30 nappies a day? Advice for my sister please!

[Viewofthehills]

Baby Nephew is now 6 weeks old.
Since birth he has been very restless and windy. Difficult delivery, major tear and heavy duty antibiotics for Mum. He weighed over 9lb. He's fully breast fed, putting on plenty of weight, but dirtying 30 nappies a day, worst day 60, which is making his bottom raw and all of them exhausted.

He has been to childrens' ward as GP was concerned and they think he is fine medically.

I wondered if he could be lactose intolerent due to her anti-biotics, but I don't know what she should do about it. Presumably changing to formula as people keep suggesting wouldn't help if this is the problem and anyway she doesn't want to!

His 4 yr old cousin is lactose intolerent. Could that be relevent?

I'd be back to the GP I think.

If it is lactose, then no changing formula won't do anything. Could your sister try cutting all dairy out of her diet to see if that changes anything?

(am guessing here btw - someone who actually knows what they're talking about will be along in a minute, I'm sure).

Thanks Jareth.
Cutting all the dairy out of her diet was along the lines i was thinking, but I don't know how long she would have to do this for to know if it's going to work and since it's a fairly drastic measure I wondered what guidance she should have if doing it?

Could it be the antibiotics your SIL is taking? I recently had to have some low level anti botics and DS(who was 14 months at the time) had dreadful diarrhea and therefore nappy rash. It continued for about a week after i finished the course.

I'd suggest frequent changing, washing the bum with water and drying really well, lots of nappy free time to help healing.

Antibiotics finished 4 weeks ago now, so even if that started it I was expecting it to settle down, but I do think it may have been part of it.

Sister is very particular about his skin, but 30 nappies a day is a real endurance test for both of them.

If you don't get any replies here you could try posting over in allergies (put something about BFing and lactose intolerance in the title). There's bound to be someone who'll have more knowledge :)

ooh, x-posts.

Have they looked into reflux

DD had reflux, but was gaining weight so it was a battle to get meds for her. Could explain the wind and nappy rash

Has she tried different brands of nappies?

If he was fully lactose intolerant then he wouldn't be putting on weight well. And as he's been checked out medically I assume they are happy with his health?

lactose intolerances caused by anti biotics, will right it's self in a breastfed baby. Formula would only make this worse.

Alternatively he could be cow milk protein intolerant. In which case cutting diary out of her diet mite help. It would need to be all dairy including hidden dairy and possibly soya to. You would expect to see an improvement after 3 to 4 Weeks, maybe sooner if he's very sensitive.

Lactose intolerance: very, very, very rare in a young baby. It has nothing to do with the mum's diet. Lactose is in breastmilk, whatever you eat.

Lactose intolerance can develop (secondary lactose intolerance) after a serious tummy upset - it is temporary.

The four year old cousin needs a proper diagnosis if he has not had one.

Sometime, cows milk protein intolerance can produce symptoms and the mother may help by cutting out dairy.

Needs a medical opinion.

Frequent pooing needs checking out.

Thank you, all.
Will get her to look into cows milk protein intolerance.
But yes, I thought if she was going to try this route it should be under some medical advice.
Cousin is properly diagnosed. Only mentioned it , in case these things go in families.

LI can run in families and has very high prevalence rates in older children and adults in some ethnic groups.

I really don't think 30 dirty nappies a day is normal. I know babies poo a lot but......

I think your sis should push a bit harder to find out what's going on, or see a qualified lactation consultant for further advice.

Please urge her to get a second opinion, I had a similar issue with ds1, but also with skin problems, eventually he was diagnosed with a rare metabolic disorder and doesn't absorb zinc from his diet. He's fine now and I'm not suggesting your nephew has the same thing as it's super rare, but thirty dirty nappies is not normal.

No , I agree that's not normal.
To be honest i was a bit horrified that it hadn't settled down after the AB's had stopped. I don't live near enough to see him very often. Will get her to go back to GP, who to be fair sounds helpful and did send her to Children's' ward.

Colief, bio-ghia probiotic drops for baby, cranial osteopathy for both of them, and making sure she isn't switching sides too often.

It sounds like too much foremilk zipping through his guts. We had this with ds2 and the above helped hugely.

Hi Lotus,
I could only find US website for bio-ghia. Is there a UK supplier?
Results sound impressive on the website.

I can't spell it seems - it's biogaia and I got it from here:
www.pcpdirect.co.uk/Pharmacy/Baby-AND-Childcare/2211-Biogaia-ProTectis-Probiotic-Drops-5ml.html

It lasts a couple of weeks I think so get a couple of bottles.

She's started Colief today and he has stopped being sick. But I think it will probably take bit longer for his guts to improve.
I have ordered probiotic drops for her Lotus so they should be with her soon.
Will report back.

I second the biogaia drops. DD3 has masses of strong antibiotics at birth and despite being fully breastfed had very smelly poo as a tiny baby. Those drops sorted that out very quickly. She had them for a few weeks from 7 weeks of age. I suspect a lactose intolerance still though as when she started dairy products aged 12 months, her poos were so corrosive that she would have blisters on her bottom if not changed instantly (by which I mean within 1 minute).

36 hrs on Colief, massive improvement.
Phew, what a relief.
Thank you!

Tiktok would be the right person to advise but do you think maybe your sis has an oversupply of breastmilk, rather than this being antibiotic related? This can make them take in lots of lactose-rich milk I think. I think it usually rights itself by around 3 months, if it is that.

Great things are looking better whatever the cause :)

sound similar to oversupply - mine was dirtyingnappies and clothes constantly and reached a crescendo of fussiness and sicking at 3wks. once i managed my supply better she got better really quick and now at 15wks we actually get poo-free days!

She definitely thinks not over supply.
Feels like she has just enough.
Lactase in Colief working as missed giving it in two feeds last night and he has had a bad day again today.
BioGaia drops arrived today so will see if they help aswell.
Best of all; Dsis sounds like a new woman. Amazing what sleep can do!

The 'feel' of whether she has enough is probably not accurate. YOu can think you have nowhere near enough milk but the baby's weight gain tells a different story :) If it's nearer to 10 oz per week rather than the more usual 5-8oz then I would still suspect oversupply.

If it was oversupply, the lactase/ colief would be helping because it would be breaking down some of the lactose that is poss present in greater quantities than in a woman with, say, undersupply or 'just enough'.

Anyhoo, it's great she's feeling better. It's true, sleep is an amazing thing and without it.... well!

Interesting Narmada- because at 8 weeks my DD1 looked like a little Buddha. She had put on close to 1lb a week since she was born, so maybe that was the trouble with her. She was also extremely colicky and sick.

Nephew is a little different as he is mainly very windy and dirtying multiple nappies, making his bottom sore, but not having a 'big' poo IYSWIM.

I suspect by the time we have fully worked it out, this period will possibly over. Certainly the medics are unlikely to be interested in babies who are putting on weight and not ill in the near future. And fair enough, it is far worse when little ones fail to thrive!