Foamy green poo lactose intolerance?

[Athrawes]

My four week old has had foamy green poo for two weeks. The lactation consultant suggested he may be lactose intolerant. Do I need to cut out all milk products, like butter and milk in cooked products like biscuits - or just cut out milk on cereal, coffee etc. A friend suggested that if the milk is cooked/processed then the lactose is changed and no longer an irritant.

I had a similar thing... I cut out dairy myself at HV recommendation for 1 week, it made no difference. I then saw the GP who prescribed (although it can be bought) Colief. It's these drops you put in a bit of expressed breastmilk just before you give a feed, it breaks down the lactose (or something or other), he told me to do it for 3 days, he said if it worked I would see it very quickly improve and he would test my DS further for lactose intolerance, if it didn't work he said my DS wasn't lactose intolerant and he would eventually settle down. It didn't work!
He's now 18 weeks and his poo is green maybe once a week, but golly it's still very foamy! I would ask your GP, try Colief and maybe the GP will want samples fir further testing.
Pebble

What odd advice from the lactation consultant (was she a real one? :)) - you cutting out lactose makes no difference to the milk as lactose is part of the milk, and has to be there. It's the milk sugar. The lactose you ingest does not go into the breastmilk and a lactation consultant should know that.

Did she mean cows milk protein intolerant? A very few babies react to cows milk protein which does affect the breastmilk, but symptoms are irritation in the baby, failure to grow well, allergic reactions like skin break-outs.

Foamy green poo means nothing significant, as long as the baby is well in every other way.

A baby who is lactose intolerant from birth is very, very rare; secondary LI can happen after a bout of gastro-enteritis. Usually there is no treatment for a breastfed secondarily LI baby apart from breastfeed :)

Well go with the cows milk intolerant idea then - same question. Once cooked is this still an irritant?

Cooking protein does modify it , but usually, if babies are clearly cows milk protein intolerant (and there is no evidence at all your baby is) mothers are told to cut out all dairy, cooked or uncooked, processed and unprocessed...and that's a pain.

Wow tiktok, is that true? I was exclusively breastfeeding (no cows milk at all for my DS) and told by HV that I needed to stop eating dairy, are you saying this would have made no difference at all (it didn't by the way!) Another reason why I really need to stop listening to Health Visitors!

Oh I see; I've read your post properly now! My DSs only 'symptom' was the poo issue... If OP is still concerned she should try it, but I have found his poos have improved as he gets older.

I found that cutting orange juice from my diet helped (I was drinking a large glass each day)... after some time due to eczema I also went dairy-free, and his poo improved no end.

As tiktok says though, it is a pain, because its in every little thing you can imagine (bread, cake, etc)- not good when you're starving from bf!

My ds1 was like this, and both my boys have CMPI (cows milk proten intolerance) rather than lactose intolerance. I know plenty about CMPI but nothing about Lactose intolerance. DS1 could projectile poo about 2 yards across a room ewwww
My ds2 was dairy free from birth, and is a fit and healthy (but still dairy free) very nearly 7 year old.

re-read stuff - and tiktok (our Resident Expert) as always sums it up perfectly. My dses are small for their age, and any contact with milk brings out the classic snotty noses, wall-to-wall eczema, and digestive symptoms.

IME the medics are quite useless baffled - we've seen paediatricians, dieticians and all sorts, they just tend to leave it to me to figure out what works and what doesn't and just keep an eye on the boys' height and weight.

pebble - I'm not saying it would make no difference, but it for sure would not have affected the presence of lactose in your breastmilk.

Any HV or anyone else who suggests cutting out lactose in the bf mother means the breastmilk is without lactose needs to go back to training and remind themselves of some pretty basic stuff!

I would always be very wary of anyone suggesting a mother one-week postnatal (FGS) modify her diet in such a tiresomely radical way - or suggesting she mess about with expressing to mix anti-colic drops. It's always far easier to investigate the really simple possible reasons for 'colicky' behaviour in a baby this young.

Also, testing a young baby's stools for lactose intolerance is not regarded as an accurate way of diagnosing it.

Green poo, foamy or not, with no other symptoms, is on the normal spectrum.

pebble - your baby had green poo at a week and your HV suggested a dairy-free diet for you?

No other symptoms?

Sheesh.

She's a liability :(

it's another HV living up to their reputation, tiktok. :( Abysmal!

