Poo is back to green- MW says baby not getting to hindmilk - any advice?

[ElmMum]

After some good big yellow poos last week DD has gone back to doing green poos - bit like pesto - and her weight gain has slowed down. Midwife today said that's probably because she's not getting to the hind milk.

Any ideas about how to make sure she gets past the fore milk and into the hind milk?

Background...

She's 16 days today, is feeding 6, 7 or 8 times a day depending, goes for a good half hour each time before nodding off on the boob. She's gulping well all through and then dozes.

The last couple of days we've made an effort to rouse her with burping or nappy changing and putting her back on. Most often, she latches on again but pretty much goes straight to sleep. A bit of quick sucking and sighing, but no gulping and swallowing.

Have tried tickling feet, back of neck, hands, stroking cheek, tapping forehead etc. She just dozes through it all and seems very content.

I wouldn't worry except for the lack of yellow poos.

Any advice??

from my experience, babies produce poo in many colours of the rainbow.

inc green.

my baby had this and thought it was same prob too - not enough hind milk otherwise known as lactose overload - tried expressing some before feeding - tried everything suggested infact. on reflection i think that it was combination of immature baby gut and will pass and the fact that i was taking lactulose cos I daren't poo through my stitches. Are you taking this?

green poo can be a sign of a lot of foremilk, however I doubt that if she has fed for half an hour on one breast that she would not be getting enough hind milk (LLL now try to discuorge the use of the words fore and hind milk anyway). Breastfed babies weight does not follow a normal weight curve, there are often plateaus. If she is passing urine, soft, regular stools, waking for feeds and alert when awake, warm to the touch and well prefused then I wouldn't worry.

Generally, when people start talking about foremilk and hindmilk its a good sign that their breastfeeding knowledge isn't what it could be. At the start of the feed theres a bit less fat in the milk, and this increases as the feed goes on - theres no cut off point

Do you offer both breasts per feed ? Switch nursing where you offer 4 sides or more per feed can be helpful if she genuninely needs to gain more weight.

At her age she does need to be feeding at least 8 times a day though, so maybe just offering more feeds is the way forward

If she seems ok and is producing wet and dirty nappies then I agree not to worry.
I thought that the foremilk and hindmilk issue was a bit of a red herring anyway, is its not important.
Have you looked at www.kellymom.com for info?

My breast feeding consultant told me this whole foremilk/hindmilk is a load of nonsense.

She said there isn't a sep. tank in each breast for each type of milk, so obviously it's a mix. It will be more watery at the very beginnning of a feed, to help quench her thirst, but then, it's a good creamy mix and she'll be getting plenty in half and hour, even if she is on/off sleep/awake.

Reminds me so much of my DD when she was wee. I even resorted to taking her out in teh cold nigth air to try and wake her up a bit. Still didn't work, beacuse the milk was like a drug and she just went straight to sleep.

She's a sturdy 2 year old now though, so I wouldn't worry if you can help it. It sounds to me like you're doing all the right things.

Cosima - I'm not taking lactulose but we did wonder whether it's something I'm eating that's making her poo green.

Cmotdibbler - I don't offer both breasts, no. I just go with one side and put her back on that side after attempting to rouse her a bit i.e. during the same 'session' IYKWIM. Usually we end up doing somewhere around 30 - 40 mins per feed on one side. Next feed we start on the other side.

I remember DD having green poo at about the same age (I think she was 3 or 4 weeks) and it worried me as I had heard about the not getting enough hind milk thing.

I spoke to my dad who is a GP and he said not to worry about it as she was feeding well, seemed content and having wet nappies etc etc.

After a week or so her poo went back to normal.

I would try not to worry, it sounds like she is feeding well and there is no cause for concern apart from the poo colour. Give it a week or so I'm sure it will go back to yellow.

BTW my feeding was the same, one breast for one feed the other for the next and it worked for me.

well also tomatoes causes green poo in my baby , infact anything citric - grapefruits etc

Interesting! I do eat a lot of tomatoes. Not sure about the citrus thing though - last week I was drinking lots of orange juice to go with iron supplements and she was doing yellow poos. This week I've not had any orange juice and poos are green.

sigh there's not rhyme or reason to any of this newborn lark, is there!

But I'm reassured that I prob don't need to worry about the green poo too much!

Thanks all x

well oranges are different to all other citrus fruits i think, one is alkaline and all the others are acid or something like that.

I think it will pass but its stressful with a brand new baby. I thought i had ruined mine but now he's gorgeous

DS's poo went through all shades of green and yellow when he was exclusively BF. If all else seems well and you are feeding on demand then I don;t think it's too much to worry about.

have you tried offering the other breast after she has had a full feed on the first side (eg the part you describe where you wake her back up again/nappy change etc then put her back on again). not sure if it would help or not with green poo situation though

Green poo is on the normal spectrum.

