Help! 3 weeks of diarrhoea + GP who doesn’t understand BFing

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My EBF 6mo has had diarrhoea for just over three weeks. At its worst it was 20+ dirty nappies a day. For the last 10 days we are down to 7-8 a day (still a lot more than the previous one a day or even every other day before diarrhoea started). The poo is green and sometimes frothy, sometimes mucusy -nothing like the normal brown. Obviously we are v worried about this!

She went to the GP last week for a stool sample which has come back clear. GP says it is likely to be secondary lactose intolerance, and that this means I must cut all dairy products out of my own diet so my baby can get better. This isn’t remotely correct from my understanding - breastmilk is full of lactose regardless of what I eat, surely?

GP also advised we should delay weaning onto solids until the diarrhoea resolves. But it’s showing no sign of improving further and my baby seems desperate to start solids - grabbing at food wherever possible. I’d be very grateful for any suggestions as to what might improve the diarrhoea, whether the lactose stuff is right, and if we should continue to delay solids.

GP has said we should go back for another appointment if no improvement by the end of the week. I’m a bit reluctant to though as I don’t really trust her to know what she’s talking about now!

He means cows milk lactose intolerance...humans are not really designed to eat dairy from another species, so they mean you cut out cow dairy products from your diet.

She I mean

It might be cows milk protein intolerance in which case cutting out dairy from your diet will definitely help. It could take 4+ weeks though to see an improvement.

Reallyreally do you mean CMPI? I really don’t think that is connected with lactose intolerance.

In any case, I am vegan! So I don’t consume dairy products anyway - it’s therefore definitely not that causing the diarrhoea. And she's only had it for 3 weeks, so presumably something started it then.

I guess it could be a bug which developed into secondary lactose intolerance - but for so long? And what do I do about it if so?

My boy has cow's milk protein allergy, he had the symptoms you're describing. I cut all dairy but it was still bad. Then I found out soya has similar proteins to cows milk so I cut that out and it made all the difference. Might be worth a try?

If it does turn out to be that I'm afraid there's not much can be done until she grows out of it.

Your doctor is not wrong, it’s definitely worthwhile trying it. They mean dairy based on cows milk.

Also, are they cutting teeth by any chance? One of mine had rampant diarrhoea like you describe when cutting teeth and I had to change to hospital use barrier creams as they were also red raw. Teething is not meant to result in such a severe reaction but it certainly did with my child (yet not with the other) - for every single tooth, and there were periods where a few were cutting at once or immediately one after another and they suffered for prolonged periods as a result. We had to have stool testing and a letter from the doctor to say they were fit for child care (nursery) as child care had never seen anything like it and claimed teething could not possibly cause that and it must be something else.

Since posting this I’m now even more baffled! Kellymom and everything I have read online about breastfeeding (La Leche, BFN etc) says that lactose intolerance is totally separate from cows milk protein intolerance, and that secondary lactose intolerance can come on temporarily in infants after a stomach bug. It is not improved by giving up dairy.

In any case I don’t consume dairy! So it really can’t be this. I see what you mean about soy 88mph, but why would that start one day after 6 months of problem-free breastfeeding?

No signs of teething yet. Would that really lead to 20+ dirty nappies a day? On NYE it was so bad we couldn’t put a nappy on her at all as it would instantly need changing, so just had to sit her on a towel. My DC1 had runny teething poos, but nothing like this.

OK I have (reluctantly!) made another GP appointment. I don’t know what to say to her though if she starts suggesting I change my diet. I really don’t want to start cutting out food groups without some more solid evidence...

How is your supply?
Oversupply can cause green, frothy, explosive poo too. What's her weight gain been like? Mega gain and green froth could indicate an abundant supply that you may need to work to suppress a bit.

Also have a look at your diet - is there anything in particular that you've recently added or increased consumption of that coincides with the start of the poonami?

Soya can be as tricky to digest for little ones as cows milk, so it's worth cutting that completely for a while to see if it makes a difference, then adding it back in gradually to see if there is a change again.

I had oversupply at the start, but it settled down around 8 weeks. My baby is now over 6 months so I don’t think it can be that.

