Help - 6Day old breast feeding but crying in pain after / during

[k4mi]

Hi,

After some help / guidance if anyone has experienced this. Our 6 day old has been breastfeeding since birth. She latches well although i have large nipples and have had concerns that possibly she is quite near the front but she seems to be getting the milk.

My milk did not come in properly until yesterday and so up until then she was getting Colostrum plus a couple of extra cup feeds given in hospital of formula (which went down fine).

Since yesterday in the afternoon she has reacted very differently post feed. She gets sleepy and is on the breast for 30-40 mins but as soon as we then move her/put her down she looks like she is in agony. Knees are up, face is bright red and screaming etc. This can go on and on and we have found no way of stopping it but she seems to get relief from pooping/farting, she doesn't tend to burp much (we have been told breastfed babies don't need to be burped?!). The only way to calm her is a little finger to suck on or the dummy. At first i thought her still hungry but she feeds for 30-50 mins every 2-3hrs and falls asleep on the breast or ejects me (i always offer again).

Her poos have been a mixture of yellow and green/brown yesterday and today. Is the green normal at this stage?

My partner is sensitive to dairy and we have wondered if this could be causing the problem or if it's something else like not getting hindmilk?

If you decide to cut out dairy as an experiment, you will need to try for at least 2 weeks, and be aware that many babies who are sensitive to dairy are also sensitive to soy.

However I would hold on for a few days and see if she settles down now you have stopped the formula, before cutting things out, because this can be stressful and it would be a pain to do it and think it had made a difference, when actually she was improving due to something else and you were cutting out dairy totally unnecessarily. Again, try cutting out just milk to begin with, then other dairy if no improvement, then soy as a last resort.

I did find that DS liked to comfort suck on a finger or dummy but not the breast, he would go mad if I offered it to him, it was odd. We went with the dummy and he rejected it of his own accord at around the time he started solids - I guess he just liked having the feeling of something in his mouth, or perhaps he was teething very early.

But how does the fibre get into the milk? Fibre is non-digestible plant bulk that helps stools move through the gut. How would that affect the baby when they bf?

TBH I'm not convinced a lot of babies suffer with wind (exceptions apply for babies with oral abnormalities like TT or babies with reflux) as wind is actually quite a cultural phenomenon rather than a physical fact. Good article here on wind in babies.

Sometimes what we perceive as wind can be attributable to an immature central nervous system (human babies are born very very early compared to other primates) and perhaps a need for more closeness with mum (sling carrying/skin to skin) to help them sort out the confusing new world.

Truthsweet La Leche League suggest the following:

"Breastfeeding mothers may wonder if diet plays a role in causing gas in breastfed infants. The Le Leche League International suggests that while no food has been specifically proven to cause gas in breastfed infants, mothers should consume a healthy, balanced diet and keep track of foods suspected of upsetting baby's tummy for future reference. Some common foods, however, are widely thought to cause or exacerbate infant gas in breastfed babies.

Vegetables and Legumes
Vegetables high in fiber are often believed to cause gas and fussiness in breastfed infants. Broccoli, peppers, cabbage and Brussels sprouts can cause gas and internal discomfort. Similar components in these vegetables known for causing gas may be passed onto infants during breastfeeding. Additionally, legumes such as kidney beans, lima beans and black beans produce gas and can be triggers for gassy tummies.

Caffeine
The effects of caffeine are not necessarily associated with gas; however, it is related to causing irritability in breastfed babies. Infants already suffering from gas or internal discomfort may feel additionally uncomfortable from consuming caffeine in breast milk. Many foods and drinks contain caffeine, such as coffee, tea, soft drinks and chocolate. While appropriate in moderation, caffeine-laden drinks should be limited to two 8-oz. servings per day during breastfeeding to reduce the chance of infant irritability and discomfort.

Dairy
Dairy products may cause gas and discomfort in any baby, however this may be more prevalent in babies whose mothers are lactose intolerant or have a known dairy allergy. Dairy proteins from foods such as milk, cheese, ice cream and cottage cheese, are passed into breast milk and transferred to baby during nursing. Infants sensitive to dairy protein can develop indigestion, intestinal gas and discomfort, which may be reduced or eliminated by removing dairy from the breastfeeding diet.

Spices
Garlic, cumin, curry and red pepper are commonly thought to be culprits for causing intestinal gas and upset in breastfed infants. Spices in general are widely used in different cultures of breastfeeding mothers. The Children's Hospital of Boston notes there is no one specific spice or food known to cause gas in all babies, though some may be more sensitive to spices than others.

Acidic Foods
Foods high in acid content can cause infant digestive discomfort, as well. Citrus-based foods such as tomatoes, strawberries, oranges and grapefruit are highly acidic, and can be monitored in moderation to see if breastfeeding after consuming these foods has any effect on baby."

here

LLL being very cautious there - lots of 'it's thought...' type stuff! And the list of things on that list is huge. You might as well say anything can cause 'wind'.

