Is my boy getting enough calories from my milk? CONTAINS A NAPPY PIC <<Title edited by MNHQ>>

[TheBerry]

I have become really concerned that my 5-week-old isn't getting enough calories from my breast milk.

I've definitely been struggling to eat enough, due to anxiety (discussed anxiety with doctor already), but I'm really trying to force the food down.

However, in the last week or so my boy has gone from having several normal poos a day to just one or two massive poos. These poos seem more watery (though maybe that's just due to the volume) and maybe have a slight green tinge to them (photo attached). I'm not sure if this is a cause for concern, or if his digestive system is just changing.

I also think my breast milk seems too watery. Sometimes he still seems quite fractious after a feed, and he definitely struggles with the fast letdown sometimes, whereas he used to normally seem soothed after a feed.

I can't weigh him at the moment as I'm away from home. He doesn't look too thin, but that's probably not a reliable indicator.

How long is he feeding on one breast? Are you switching?

The poo looks ok to me and breast milk does look watery compared to formula or cows milk. So I wouldn't worry about that.

On the other matters, have you considered contacting La Leche League? They supported me when I was struggling with breastfeeding DS2 and their advice was invaluable.

It's normal for the frequency of poos to reduce after a few weeks. Is he still doing lots of wet nappies? The poo looks fine to me. If you are concerned, contact your health visitor and get him weighed, as long as he's gaining weight and feeding regularly as well as lots of wet nappies he should be doing fine! Breast milk looks watery at the start of a feed, the thick stuff baby gets at the end (hindmilk) which is the fatty stuff, so make sure you are keeping him latched until he comes off himself x

The poo looks completely normal.

While you shouldn't starve yourself, your milk will be fine even if your diet is poor, it's you who will suffer first. Breastmilk is a blood product and not made directly from food as such.

You want to change him approx every 2-4 hours and look for wees as well as poos. As long as he's having at least 6-7 wees and/or poos within 24 hours that's fine.

Don't worry, don't try to manipulate his feeding time - follow his lead.

It’s normal for breastfed babies to go ages without pooing after the 1st few weeks. Mine once went about 2 weeks I think. Was absolutely terrified, and then more terrified of what was to come out. It’s to do with there being so little wastage form breastmilk I believe. If he’s doing 1or 2 big poos per day he’s getting enough.

oh and your diet won’t affect your breastmilk. Obviously it’s not great for your own health and energy levels to not eat a nutritious diet but even a woman who is severely malnourished can carry a baby and breastfeed. It’s happened. So please don’t worry about that as it will make your anxiety worse and create a viscous cycle.

Thanks very much everyone for your replies. It's really reassuring. I'm glad that my breast milk shouldn't be affected by me not eating enough, although obviously I'm still going to try to get my calorie intake up.

He normally feeds 10-15 minutes on each breast. Is that ok? I do sometimes take him off a breast after 15 minutes and switch him to the other one, but that's because by that time he rarely seems to be swallowing any more and I think is sucking for comfort more than anything. But I may be wrong.

I'm glad his poo looks normal, too.

I'm feeling better now after reading these replies.

Timing of feeds varies between babies and sometimes between feeds, so it's less helpful to count minutes and better to look at the baby. It's normal for their sucking to slow down after a while and even for them to take long breaks between swallowing, but he is still getting milk. It's beneficial to leave him on until he falls asleep or comes off by himself. But occasionally if you need/want to do something else it's OK to interrupt this slower, sleepier feeding - just don't think it's pointless because it's not :)

You can try block feeding (so feed only from one breast for 2-4 hours and then switch) and that means he’ll be getting the rich, fatty hindmilk from each breast.

But from what you’re saying I don’t think there’s anything to worry about. One of the best things about breastfed babies is that they don’t poo often usually! The breastmilk has very little ‘waste’ that needs to be emitted so that is super normal.

As he gets older he will get much more efficient at removing the milk, so you’ll find he feeds for less time. 15 mins sounds about right. Just keep an eye on his feeding cues and feed as a when.

That’s a healthy breast milk poo. When you get home try to find a breastfeeding peer support group so that you can get advice, someone to observe a feed etc, but it sounds absolutely perfect to me.

My breastfeeding councillor explained that the fat is added to milk as it's pulled through the ducts by the baby rather than at a uniform percentage of fat per ml.

When they are sucking fast at first, not much fat gets added as it speeds through too fast. When baby starts slowing down after thirst / hunger is quenched then the milk is being produced much more slowly and more fat is added as it sits in the ducts longer.

So that's why the 'hind milk' is fattier / more calorie dense.

That slower sucking period is important so don't feel that you need to switch breasts too quickly.

Equally though I echo everyone else - the body will always prioritise the baby so no, he won't be affected by your diet.

But please do seek help for the anxiety etc and look at what high calorie drinks maybe you could add.

No don't do block feeding - sorry Ostryga, I know you mean well, but this is incorrect advice. Block feeding is nothing to do with "hind milk", this is outdated - what FusionCheffGeoff says is correct. Block feeding is a technique to reduce supply in cases of oversupply so it does have a useful purpose, but for OP who hasn't mentioned any signs of oversupply it is not appropriate and may cause problems.

Just to add the supportive comments here… my breastfed babies poo changed radically in frequency (several times a day to once a week) and consistency, but grew regardless.

My first child I was really worried about his weight but by my third child (so I hope this is helpful, as I’ve been where you were) I learned to look at signs of growth by other means - oh, that nappy size doesn’t swamp them any more, that babygro fits properly now, I wonder if this outfit the next size up will fit them, oh I’ve got to hold him differently so his feet don’t catch on the chair etc. And by looking at photos you can see they grow in a way you don’t notice day to day/week to week.

i hope you manage to eat more for you (and, I’m no nutritionist, but eat whatever you can manage right now - if it’s only cake and not fruit and veg, then so be it) and things feel easier soon.

Thanks all.

In fact, thinking about it, I reckon I DO have an oversupply. I definitely have fast letdown, and my boy often chokes and pulls off because he can't handle the flow. So, maybe I should try the block feeding.

I think the fast letdown is contributing to his reflux, too. It actually seems to be getting worse instead of better. Not sure why my body isn't adjusting.

It sounds like you are doing brilliantly @TheBerry but please call one of the National Breastfeeding Helpline on 0300 100 0212 an have a chat with a trained Breastfeeding Counsellor as as @BertieBotts has explained some of the information you have been given here is incorrect. Please DON'T try block feeding without a further chat or you risk increasing the chances you will end up with blocked ducts and mastitis. The choking you mention can often be helped by simply leaning backwards to slow the flow of the milk down and is very common in young babies.

Thanks @Bert2e

I do think the fast letdown is quite bad. In fact, it seems to have got worse over the last couple of days. I thought my body was meant to be adjusting!

It sprays out so fast, and just spills out around his mouth and gets everywhere while he's trying to feed. He often chokes several times. I tried draining the breasts a little before putting him back on, but it just keeps spraying and spraying.

This morning I did just let him feed from one side, and finally after about half an hour the flow seemed to slow enough for him to calm down and swallow it properly.

There's definitely something weird going on. I'll call the helpline, thank you!

Oh and I've tried leaning back many times and unfortunately the milk still just pours out 🙁