in his mouth. GP gave Nystan to me after I suggested DS might have thrush, so again this doesn't give me much confidence. I'm not a trained specialist and it worries me that doctors seem to blindly trust any diagnosis I come up with but not offer anything themselves :/ Thank you for explaining block feeding - I read up on it and think it can cause a decrease in supply. I'd have to think if I'd be prepared to risk it.

@user148

We seem to have only one professional/accredited lactation specialist in my area and I've emailed them yesterday. Fingers crossed!

@smokeyMountains

So sorry to hear you had to go through all that needless pain! I really have some serious reservations about the NHS but don't want to seem ungrateful... GPs seem to be the problem IMHO, once you get to see specialist they are top professionals, and dare say more pleasant as well (perhaps GPs are fed up of seeing hypochondriacs coming with common colds I really don't know.) It doesn't surprise me you had to go through a streak of trial and error diagnosis - I wonder how mortality rates are not higher here with all this messing people around. I'm pretty sure I've read somewhere that GPs are somehow penalised for making referrals as referrals inflict extra cost on the NHS - though I'd argue a patient who keeps coming back inflicts much larger cost long term then a quick round of blood tests! I hope you're okay now anyway xx

@SerialReJoiner

I'd be checking for tongue tie when he wakes up and let you know! Btw - how can someone be a health visitor or feeding specialist, do that for years and miss simple things such as tongue tie etc is beyond me. I don't want to seem like an arrogant cow but having done soooo much research on latch issues in the last 7 weeks I feel like I could do a much better job than many of these people. 

@AGnu

8 weeks is when our weight gain problems started as well. Good to hear you got this sorted out and resolved xx



 

[RockCrushesLizard]

Call the National Breastfeeding Helpline OP.
You'll be able to speak to someone who knows breastfeeding inside out, and they'll help you identify a probable cause and come up with a plan.
I've found them really helpful and supportive.

There are too many things that could affect feeding for anyone to diagnose online. Good luck!

0300 100 0212

[Sunshineandlaughter]

Thrush majorly affects feeding my lo.
You can tell by looking into his mouth and seeing if you can see any white patches.
Oral daktarin much better than nystatin IMO but babies have to be a certain age to use it. Make sure you treat your nipples too else you'll keep reinfecting each other. You can get daktarin for nipples too (can be used at any age).

[Sunshineandlaughter]

You can get thrush treatment from boots over the counter - probably why your GP was relaxed about it.

I'd definitely treat that properly - only when it's gone (treat for 7 days after white patches gone) can you actually see if there's another prob going on. It really hurts them to feed with thrush so he's prob in pain when feeding hence coming on and off and fussing.

[Kuverty]

Thanks @Sunshineandlaughter I didn't know Nystan was available over the counter. Still wouldn't want to pump LO with unnecessary chemicals if it can be avoided. But seems like I really need to get this sorted now because like you said need to eliminate that first before investigating other possible causes. It just seems so minor there are maybe two tiny white dots on his pallet, his tongue is a bit white but I was told it's probably just milk residue ( I can't get if off though )