4 weeks in and struggling

[Nousername2015]

FTM here so would really appreciate advice/other experiences please.

Ds was 1 month old yesterday and is currently EBF. 2 weeks ago we started having green poo and I have learned this could be either milk imbalance or CMPI so I am currently off dairy. I have been block feeding to try to correct the imbalance but we have still been having green nappies, however they are only early evening. The rest of the time they are normal.
We have seen a lactation consultant and also go to a breastfeeding group. Latch has been checked. Ds is a very frequent nurser (2 hour intervals are unheard of), gets a lot of wind, can be fussy at the breast, there is a fair bit of back arching and milk can leak down the side and is usually all over his face when he finishes.
Over the past 24 hours things have taken a turn for the worse and I'm now wondering if we can continue breastfeeding as I don't think he is getting what he needs. I have to admit that if we end up switching to formula I will view myself as a failure and I don't know where it will leave me regarding pnd.
Over the past day ds has been falling asleep at the breast and the length of time of feed has also drastically shortened. I've been doing the usual tricks to wake him up and also trying breast compressions to keep him feeding. This afternoon he became inconsolable, screaming and wouldn't feed even though giving cues. When feeding he has come off the breast crying and has resisted. He's been more sleepy today too. I managed to feed him in the laid back position and allowed him to self latch. We've had the usual amount of wet nappies but no poo for over 24 hours now. He has also been very farty/windy. I'm currently giving infacol before feeds when he started arching his back in feeds.
I know he's going through a leap at the moment, could this be related to that? If not, what could it be? It breaks my heart to see him like this and I am questioning if breastfeeding is working for us.

Reading your post reminds me of the first few weeks with my DD and her feeding. Turned out she was tongue tied - 100%. Have you had this checked? Once snipped everything improved and we're now 6 months in and doing great with feeding.

Also, it does get better as baby's digestive system matures and they become more efficient at feeding. DD only feeds for 5 mins at a time.

Oh and she only poos every 3-5 days too. When she screams at the breast, I don't force it. Green nappies aren't necessarily a bad thing btw - the whole foremilk/hindmilk thing has been debunked.

Thanks for responding so quickly mywey. Who would check for tongue tie? The hv or do I need to see a gp?

I am not sure what the Problem you're facing is? So one by one -

The green poo is on the normal spectrum - in itself the green poo frothy or not isn't a cause for concern of there are no other worries

Has CMPI actually been diagnosed? 4 weeks post partum isn't the time for drastic changes to your diet like cutting out dairy

The fore and hind milk issue is usually not so much an issue really if you're ensuring he's emptying a breast

Duration of feeds will reduce as he becomes a more efficient feeder

Is there a reason for trying to wake him up? If he is fussing and doesn't want it maybe he doesn't actually want it and it's his only way of saying no? If he roots and you offer and he refuses then yes by all means try in a calmer place but maybe let be for a while till he asks again?

How's the weight gain? Has any HCP advised of a need to intervene or do block feeding, dairy eliminating, colic drops, CMPI diagnosis, trying to "fix" the green poo (nothing to be fixed usually), waking up to to feed or the breast compressions?

If there isn't a need or a real problem perhaps just letting him be and take what he needs may help? :-)

And ebf poo can be once every few days they too a normal

My dd had green poo for weeks! It's normal at that age.

Also they get quicker at feeding as they get older, he might just be more efficient!

And all babies are fairly farty at that age.

Not saying there definitely isn't an issue, just that a lot of what you're saying sounds quite normal.

Midwife can check for tt. Try your local bfing support group. A heart shaped end to the tongue can be an indicator but better to get mw to look.

Agree with PP that lots of what you are saying is normal at 4 weeks pp so just go with it. Get lots of support from other mums and peer supporters at a support group. HVs are often not the best people to advise on bfing I'm afraid.

Oh and do you possibly have a fast let down? I do - milk squirting in everywhere - so I recline when feeding which is a big help and use a widgey pillow which takes the pressure off my back.

Oh and also it does get easier I promise.

