CMPI or foremilk/hind milk imbalance (oversupply?)

[FrogsGoWhat]

2 week old dd is consistently having greenish poos although still seedy looking. She also appears to have stomach pain occasionally and arches her back while crying for no known reason.

I am tandem feeding her older sister as well so may well have an oversupply causing dd2 to get too much foremilk.

So how can I tell if it is cows milk protein intolerance or oversupply/foremilk problem?

(and I know that there is no such thing as foremilk but the first bit of a feed is higher sugars, lower fat, so if baby just gets this, while toddler gets the fatty bit, it could cause issues)

Could you try putting the toddler on the breast first, then letting the baby have the "hind milk" (I know there is no such thing as hind milk). Alternatively, some tandem feeding mums find they end up with one breast for the toddler and one for the baby.

If that doesn't work, it might be worth keeping a record of what you eat, so that you can track any reactions. Cow's milk is the most common culprit at this age, but could be anything (for example, egg is is also a common allergy).

Does your baby have any eczema? How is her breathing?

If you have continuing concerns, you could post on the allergy board?

I think greenish poo can also be caused by jaundice - we had two lots of treatment and the midwives we're very keen to see we we're back to mustardy poo as it meant the jaundice had cleared. Could this be the cause for you?

Also, you both talk about fire and hind milk while refuting its existence. This makes no sense to me! Can you explain?

anythingnoteverything years ago, HVs used to talk about foremilk (watery) and hindmilk (fattier). It was a very simple way of describing how the composition of breastmilk changes throughout the course of a feed.

When I trained as breastfeeding supporter a few years ago, we used to talk about the "three parts of a feed":

1: this first bit used to be described as "fore-milk", just after let-down, quite watery, this is the SOUP STARTER - quite watery (sometimes thirsty babies just need a drink and stop after this bit).

2: the second bit is when babies settle down to serious feeding (suck-suck-wait, suck-suck-wait, with lovely fat little cheeks as they suck). This is the MAIN COURSE, and this part of the feed can go on for ages depending on how hard the baby sucks. The fat and nutrient content is much higher than in the first part of the feed. This is "hind-milk".

3: the third bit is when babies look like they have finished, but haven't quite let go. This part of the feed is sometimes described as "just messing about at the breast" or "using you as a dummy". The babies might look nearly asleep but, if you poke them or twiddle their ears, they latch back on and do fluttery sucks that are highly efficient - this is the very valuable CHOCOLATE PUDDING part of the feed, very high in fat and nutrients and should not be missed by taking the baby off the breast too early.

Now we don't even talk about 3 parts of a feed, because it is still too clear cut and formal. The composition of breastmilk changes throughout a feed and to suit your baby, depending on the way your baby sucks.

Frogs - thinking about it, too much "fore-milk" would not really explain the back arching etc. Obviously you should try compensating with making sure she gets enough "hind-milk", but be prepared to go to the GP if necessary.

If it is a reaction to dairy or any other food you are eating, please be reassured that most babies grow out of this. My DS1 is one of the ones that didn't, and I have found much support on the allergy boards.

OP could you exclude cows milk from your diet for a couple of weeks to see?

Greenbananas, thanks for the explanation there - makes total sense. A few people have told me to not let mine use me as a dummy as it's "only comfort feeding" and to delatch during the "pudding" phase you describe. But I have ignored this and let him keep going, as he seems quite happy and peaceful feeding semiconscious. He's gone from 50th to 99th percentile in 10 weeks and this probably explains why.

Thanks! I suppose I need to exclude dairy which is a real pain as I eat/drink loads :(

The arching back and crying could be silent reflux?

Oh andno eczema, breathing is fine,just the green pooandoccasional unexplained crying

Thanks greenbananas. I often hear fore and hind milk mentioned but discounted. I know that it's important to let baby lead at the breast and finish when he/she is ready.

I read about lots of mums getting really stressed about whether their baby is getting the right amount of the right bits of milk. I've never read anything definitive that doesn't contradict itself in the end!

Well a couple of days of making sure the toddler has the top of each boob, and the poos have gradually got less green, and this morning's was back to yellow :)

Si I reckon its a lactose overload problem not CMPI, but i can revisit if necessary.

Thanks for the help :)

That's great news about the poo hopefully that's all the problem was.