Fact is, there is no reason why grapes or cabbage or beans or anything else could cause 'wind' in a baby. I know midwives say these things, but I am dismayed that the same ideas are being taught to peer supporters.

If a mother says her baby has 'trapped wind' ( which I suppose means ' the baby makes a great fuss and is in distress, and then ages after this starts, finally burps or farts' as if one has caused the other) then yes, she needs support and information, but honestly, looking for dietary connections is the very last thing worth exploring.

I am not saying it does not happen. I am saying there are many other reasons why a baby might show discomfort and which are a whole lot more likely.

On the whole, babies don't need to be winded, but I suppose the occasional baby might benefit from it, or appear to.

And the midwife who laughed at the mother who ate grapes? And blamed her for her baby's discomfort? Rude, as well as (almost certainly) wrong :)

OP: just feed your baby when she shows signs of distress at being taken from the breast. It's fine for her to sleep on the breast, or near it, snuggled up to you :)

Your midwife can weigh her and this will help you judge that she is now doing well.

Yellow/green/brown poos on day 6 could be normal in a baby who has had formula, but you can check this with the midwife, too.

We were not taught that as peer supporters; however, whilst no foods are ruled out to eat during breastfeeding tiktok, doesn't mean that some do not cause problems in some babies.

Another example is a mother who is now dairy and wheat free because of her baby's skin problems/allergy probs. Now this wasn't just hearsay/midwife that told the mum to cut out all wheat and dairy; it was the consultant who examined her child. Now, if there is absolutely no way that the food mothers eat affect their baby, then why would a paediatric consultant suggest she (the mother) goes wheat and dairy free? The baby is entirely bf.

Plus I only mentioned the grape/diet thing as another possible.

Wheat and Dairy are different to things like grapes/fruit though as a lot of people as adults react to traces of gluten/CMP in foods so why shouldn't a baby who has an open gut react if small traces of gluten/CMP come through their mother's milk?

What I was questioning was the idea that the foods that make adults gassy when consumed directly could get some how into BM, when what makes those foods gassy is the non-digestible (for humans) fiberous bulk that bacteria in our gut digest and the sugar raffinose (beans, brassicas and other veg contain this sugar) which is again non-digestible by humans but is broken down by bacteria in the large intestine which causes methane, CO2 and H2 to be released (once the sugar has been broken down by the bacteria it can't be broken down again).

Why would any of that make a BF baby 'gassy'?

it sounds like you're doing fine.
Newborn babies just want to be near you, being held.
They've just spent 9 months inside you, being rocked to sleep and comforted by you.
It's great that your milk has come in!
Over the next couple of weeks, you'll feel like you're feeding constantly, and that's fine, that's normal.
I think I spent 2 weeks thinking that she would never stop eating!
But it's great that she's doing that- she's making sure that your supply builds up so she's got plenty of food :)
and yes, it's normal to fall asleep on the boob too.
Remember that newborn babies have such tiny stomachs (isn't it the size of a walnut?), and that she will need constant food to fill it! (have you seen how much they poo?! they're emptying their stomach every time!), and that it takesa lot of energy eating all that lovely milk, and a lot of energy just growing and being alive, of course she'll want a lot of food at this stage.

And yes, BF babies do fart and burp a lot too. So do adults. All food makes us fart and burp (they're lying if they say it doesn't!), so babies are going to need to burp on breastmilk too. I think they just don't burp as much as ff babies.
Always try to wind her after a feed - if she falls asleep, just lift her up onto your shoulder and rub, she might not even wake up but will burp if there's one there.

WE had this with 12 week old dd and couldn't figure out what the hell was wrong. DS had colic from 4 weeks, bt it wasn't that, we just could not lie dd down after a feed.In fact, we used to end up bringing her in bed with us just to get soem sleep. WE tied everything - nose drops 'cos she sounded a bit congested, olbas oil, bed raised, warm towel, mum's clothes...I thought it was reflux and spent hours researching symptoms, but after a few weeks it just vanished.

She still gets windy - and very, very upset if she's pre-poo, but she will tolerate lying down to sleep; even she's not completely happy with lying down to play.

And everyone told me the second child would be easier.

DD1 was like this. She responded really well to being in a sling, having a bath with her Dad and to tummy massage. Basically anything that involved her being either snuggled up to someone (didn't really matter who if she'd been fed - Dad, Grandma, Grandad, Aunts and Uncles - anyone would do ) or having skin to skin contact.

She's 4 now and is still the cuddliest of my DC, my Dad says she's like a cat, as soon as anyone sits down she wants to curl up on their knee

Just go with it...she won't be tiny for long, and the housework will be around forever.

I am a bit confused about ff before your milk came or why you did this.
Could be reflux if fussy on the breast and then all tightened up after.

Could also be reflux/ silent reflux which is often eased by milk or sucking.

