Breastfed baby always sick

[pinkoyster]

I'm at the end of my tether. DS is 22 weeks, ebf so far. He gets a cold every other week, which lasts for 2 weeks. During these 2 weeks sleep is naturally disrupted as he can't breathe through his nose so gets up hourly (I use olbas, calpol nasal spray and a humidifier to aid breathing all of which help a little). In the 5 months of his life so far, he has had 5-6 full blown colds with chesty coughs, which take him ages to shake off. So much for breastfed babies rarely getting sick!

As well as his cold, he has dropped 3 centiles from his birth weight. He was born on the 98th and is now in between the 25th and 50th. His poos have been green and mucousy since birth. He poos roughly 6-8 times daily. I often see it come out of his bottom and it is like green water (tmi alert). He is under the care of a paed who has seen him once so far and has diagnosed cows milk protein intolerance. He instructed me to bf till 4 months, then switch to aptamil pepti. I have ignored his advice as I truly believe that bm is best (I am totally dairy free btw). I bf my eldest dc for 18 months and he totally thrived on it. He'd hardly every get ill, and even currently has the constitution of an ox, despite the fact he was a premie. I am just wondering why oh why is my bm so crap this time?!

How long have you removed milk from diet, and are you REALLY milk free?

as his guts have been inflamed from the intolerence it will take WEEKS before it can heal. as we cant let our guts rest and stop eating!

good luck with the pead.

eragon, I've been totally and absolutely dairy free for 19 weeks. As well as dairy, I also avoid beef and products with beef gelatine (as well as onions, garlic, chocolate, eggs, all green veg and pulses) as they seem to upset him too. Before that I was off dairy, but would have products like crisps which'd have milk products in them. Now I check the ingredients of all foods I eat (including bread). The last time I ate out was 4.5 months ago as I'm not sure that the food I order will be dairy free. I don't really know how I can get much stricter!

If he has a problem with lactose, then no dietary restriction can help because its a major component of breastmilk no matter what you eat.

It is really rare but my best friend's two children have both been lactose intolerant from birth, failed to thrive, had constant squirty green poo etc. She tells me (just asked her on FB) some people have success with lactase enzyme drops but her DC were beyond that.

That sounds really upsetting and stressful, you have my sympathies. It's just a thought but green mucousy poo is also consistent with a baby with a cough and a cold. I see it again and again here. Perhaps it is just a side effect of being constantly ill ?

How old is your DC1? I found that my DD went through a phase between 18mths to 2 yrs of having a constant headcold. July baby, second winter was a killer. Just one back to back cold after another. Summer came around and it all cleared up and this winter just gone was much better, I guess she had picked up enough germs in the prev winter to have some immunity.

So my point is, perhaps because your DC2 has exposure to a toddler and is therefore picking up every bug going, even if your toddler is not particularly ill that it is the root cause of his failure to thrive? Your words by the way. Yes it's a big drop in percentiles but it's not heading for 5%. Is DC2 happy otherwise - between nose blowing

Have you started weaning or are you waiting for the 24 week point? Your BM may be fine, it may just need a bit of Vitamin D and some solids..... It sounds like you have done everything possible and I'm not surprised you are at the end of your rope.

Thanks oscar. Dc1 is 27 months, but he's rarely ill. He may be passing the germs on, but tbh he has very limited physical contact with the baby, though of course they may pass through the air or through DH and I. I started giving ds2 a one table spoon of baby rice this week mixed with one ounce of aptamil, and his poos are still liquid. I've only been giving it to him once a day, so I don't know what will happen once we start properly weaning..

Just to add that if he reacts to dairy via BM then you would need one of the amino acid formulas e.g. Nutramigen AA or Neocate. The peptide chains in the hydrolysed formulas are similar size to what passes in breastmilk, he is likely to react to these over time as well.
Is there any history of antibiotic use for either of you? Have you considered probiotics? These symptoms can sometimes be linked to leaky/damaged gut.
My sympathies - I BF DS2 who was MSPI for 2 yrs. It's very tough restricting your diet and it sounds like you have had to cut a lot out. There comes a point where it's ok to say this is not working for you and Neocate or similar is the best option for all concerned, but I understand your reluctance.

baking, I'd heard that neocate tastes really bad. The paed recommended this at my earlier appointment, but I said I'd stick with the pepti. I've also heard worrying things about soy based formulas-that it affects a baby's cognitive development (rightly or wrongly-it may be scaremongering). I'm just stuck. I guess a part of me thinks that if I've made it through to 5 months I should just continue. He's reasonably happy when he's not ill-but it's so few and far between that I don't actually know what he's like (does that make sense?). I will see what the paed says tomorrow. I just wish he'll listen to my concerns properly...

Have you tasted the Pepti? It's vile. I thought Neocate was less horrible, personally, but they are all pretty bad. It's something to do with cleaving the protein chains and exposing NH3 groups on the ends of the molecules.
I made the decision to carry on BF on a restricted diet, and with hindsight I think it was the right decision for us. However, I also know (in the internet sense) a lot of people who have switched to Neocate or similar and that has been a turning point for them.
The avoiding pulses struck a chord with me as they seemed to upset my son too and he turned out to be MSPI (milk and soya protein intolerant) 50% of CMPI children also react to soya and again it's in lots of unlikely places, particularly bread. I know this was mentioned upthread, but worth considering.
I BF my first son who was a massive robust chunker, and I'm so glad, because everyone was so keen to blame my milk for DS2's failure to thrive - he dropped from 25th centile right off the charts by 4m old. Had DS2 been my first baby I'd have believed them. I don't think something has gone wrong with your ability to provide nutrients for your baby, and even on a very restricted diet the quality of breastmilk should not be affected. It may not be the best thing for your own health, but that's another issue.
Our paed was not exactly anti, but certainly not proBF. Luckily for us it took such a long time to see someone that we'd got most of the way there by ourselves by then and stopping BF was no longer up for discussion (he said if he'd seen us at the 3-4m stage he'd have insisted on hypoallergenic formula)
Respiratory symptoms can be a sign of silent reflux/CMPI due to damage to the throat and airways from acid reflux. How sure are you that his "colds" are due to viruses, particularly if other family members are not being affected?
The other thing is that occasionally food intolerances are linked with low blood levels of IgA which can cause impaired immunity.
Sorry, probably no answers there, but maybe some lines of enquiry to address with the paed. I hope your appointment is fruitful.

This needs more input from medical professionals then, are u seeing a pead or a pead immunologist? might be worth asking to get reffered to an allergy clinic if you can.

I agree, I think there's a need for further paed input here, especially if you've alread cut out soy.

Have you tried... (oh how I hated that phrase when I was struggling with DS) lactase enzyme drops? I am sure you must be able to buy these more cheaply than it comes in the form of Colief (££££££), if you look on the net. I guess these drops would be quite hard to administer while BF, but it might be worth a try while you wait for a second opinion/ follow-up appointment.

DS had secondary lactose intolerance - secondary in the respect that he also had CMPI which had totally wiped out his body's ability to produce any lactase for a fair few weeks. IIRC, Pepti has quite low levels of lactose in it, which might account for your DS faring better on it. Totally guessing, here, though - mightn't be relevant at all.

Have you had a thorough health check yourself for things that (I think) can affect milk production - e.g., hypothyroidism, anaemia, Did you have any sort of haemmorhage after the birth that would put you at risk of these things? I am sure it's not you and your body (and your milk) that's the issue, but maybe it would be as well to rule these things out?

But to sum up, please do go back to the paed and say things aren't working, and ask what else s/he can suggest.