I must stop putting "Oh" at the start of every sentence

Like others have said most of the things you mention can be normal for breastfed babies. Green poo's, falling asleep at the breast, farting lots, feeds becoming quicker, poo's becoming less frequent, fussing etc. I hope this is reassuring for you, it really helped me in early breastfeeding to know all these things were normal as there's lots of confusing info about, particularly on the Internet.

I wouldn't block feed for green poo's as it can reduce your supply and that's not what you want unless suffering from serious oversupply. I wouldn't cut out dairy without a diagnosed CMPI either. Infacol has no proven benefit, a placebo was more effective in trials! Is weight gain ok? Lots of wet nappies and managing laid back feeding is great. Sounds like you've been getting loads of confusing advice to 'fix' something when there may be nothing to fix?

I thought we were a few weeks away from the feeding times shortening and the decrease in stools - these changes have literally come on in an instant. If he was nursing efficiently, would he not leave it a bit longer between feeds? We are talking feeding about every 30 minutes all day.
The lactation consultant and breastfeeding support both advised of a milk imbalance and that green poo was a problem which is why I was thinking that way.
I do potentially have a fast letdown mywey, ds does often gulp at the time of letdown as if he is struggling to take in all the liquid. I have been trying laid back positions but I need more practice really. I'm also finding that rolling up a muslin and putting it under my breast helps too.

DS2 is 3.5 weeks and EBF. He's had green poo on and off since a week old, but I was told that if he is gaining weight and otherwise well, it cak be normal. He also nurses every 2-3 hours (usually 3 hours in the day, 2 hours at night ) and gets gas / belly ache sometimes. I'm just writing this as a lot of what you describe sounds normal to me, and I wonder if you are more anxious than you need to be. Is he gaining weight, and settled between feeds?

Where I live there are several support groups. Could you try another for a second opinion?

BFing is hard at the start and babies don't follow rules. I would def get tongue tie looked into and also continue reclined feeding as a fast let down can be overwhelming for a baby but could also explain the quick feeds.

If you want to keep breastfeeding though then do - your baby will be getting what they need if they seem well and still have plenty of wet nappies. It doesn't sound like your supply is low.

I also know it's not pc to admit but I am quite proud I struggled through those early weeks and am now 6 months down the line and my baby had nothing but breastmilk for all that time so I totally understand where you are coming from with your concerns about stopping.

No one should be telling you that green poo is a problem. It is well within normal.

Please get another opinion. Everything you describe in your post can be normal in a new baby.

It is way, way over the top to change your diet.

Some of what you say can be explained by you trying to get him to stay on longer than he wants. The back arching and the refusal and the fussiness - all possible reactions to this.

If your baby is thriving then perhaps think about continuing the move you made today - letting him self attach and bring responsive to his feeding cues.

Of course maybe there is something going on, but I bet my bottom dollar it's not cows milk protein intolerance :)

I don't see the need for infacol either, from what you say.

If your baby is well, and growing, think about chilling a bit, letting him set the pace, and reviewing in a week or so if things are still the same.

It's really sad you are thinking that any of this means BF is not working for you.

Hope you find things get better and you regain confidence.

Ps. There's maybe a bit over supply going on here. Easily dealt with. But a month old is a bit too soon to be sure of it.

Thank you for taking the time to reply, I appreciate you taking the time.

I'm not overly anxious, no more than the usual first time mum really, just very new to this and needing to build confidence. Antenatal groups and books haven't done a very good job as reflecting reality and none of the other mums in my antenatal group seem to be experiencing the same things as I am which is why I was thinking there is an issue.

I have gone back onto dairy this morning, I hadn't excluded it completely but was drinking goats milk instead. At least I can use up the cheese and yogurt in the fridge now.

The back arching and fussing was going on before I was trying to extend feeds so this is not a result of anything I've done. He was less fussy last night when I was letting him self latch.