My ebf daughter is ten weeks now and it seems to cause her pain to poo. Our HV suggested that her digestive system is still immature and that infacol would help to ease the milk through. It has definitely made her more regular and she is in less pain although still uncomfortable sometimes. It's fine to use from birth. I would also say that we need to wind her after every feed.

I agree that in a very small number of mothers, wheat and dairy may cause problems. I think the no. of babies who are affected by grapes, apricots or cabbage or whatever is even smaller .

loopy, I am sure you are sincere and wanting to help mothers - I am not criticising you.

But I think - personally - peer supporters should not be making dietary suggestions to mothers anyway....maybe your training allows this, but my opinion is that it's over your boundaries. That may sound not nice to you, sorry - it's my opinion, that's all!

As a breastfeeding counsellor, I don't do it, for example.

Hi tiktok - the training does cover explaining to mums that whilst they don't need to avoid certain foods, there may be some foods that could affect the baby, ie chilli, garlic, too many brussels etc.

This was not us giving her medical advice; simply that she told us she had been eating high quantities of dried fruit and greens and myself, the other peer supporter, along with two other mothers, all suggested balancing the diet of fruit and fibre a bit. We didn't tell her anything she couldn't have read in a baby magazine and certainly didn't give her any medical advice.

I know you're not criticising me .

Well....what can I say, loopy? I don't think your information was right, and I don't think you should have suggested 'balancing' her diet.

I don't think pointing to the crappy stuff in magazines is a justification. You and your colleagues should not be reinforcing the rubbish that's out there.

We don't reinforce rubbish in magazines- it was an example of the level of topic we were discussing. The fact that La Leche League, for most of the time by most of the breastfeeding community, seem to be taken as knowledgeable and actually said the same thing on the website I linked as we did to the mum in the group seems to bypassed you.

It was an example of what a low level piece of info it actually was and explaining that the information given (by other mums at the group, not just the peer supporters) could have been given by anybody and we were not going against our training by giving it.

It wasn't medical (when I said about balancing the diet, it was more suggesting she eat a normal diet from all the food groups rather than eating a kilo of prunes!). She had not been told to eat bags and bags of dried fruit from any HP - but had taken it upon herself.

The women in the groups are mums getting support from mums and yes, as peer supporters we know there are boundaries.

Explaining to that mum (imo) about how eating vast quantities of dried fruit and veg may affect the baby's tummy with wind, is nowhere near as serious as some of the misinformation the HVs tell the mums who come to our groups.

I was obviously trying to help the OP but now I feel as though you're telling me off.

Anyway op, I hope your LO is a bit better since you posted on Sunday.

Has her tummy pain seemed to calm down now do you think?
I imagine that now you've stopped the formula and your milk is fully in, she's guzzling away and feeling much better .

I agree that some of the info mothers hear from HVs and other HCPs is appalling, loopy....and may have more serious effects than the suggestion to eat a balanced diet.

If you read what LLL actually say, they are cautious and much of the information is written in a 'some think' sort of way. I think, even so, that the overall impression of that quote is to vastly overstate the effect of diet.

Peer support does a great job in normalising breastfeeding and enabling mothers to feel comfortable enough to choose bf, in our society which does not value this choice or give women strategies to sustain it.

But peer supporters' role is generally not to make suggestions about diet or to suggest stuff with no good evidence (and despite what LLL says, there is no good evidence for apricots or grapes or whatever) - your first reply to the OP was great stuff, and showed you understand how bf works, and when the mother needs to seek further info from a midwife or other HCP.

I am sorry for making you feel as if I was telling you off - I am struggling to find the words to correct myths without criticising well-meaning people who perpetuate them :( You sound as if you are a really helpful peer worker and don't stop!

Thank you tiktok. I know it's hard to express in typed words sometimes what I mean and I think when describing bf issues, it's even harder sometimes.

In our group, we always say 'some mothers may find that....' or 'perhaps you might like to try......' etc. I completely understand the role of the peer supporter and whilst it's often frustrating, I know how dangerous it is to give personal opinion (something I don't do) and to give support that is not backed up.

At the same time, the very nature of peer bf groups is that often, other mothers sit there and tell each other things that are completely false and we either have to just listen and try not to say anything or say it in a way that explains it's wrong but in a non-patronising way - tricky! We can't seem to be undermining other mum's help if that's what they're trying to offer - often a difficult thing to manage in an open group.

Totally understand, loopy , and have been in that position myself.

You overhear someone saying something preposterous to another mother (such as 'I think it's fine to give them a bit of porridge - mine's had it since she was five weeks old and she's fine, she loves it' which is one of the milder things I have heard). What do you do? You were not even part of that conversation in the first place - and the porridge mum is only wanting to help or chat.

:(

My five week old is definitely reacting to what I am eating thru my breast milk, as did DS1. My HV and dietician at local hospital v supportive. My advice is try a bland elimination diet based on rice and good vitamin supplements for a week or so and if you notice a difference, you will know how to proceed. Get a dietician... You can self-refer at many hospitals and trust your instincts and your baby. Best of luck..... You are not alone with this x