I know some folk don't buy into this but could it be "fore/hindmilk imbalance"? In quotes as I know there's not officially any difference. My babe had the green foamy poo & it cleared up when I followed the advice for this cause. It is easy to do, much more so than changing diet (altho there was some cutting out excess sugar, in my case all the fruit squash I was drinking as I was bored of water). Look it up on the Kellymom site or google. It worked very quickly for me, as in a day or two. I do agree that it's not a problem having this green poo, unless possibly there are other health issues. But it was more comfortable for babe not to have such yucky stools (we were EC-ing so I was very interested in all things poo & wee-wise).

DS had the foamy poo too - I started single side BFing (alternating boobs between feeds rather than both at each feed) and it made a big difference pretty quickly so I think there might be something to the "fore/hindmilk imbalance" thing (based on a very scientific sample of 1 ). I did have a lot of milk though and DS didn't switch to double side feeding until he was 4/5 months (and then not every time).

My ds had green poos (lots of them) for 4 months. The gp explained that some babies had a slightly immature gut and it took a bit longer for it to mature. That made sense as by 4 months he was getting proper yellow bf poos. If he seems well and is gaining weight i wouldn't worry. The 2 hv I saw totally panicked at the sight of the green poos when, in fact, he was fine.

Yep - one sided feeding can do the trick, if a trick is needed in something that's actually not a problem :)

Green poo is 'intestinal hurry' - the waste has not hung around in the gut long enough to turn yellow. There is no nutritional issue here - we are talking about residue that the body has to get rid of. High volume feeds - often from a mother who is producing very generously - will contain proportionately more lactose and lactose speeds gut transit.

This is not 'lactose intolerance' though.

But if a healthy baby is gaining and thriving, there is nothing wrong with experimenting a bit with keeping the baby on one side only for a few hours if you prefer yellow nappies :) :)

Sorry haven't read every single post, but I can say that if you are lactose or cow milk intolerant, cooking it will make no difference.

I seem to have an interesting combination of the 2 which I developed a couple of years ago and manage with diet and lactase tablets. Being run down or stressed always makes it worse too. I have found that switching to goats milk made a huge improvement and it has also helped my 2yr old DS who has a terrible habit of bringing up stomach acid and swishing it around is mouth (shudder). The change to goats milk means he doesn't bring up near as much as he used to.

It maybe worth a try for you rather than going totally dairy free (which is nigh on impossible TBH!).

Unfortunately I'm not much use with the green foamy poo though, although it looks like you've been given some other good advice too.

DD2 had foamy poo, foamy green poo, turned out she had silent reflux. Infant Gaviscon completely sorted it.

Goodness me tiktok... I'm going to come to you for advice from now on! :)
He was 3 weeks old, I changed my diet for a week, I expressed just before everyfeed and mixed in the Colief... We were knackered!

None of it helped!
Like I said he's improving (only green once a week-ish) but still very foamy.
I'm going to reread this properly, particularly the fore/hind milk issues!
I feel very bad for passing on the bad advice I received to the OP, so OP please ignore me!

pebble - it's your HV who should be feeling 'very bad' :(

Nothing you did would make much difference, 'cos it certainly sounds like there was and is nothing wrong with your baby to 'fix' :)

Does it matter if they have foamy green poo if they are not bothered by it?

Foamy, green poo in a healthy, thriving baby is not normally a health issue - so I suppose you could say it does not matter, Morloth.

I would usually suggest 'check with the HV' but if the HV is going to diagnose lactose intolerance and recommend a diet which can make no difference, it's maybe not a good move

Sigh my baby doesn't really poo at all, he seems to expels waste as a gas, I would be quite happy to see some poo - of any colour really.

I'm really glad to see this thread - our EBF DD had green foamy poo from when she was about 8 weeks to 10 weeks. We tried not to worry about it too much because she seemed fine otherwise. Eventually I asked HV just to check that we were doing the right thing in not worrying and she said that I was "overfeeding" - which fits with Tiktok's explanation - but I didn't find it massively helpful advice at the time. I just carried on doing what I was doing before and it sorted itself out. I've pretty much always only fed DD on one side at a time because it's all she has wanted. Only now at 15 weeks is she showing interest in feeding on both sides at one feed and, even now, only sometimes.

Athrawes, I could have written your OP myself! We've also had a couple of weeks of green poo.

Tiktok, thank you so much for the explanation and advice, it makes a lot of sense.

I'd also been trying to work out what foods were causing it as several people suggested cutting out dairy (or some other mysterious food that I had to work out what it was!) Cutting out dairy certainly made no difference to my baby. Not that I managed it for long enough to be scientific about it! Where do people get this 'lactose intolerant' thing from...?