Long term breastfeeder here who had a short period where cutting milk products for myself whilst breastfeeding made all the difference.

However, you are vegan, so 88mphs suggestion may be one route, and very interesting, I had never heard that before. I have however heard of babies who didn't react well to the soy formula they were put onto.

One half of my family has citrus intolerance (??), and get loose stools and bowel issues when they eat oranges, pears, raw tomatoes (not citrus I know) or fresh lemon. Only as a suggestion, could these be causing irritation via your breastmilk?

Don't quite understand about delaying solids till the problem resolves. Have you thought about Baby Led Weaning, where the child is allowed to messily grab food and feed itself, thus choosing itself what it puts in its mouth. Theoretically it would avoid any foods which upsets their tummies.

Also in some cultures (Russian i think) they wean babies onto non milk foods starting with meat broths and fermented milk products, as these latter are full of probiotics. Please of course research thoroughly and take my suggestions with a pinch of salt.

www.babyledweaning.com

Thanks for all the suggestions!

Yes, I did BLW with DC1 and would definitely do it again. But we were advised not to introduce solids until bug (or whatever it is) has cleared up, so as not to upset digestion potentially further. But as diarrhoea shows no sign of clearing up, presumably we can’t delay indefinitely!

If it’s is something in my diet that’s upsetting her digestion, I simply don’t understand how it could come on overnight. For a full 6 months breastfeeding has been fine, and baby happy, healthy and gaining weight. Then BAM! Boxing Day morning the diarrhoea started and hasn’t gone away. I haven’t changed my diet at all in the meantime.

If could be lactose intolerance. Was colief suggested at all as it breaks down lactose in formula and breastmilk and could help until your lo's lactose levels increase again? If you wanted to give solids then carb rich foods can help firm up poo.

And yes, cutting lactose in foods will not help as breastmilk is full of it

www.breastfeeding.asn.au/bfinfo/lactose.html this suggests 4 weeks or sometimes a bit longer for the gut to recover

My boy was fine until he was about 4 months old, he wasn't diagnosed until 6 months. I'm no expert, but as far as I know it can take time for the protein to build up enough to cause a reaction.

I hope the GP is able to find a solution this time, it's horrible seeing them sick and not being able to do anything about it.

I think I would have a word with my health visitor.

Apart from the nappies, which have now decreased, how is your child? Unsettled/losing weight? I ask because I posted a picture 2+ years ago of a frothy, green, scrambled egg type nappy which became the norm for my ds between maybe 3-6m. He didn't have so many per day tho. Gp didn't look at sample just said he's thriving, no need to investigate lots of reasons why it could be grgreen it resolved by itself with solids. If he's been thriving and gaining and sample came back clear, I think I'd move on with soluds and see how you go.

You are right about the lactose, your body makes it regardless of diet. I would also try colief though.

Mikado, she’s mostly OK. A bit more unsettled, obviously stomach is uncomfortable sometimes, lots of wake ups in the night with wind (and sometimes poo), but still her usual jolly self lots of the time. Her weight seems to have plateaued a bit but no weight loss.

Pixie, 4 weeks?! Right that seems likely to be it then and we just have to wait it out. Not sure what I should do about solids in the meantime then.

I would give them a go..

In any case, I am vegan! So I don’t consume dairy products anyway - it’s therefore definitely not that causing the diarrhoea

this is kind of crucial, and I'm not sure why the whole conversation with gp etc wasn't just nipped in the bud by you saying you are vegan!

For what it is worth, my friend's dd had massive milk allergy - drop of milk on back of the hand caused her hand to swell.
She was EBF and she only managed to bring the baby's allergy under control once she went dairy and egg free herself, even though the evidence form her online research was split as to whether it should effect her brest milk, in her experience it did massively effect her baby.

this is kind of crucial, and I'm not sure why the whole conversation with gp etc wasn't just nipped in the bud by you saying you are vegan!

I know! But the GP's response to that was "oh, then it can’t be secondary lactose intolerance, can it?” - which as far as I can tell is absolute rubbish.

Doesn't sound like they knew what they were talking about at all! Lactose is the sugar in all milks whereas a lot of babies have issues with cows milk protein.