Whats the matter with my 8 week old breastfed baby please-at end of my tether!

[fakeblondie]

My daughter is 8 weeks old.
I am a trained nurse and midwife so not completely a novice but still at the end of my tether and probably not even seeing reason anymore.

She has an explosive bowel movement everytime she strains in any way-thats sneeze, cough laugh move vigorously - we can easily get through 7 nappies at one change-unable to get one on before it literally shoots across the room.
She is solely breastfed and goes withinn minutes of being fed.
her persistant loose watery stools have caused severe nappy rash which was infected. She goes without a nappy all day and i just lay her on a towel all day and do the washing-hence we cant ever go out because she never doesnt have a dirty nappy and it burns her.
I have seen her rash worsen on days when she no nappy on all day !

Have tried anti fungals, strong steroids, antibiotic cream-the lot.
She had a 4 day course of oral metronidazole following a positive nappy rash swab which was sensitive to this antibiotic-while it didnt improve her nappy ulcers it cleared up her loose bowel movements (when we though it would make them worse ) so much so that this is when we realised it was in fact her stools that were the problem not the nappy rash.

She goes 40 + times a day.
I have a healthy diet.
I take 1 blood pressure tab a night-propanalol.
I do drink a glass of wine most evenings.

I have cut out diary and alcohol for a week and no difference was noted.
The only time we noticed an improvement was about 3 days after she finished antibiotics.
She was like a differrent baby for a few days and even her nappy rash went just using fucidin (antibiotic cream )and vaseline
She is weeing well.
She is gaining weight-massively-2600 kgs to 5070 in 7 weeks ! ( 5 10 - 11 lbs ) - so she gained over 5 lbs in 7 weeks !

Stool sample has gone today for culture and another for reducing sugars plus another swab.
I just want my lovely baby and my life back-i`m constantly bottom watching or crying because she looks so sore.
I had her for about 4 days well and it was absolutely fantastic. I thought it was all sorted but today back to square one.
I dont think the doctor believed me until she decorated his walls with poo literally today and now at least he is doing more tests.

Am i missing anything obvious because i am possibly becoming obsessed with the whole thing as its all i seem to have done since she was born is try and solve this-am i over worried /
Thank you so much x

Goodness how awful for you both. I think you and your doctor are doing the right thing. I can't think of much else to try except probiotics for you (these have been shown to make it through to baby and so may help). I would also try cutting out the alcohol completely for now and perhaps exclude gluten (bread etc) from your diet also. Failing that I think I would be tempted to try bottle feeding her (I realise thats controversial but in these extreme circumstances it would seem to be worth a trial at least).

does any of this sound familiar:

Oversupply

i have read this and feel for you- id try a differetn doctor or health visitor-or maybe ring a breast feeding helpline? how about you trying to have somehting like an actimel daily- maybe her tummy bacteria is out of sinc??sorry i cant help

I think it takes two weeks for a diet change to work. Can you try keeping a food diary of what you eat and how her poo and rash are to see if you can make some connection? I would recommend the probiotics as well esp if she's been taking antibs. Also if you drink peppermint or fennel tea it mighthelp if she has tummy problems.

As far as treating the rash goes I think you're doing the right thing with no nappy time. Try just using a warm face cloth and water with a few drops of tea tree and/or lavender to wash her and dry herweigh another v soft cloth or just blow on her gently! :) I would stay away from disposables completely iiwy. Ds had a terrible reactionto them when he was just born. We used moltex nappies for a while and then washables. I think sainsburys do an Eco nappy too which we had to use a couple of times with no ill effects. Maybe even just having them on at night is enough to flare it up again?

I don't know if you posted on the breastfeeding board but someone else there might have experienced this and be able to offer some advice.

You seem like a very caring mum and you're doing your best for her. HopefullY these tests will give you some kind of answer!

What did you think of Seona's link?

Is your BF regular? Does DS get the right balance of fore and hind milk?

We gave DD1 prebiotics (not too sure if they worked) and Colief drops helped before feeds.
We also topped up with formula whilst she seemed to be not absorbing much breast milk.

DD1 would always react badly to any wine I'd had so I had to stop completely.
Many others will tell you it's fine but I was one of the few, the effects were immediate though.

I have no medical qualifications but my instincts are saying that she is reacting to something in your diet and I think alcohol every night might be it? Or is there anything else you have a lot of or that is particulary strong/spicy?

How does she react to formula? I thunk I'd try that rather than be housebound all day and seeing her in pain

I really don't think introducing formula is a good idea if you don't know what is causing the problem. If there is a dairy intolerance, and you probably wouldn't know until you've cut out ALL dairy for about 2 weeks, then you could make it a lot worse - not to mention introducing all the other risks that formula brings and potentially compromising breastfeeeding but I'm sure you know all that as a midwife! :) . Seriously, have a look at the feeding board on here - there are some really great people who might be able to give you advice. Hope she's doing a bit better today. We've had a few upset tummies here over the last few weeks and the nappies have been woeful but nothing compared to what you're describing so I hope you see an improvement soon!

Have you tried expressing some of the foremilk and disposing of it and just letting her have the concentrated hindmilk for a couple of days? She sounds windy and colicky so maybe coleif drops might also help. She sounds as though she needs quality not quantity. If you tried this for two days it would at least rule out the oversupply possibility so you could then concentrate on food intolerances.

hi i remember now that my first son had something similar but not as bad and i rand laleche?? or someone and yes- i had to pump express out my foremilk and give hindmilk the calorific milk- my milk weas coming out too fast too so he was getting full of fast watery milk and exploding with his bottom straight away- it worked and also i had to offer the same breast for feeds for a bit and pump off the other breast/??

If your going to cut out dairy I think it needs at lest 2-3weeks before it's out of your system altogether.

If it is a case of two much formilk, then block feeding may help. Offering the same breast for 2-3 feeds at a time then switching sides. Although if weight gain is good this is possibly not the issue.

Good luck

If your going to cut out dairy I think it needs at lest 2-3weeks before it's out of your system altogether.

If it is a case of two much formilk, then block feeding may help. Offering the same breast for 2-3 feeds at a time then switching sides. Although if weight gain is good this is possibly not the issue.

Good luck

hi girls - update and pls excuse punctuation doing this one handed !
thankyou so so much - totally different baby.
it looks very likely oversupply.
my let down is so strong i let the initial surge go straight inot a muslin and give her the feed when the flow has slowed.feed from same side and one side .i caught the fast flow milk from both breasts in breast shells once and had to empty both sides twice collecting just under 8 ounces at one feed which is huge.
her bottom has healed.
she is doing normal breastfed poos.
when she feeds she obviuosly isnt choking and spluttering anymore either and only pooing a few times a day instead of straight thro her.
hope i`m not jinxing things by being so impressed -thanks again girls.i freally feel like our lives have changed. went out with my pram today and had coffee out with friends in the sun - yippee !! x

what a result. am really happy for you and dd x

Great news! :)