Breastmilk causing digestive issues

[Odellio]

With my DS, I combo-fed at first (he was poorly in hospital and needed top-ups), then mostly breastfed with one nightly formula bottle. He self-weaned at 8 months, preferring bottles.

With my DD (now 3 weeks), I planned to do the same: breastfeed with one bedtime formula bottle. But she developed severe nappy rash at 1 week old — constant watery poos, bleeding sores, screaming, unsettled, pulling her legs up. We’ve seen the GP 3 times, tried every cream, and now she’s on steroid/antifungal/antibacterial cream with little improvement.

Yesterday, I switched her to exclusive formula and pumped to maintain supply. Within 12 hours she was calmer, stopped constant poos, and her rash started healing. I suspect lactose overload from my oversupply/fast letdown, as she was comfort-feeding often.

Now I’m torn. I want to give her the same as DS and continue breastfeeding, but formula seems to suit her better. Has anyone else experienced breastmilk causing digestive issues, and had to switch? Or is there a way to fix lactose overload and continue breastfeeding? (I’ve tried block feeding, sticking to one boob per feed and ensuring she empties boob already).

It's definitely possible to improve this, 3-6 weeks can be the most challenging. Your letdown/ supply will calm down in time but there are things you can do to help as you know. Is there any specialist bf support where you are? Midwife or HV can refer you usually. You can also call/ message the national breastfeeding helpline, they are great.

Could it be a reaction to something you have been eating? Might be worth getting this checked out.

Colief drops are supposed to help with lactose issues. Worth a try, you’ll know very quickly if they help I think

Also side lying feeding can help with fast letdown, it slows the flow a bit. Not sure if that helps with the lactose though, it’s more that it helps them not choke and splutter and take in lots of air if you have a “fire hose” letdown

I am hoping that with time her digestion will improve (6-8 weeks old) and I can go back to breastfeeding. She’s a completely different baby now on formula, not in pain or upset at all.

I will try out colief drops to see if that helps, but she can’t be lactose intolerant because lactose is in formula as well? So something specifically about the composition of my breastmilk? Doctors have referred for allergy tests, but can’t be milk protein because again she’s fine on normal formula.

I might try and slowly introduce my breastmilk into the bottles once her rash has completely cleared and continue pumping. Like 3/4 formula 1/4 breastmilk and work up.

She’s just had the most normal and reassuring newborn poo, much more like DS had and not watery at all. It all came out at once rather than leaking out poo every 10-15 mins. She’s on the mend. Just need to figure out if I can get her back to boob eventually or not.

Sounds like she is severely allergic to something that you are eating. You’ve ruled out lactose because she’s fine on formula. Do you really have the time , or the energy, to go on an elimination diet to work out what she’s allergic to when she’s fine on formula.
Also an elimination diet will be very hard to get enough calories in to make the milk. It is very illuminating though.
If she’s not suffering on formula and is a completely different baby, why put her through it because ’breast is best’. It is generally, but not always.

I guess because I would rather breastfeed if possible. Her being happy and healthy is my absolute priority though. I will exclusively formula feed if the breastmilk continues to upset her. If it is an allergy I’ve got to rule it out at some point, either now or when she’s weaning.

Well the most common allergies for babies and young children are dairy (can’t be if formula is ok), eggs and nuts. Shouldn’t be too difficult to eliminate eggs and nuts and see if that helps.

I think wheat, soy, fish and shellfish come next on the most common list - wheat is hard to eliminate but can be done.