I think he's just extra fussy at the moment due to a growth spurt/this leap business, we didn't get a lot of sleep last night and he was very tough to settle which isn't something I'd experienced before. Still today is a new day so I'll carry on, onwards and upwards as they say.

We also got 2 poos last night, 1 green and 1 browny/yellow.

How has today been? My little one has been fussy today, and on and off me all day. I do think they just have fussy days at this age, but it does get easier.

Thank you for asking, we've had a much better day today. I've been making sure I offered both sides for feeds and we actually managed a couple of 2 hour stretches between feeds as I think I've managed to catch the feeding cues a bit earlier than I was doing. Still had our evening green nappy despite today's extra efforts but hey ho.

How are you getting on? I hope things are still getting better. The bfing journey is very special but it is tough too.

Not great yesterday, the day was fine albeit still with very frequent short feeds. I called our nct teacher about organising our reunion meet up, however she is also a lactation consultant and asked how we were getting on. Told her my concerns, her suspicion is that there is a tongue tie or s reflux issue. It's going to be hard to get a tongue tie diagnosed or treated but she has recommended somewhere to take him. Last night he screamed for hours, juat wanted boob but whenever I gave it he fought with me and came off crying, or gave it a couple of sucks and cake off crying. I think he fell asleep in the end through exhaustion. It was awful, really pushed me and dh to breaking point. I expressed into a bottle and dh tried with him but no luck.

I'm so sorry to hear about the screaming, we had this with my DS and it's very difficult to cope with I know! Looking back (he's 6 months now) I think it was a combination of wind and tiredness as it often ended up with hiccups then sleep. I also had oversupply which was helped by block feeding but I think makes comfort sucking difficult for them. We had green poos here too but they went back to normal and really weren't anything to worry about although I know they can look a bit alarming, especially when they change colour out of the blue!

All I can say is just try and take it one feed at a time, one day at a time and remember things can change so quickly and you'll suddenly realise that's not happening any more. You are doing the most wonderful thing for your baby x

Hey, sorry to hear about your troubles. I went through similar issues with my lo. I found the midwives varied significantly in how helpful they were. Have you looked for help outside the NHS? Other mum support groups/LLL or a pvt. consultant (more expensive). Where are you located? There is a website that lists these support groups - www.encyclokidia.com. Perhaps you can find someone more useful.

Hang in there. Something magical happens at 8-weeks. Bfing suddenly becomes easier. So many mums told me and it happened to me too.

This all sounds quite similar to my experience. My son is coming up for 14 weeks. GP checked for tongue tie, HV checked latch and no issues...he has milk down his face when he nurses and its on his face, he latches on and off and cries, takes me a while to calm him down and sometimes it goes on for so long he falls asleep on me without getting a proper feed...I have a very fast let down so I think he is on and off to cope with it (I end up with a very wet arm as it spurts so far, also have an oversupply issue as often soak through bra/pads/top) and this on and off causes him to be very windy so he fusses/cries etc. I set myself goal to get to 6 months with BF and despite the problems he's gaining weight and I just hope things will improve soon...sorry no magic answer from me just support that I share your frustration, arm/back ache and permanent state of covered in sticky breast milk! I figure we've done great to get this far so hang in there! X

Just to say green poo is only a sign that things are passing through the baby's digestive tract more quickly than usual. That can be for a number of reasons (including too much foremilk, an unsettled stomach, CMPI or a virus (DD always gets it when she has a cold)). When their systems are young and are maturing, it is definitely within the range of normal.

Re CMPI, it is more common than people think apparently. My gastroenterologist paediatrician said that except in extreme cases you don't need to fully cut out ALL cows milk (i.e. you don't need to be reading the small print on food packaging for the slightest trace of milk), often it is enough to just cut down (i.e. don't drink glasses of milk, eat yogurts or a mound of cheese, etc!). By the way, if they have CMPI they are also very likely to be allergic to goat's milk...

Sometimes babies just go through this colicky stage and you have to ride it out for a month or so. The thing the paediatrician emphasized was that the best thing was to keep EBF.

My DD improved a LOT at about 8 weeks.