Lactose Intolerance/Lactose Overload in a BF baby

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Hi All

I have an 8 week old baby with the following symptoms:

Very windy and smelly wind
Snotty sounding when breathing
Green explosive poos which smell pretty nasty
Difficult to put down
Light sleeper
Chokes when feeding sometimes, clicking sound when feeding although latch is good (I don't have a typical fast letdown as when she initially latches on, no milk comes rushing out, although she'll often gag a minute or so after latch and a mouth full of milk)
A light rash behind both ears

The HV has said to cut out dairy as she might be lactose intolerant, although she has excellent weight gain. I'd read about lactose overload, which sounds more appropriate - has anyone any experience or advice about this?

People say she's got colic, but its not colic as such as she's not crying for hours on end (or they say babies get windy which drives me mad as I know that. I get so annoyed when people say, oh yes thats colic....it makes me feel like I'm stupid). She gets bad periods of trapped wind, which can be relieved by winding or bicycling legs, although it doesn't always work.

Cutting out dairy (it's been a week now) has worked marginally, although not as much as I'd hoped. Could there be any other allergens, especially as she's got this rash behind both ears - I'm thinking could be egg?

its pointless to cut out dairy for lactose intolerance as breastmilk contains lactose too. Block feeding is normally recommended for oversupply.

Lactose Intolerance and the breastfed baby

Is my baby lactose intolerant?

My DS is allergic to many things. Cutting milk and eggs out of my diet helped him enormously, shame it took us so long to realise he was allergic to more than just milk.

If it is lactose that is the problem them you can get lactase drops on prescription, or buy them at the chemist called colief. You give them in a bottle before you bf, it is a major hassle.

Hi there
I've been block feeding as advised by the HV - I keep on the same side for 2 hours, if baby wants to feed within the two hours, I put her back on the same side.

The only problem with that is that she can get very annoyed towards the end of a feed, or if she's fed on that side several times when I think there's not much milk left on that side and is pulling at my nipple and wriggling around on it and crying. As soon as I change sides, she is happy again (or is because she's happy as she's getting the sugary foremilk?) I've introduced a dummy as well, and sometimes she'll happily suck on that.

They are interesting articles there Seona. Sounds to me more like Lactose Overload. I'm wondering whether to block feed to 4 hours on each side, although I'm really worried about reducing supply?

Oh and yes she is a massive comfort feeder and would happily feed all the time......I think that may be making the problem worse.

If it's a cow's milk protein intolerance, I think it takes more than a week for it to be completely out of your system - you might see more improvements in a couple of weeks. And watch out for milk in all kinds of packaged/processed foods that you might not expect - things like ketchup, tinned soups etc.

idid - as Seona says lactose is in breast milk so if your baby is intolerant of it cutting out dairy is not going to alter the composition of your milk. Cutting out diary if she is intolerant/allergic to cows' milk protein will help though as those proteins won't be present in your milk - though I have heard it can take 2 weeks or so to get the full affect.

Plus all kinds of dairy needs to be cut out not just the raw/fairly unprocessed kind (milk/cream/cheese/butter) things like whey powder, lactose powder, etc which are found in some cakes/biscuit/chocolate/crisps/ready meals/etc can also affect a baby who is CMP allergic.

Could it be you have a forceful let down NOT an over supply? The two things can go hand in hand but one can be present with out the other. If you are block nursing due to forceful let down, you can end up with low supply - the milk supply might be the right amount for your baby just attached to a high pressure hose - so by block nursing you are telling your breasts less milk is needed and supply goes down.

Kellymom explains different ways to deal with forceful (aka overactive) let down and over supply here

Have you tried one of the breastfeeding helplines for specialist advice? The numbers are for the different helplines here. As they are staffed by (trained & experienced) volunteer mothers you may need to try more than one to get through to someone.

HTH

Ok, so I'll give it a bit longer. If it is an intolerance, do I avoid dairy for the whole time I'm breastfeeding (I bf my other DD for a year last time)?

I don't eat a lot of processed foods although I'll scrutinize the labels more carefully - I didn't realise it was in ketchup though!!

THanks for that truthsweet, I've just looked at the link although I'll need to read in more detail.

SO if I am correct, by block feeding and changing my feeding positions, that could help baby?

Yes it could but I would be wary of diving straight in at 4 hours block nursing, if as you say, she gets frustrated with the 'designated' breast towards the end of the 2 hours block nursing you are doing now.

Do you have lots of leaking/engorgement/discomfort in the other side whilst you are block nursing? If you are not then it might not be forceful let down AND over supply but just forceful let down by it self.

On the CMP front some mothers do a challenge after a period of no allergic symptoms in the baby by eating something with a tiny bit of dairy (perhaps a biscuit with whet powder as an ingredient at the bottom of the ingredient list or similar) in it. Then they can see if that has any effects and work up or down from there depending on the babies reaction. But it would probably be best t talk it over with her Dr before doing anything if she is happy and settled on no CMP. It might be worth while asking for a dietitian referral in preparation for her starting solids as well.

If you're not sure you have an oversupply you might want to avoid block feeding as it will reduce your supply. I had a bit of an issue with fast letdown when ds was little (not to the extent you have though) and found he was better feeding really often - when there were big gaps between feeds and I was really full the letdown was even faster. Biological nurturing type positions where the baby is on top of you helped, as did taking him off briefly during the letdown (have a muslin or breastpad to hand!).