To talk of getting past the foremilk and into the hindmilk is very confused and confusing. Fat content of the milk is related the degree of fullness of the breast, and nothing to do with time on the breast...very full breasts = less fat; less full breasts = more fat.

Frequent feeding ('6,7 or 8 times' is prob rather less than most 16 day olds need) is the way to go, with both breasts used each time.

Hope this helps.

This explains the foremilk/hindmilk thing very well. Maybe you should show it to your HV to clear up her confusion too .

most common reason for green coloured poos in newborn babies is unabsorbed iron. This means if she is otherwise healthy and putting on weight then you have a high iron content in your milk and your baby is taking all she needs and passing out the rest.

Is she colicky and windy as well as doing green poos? DO the poos come out in violent explosions? If she is content and settled but doing greeny poos it's probably nothing to worry about.

If you are concerned that she's not feeding often enough then try carrying her around (in a nice ring sling perhaps?) or having her on your lap, rather than putting her down between feeds. Babies of this age can literally feed in theier sleep, so unless you have sore nipples there is no reason to take her off the breast if she appears to fall asleep, just leave her there. At this age I would expect her to be feeding every coupld of hours during the day, and every 3-4 hours during the night. Carrying her or keeping her on your lap will actually encourage her to feed more, so she will gain weight and you won't be getting "full" or engorged breasts so she won't get gallons of "foremilk" so your HV will be happy!! LOL!

If it is something you are eating there are a few likely culprits, dairy is the most common one that babies pick up on through mothers milk, but tomatoes and wheat and citrus fruit can also give some babies belly ache. As a rule though if it is a food intolerance (to something you are eating) then she will be unhappy and windy/colicky too, and possibley possetting/vomiting or have silent reflux.

Monkies

ds has had green poos on and off since birth (now 19 weeks), and I've posted about them here a few times The last period of green has lasted about 3 weeks! I haven't been able to correlate colour with anything in my diet. Through all that time he's grown well and is happy and healthy. Don't worry about the colour, focus on how she is in herself and let her feed often

fiodyl - where have you got that info about iron from? It's news to me (not disbelieving you). Iron content of breastmilk does not vary a lot between mothers.

ElmMum - when you say your baby's weight has slowed down, what are the figures?

And I see you only offering one side per session. I worry about mothers being told to do this. Babies in the early days should always be offered both sides - otherwise the risk is that breastmilk is not built up and maintained. Who told you to do it one side only?

at the poor level of info bf mothers get.

In my experience, poos may go a bit green every now and then, but then go back to yellow again soon after. I haven't been able to find any reason for the green ones either.

I also want to echo tiktok on the offering one side thing. I had a problem in the early days with my dd and weight, and it was offering both sides that really built up my supply and got things going again (that was tiktok's advice as well!). All midwives I came across in the early days told me that all recent advice said just to feed on one side. One even said this was the advice of unicef... So, elmmum, I would really advise that if you want to accelerate weight gain offering the second side after your lo has finished the first is the way to go. You'll often find that he/she wakes up a bit then as well after you've winded him/her.
Hope that helps!

tiktok- biology lessons at school- we did alot about the effect on diet on colour/consistency of poo!!

If an adult has a large intake of iron(night out drinking guiness) they will get dark black/green poo. But bcos a newborns 'normal'poo colour is yellow( as opposed to brown in adults) iron shows as a geeny grey.

I didnt know that iron content is fairly standard in breatmilk, so maybe its just cos the baby has a very good iron store from pre-birth so doesnt need much more.

FF babies often have green poos cos they put so much added iron into formula- but babies obviously dont need it.

Actually that is interesting, as the iron in formula is in a less easy to absorb form that it is in breastmilk.
I was told green poo may indicate colic.
As for the foremilk/hindmilk, I think of it as turning on a hot tap, first the water starts off cold then gradually gets hotter and hotter.

Oh forgot to say, my ds had green poo between 2-3 weeks, and it just went away. He was fine throughout, weight gain was fine so slow weight gain and the green poo aren't necessarily related.

fiodyl - you have got this wrong, then. You are extrapolating what you have learnt about an adult's digestion to the immature and very different gut of a newborn. The colour of the newborn's poo does not reflect iron stores - at least I cannot see why the baby's iron stores would be excreted in the poo in this way....PLEASE don't make things up when you do not know the answer.

The reason some formulas give the baby greenish poo is not the iron either - but the type of vegetable fats used in the manufacture of the formula.

Green poo can be normal in a baby. It reflects gut transit time. The bile juices turn waste material yellow, if the waste matter stays long enough in the gut. If it speeds through relatively quickly, it has less time to turn yellow. Gut transit time is affected by a number of factors - sometimes, it's a stomach bug (which means the gut works faster), sometimes it's less intake of fat (which may or may not be an issue). In an otherwise healthy baby, the colour of the poo is not a sign of anything actually wrong, but with a very young baby you'd want to ensure all was well by checking everything else out.

Midwives who think babies should only have one side offered to them per session have badly misunderstood the research, and I wish training was better in this respect.