Newborns are born with immature digestive systems. Breast milk is the absolute best thing for
their immature system, but even under normal conditions, their
bodies/bellies/guts/and little butts are learning how to digest (and poop out)
food for the very first time, so some difficulty and a “learning curve” is
normal and to be expected.
However, even Moms who are exclusively breastfeeding might
observe digestive issues in her baby that she would consider greater than
normal: frequent spitting up, watery, green and/or mucousy poop, gas, or
discomfort which leads to frequent crying, reflux, etc.
There are two VERY COMMON (more common than not) issues that
can cause these digestive problems, and even if you are aware of them, it can
be difficult to tease out WHICH of these things is the true issue or if it
could be both.
Oversupply
The first most common issue is oversupply which can be
coupled with overactive letdown and typically a foremilk/hindmilk imbalance
. MOST Moms are made to nurse
twins—evolutionarily it makes sense given the odds of twins and the fact that
before formula, a baby who lost their mother during childbirth or who was
separated from their mother for any length of time would need to be nursed by
another mother also nursing her own baby.
It is literally more common than not to have SOME amount of oversupply;
meaning that when the Mom’s milk comes fully in—usually between 5-10 days
post-partum, they might find that they have much more than they need.
It is a common misconception that more milk is better. In fact, it is best for your baby if you are
making the exact right amount of milk and no more.
Oversupply causes a fussy stomach for several reasons:
One, the fast flow of the milk means that the baby is taking
in extra air when he/she is nursing.
This extra air causes gas and discomfort.
Two, the milk that comes out at the beginning of a feed
(foremilk) is very different than the milk at the end of the feed
(hindmilk). The milk at the beginning is
watery and sugary, almost like milk-juice.
This sweet milk gives baby energy and motivation to keep them
nursing. However, the milk which comes
out when the breast is getting more empty is equally, if not more
important. The hindmilk is much thicker
and fattier, the “cream”. This thick
milk sticks to the stomach and makes it easier to digest.
The problem arises because oversupply means that often the
baby gets full on the foremilk—they are already done nursing before they get to
the “cream” which comes out of a more empty breast. This foremilk is much higher in the sugar
lactose, and lactose is much harder for a baby to digest. This will cause watery, green poops, and
stomach upset.
Additionally, babies whose Moms have oversupply will sometimes
actually have LOW weight gain because they have so much trouble getting to the
fatty milk.
I think there is a further issue with oversupply which is
rarely discussed—it is SUPPOSED to take WORK for the baby to extract milk from
the breasts. Babies who are used to a
high supply do not have to work very hard to get milk out. This can cause issues later when the supply
regulates because the baby finds himself for the first time having to work hard
to eat. Many Moms at this point (3-5
months) will start to notice issues like bottle preference or fussiness at the
breast.
In my opinion it is GOOD for your baby to learn IMMEDIATELY
that life isn’t easy and that you don’t get something for nothing. You can think of this as the first way to
build self-esteem and self-efficacy. You
are teaching your baby that working hard will reward them, a lesson that is
never too early to teach in my opinion.
Babies whose Moms have a regulated supply have much more patience and
determination, not only for nursing but I believe this translates into other
areas of life as well.
Oversupply can also cause issues for the Mom: nipple pain.
Because the milk is often flowing too fast for the baby, they will clamp
down on the nipple to reduce the flow. I
can tell you from experience: OUCH.
Food Allergies and Sensitivities
Another very common issue is baby reacting to one or more foods in the Mom’s diet. About half the time, the problem is dairy. The next most likely culprit is wheat, after that, soy. Some babies will have issues with caffeine, also, or you can have one like mine who basically reacts to EVERY food in existence.
Another very common issue is baby reacting to one or more foods in the Mom’s diet. About half the time, the problem is dairy. The next most likely culprit is wheat, after that, soy. Some babies will have issues with caffeine, also, or you can have one like mine who basically reacts to EVERY food in existence.
However, luckily, half the time, eliminating dairy in the
Mom’s diet will solve the whole issue.
Our society has a growing awareness of food sensitivities,
and it is increasingly common to discover sensitivities to dairy, wheat,
gluten, soy, etc. Luckily it has never
been easier to lie allergy-free.
Like oversupply, food sensitivities can cause watery poops,
gassy stomach, frequent spitting up, and colic.
So if your baby has a fussy stomach and is exhibiting these
symptoms, what is the problem? Is it
oversupply or food sensitivities? It can
be very difficult to tease apart the problem, but there are a few ways to tell.
Oversupply will often start causing symptoms from the first
week or two. Mom will often feel
engorged, experience her milk leaking, letdowns when the baby isn’t hungry . .
. the baby will often be satisfied with only one side. If the Mom ever pumps and can get more than 4
ozs per side, that is a sure sign of oversupply. Again, the nipple pain is also a very good
sign.
Oversupply is often linked to an overactive letdown…this has
many tell-tale signs. After a minute or
a few minutes of nursing, the baby might
start fussing—come unlatched and cry, or be sputtering and choking on the
milk. Mom sometimes sees her milk
spraying at this time. This is a
definite sign of oversupply.
Oversupply will more often cause GREEN watery poops,
sometimes in huge diaper blowouts. The
green is evidence of the excess lactose in the milk.
Baby will have issues from the first or second week and the
symptoms would usually get BETTER over time, though some Moms unknowingly make
the problem worse by pumping off extra milk.
Supply is highest in the morning and lowest at night. If you have oversupply you might notice the
most spitting up and discomfort in the morning and early afternoon, while the
spitting up is less frequent at night.
HOWEVER MOST babies have fussy evenings and want to nurse frequently in
the evenings, so this can be a hard thing to gauge.
Oversupply, especially in the absence of excess pumping,
will get better over time instead of worse, often resolving itself between 3-5
months.
Meanwhile, food sensitivities look a little different.
Most food sensitivity issues will not be present
immediately. If oversupply is not an
additional problem and it is ONLY food sensitivities, Mom probably would not
see many digestive problems in the first month.
However, between months one and two she would notice an increasing
problem. Weeks 6-8 is the most frequent
time for food sensitivities to start causing major issues.
Food sensitivities will also cause watery poop, and it can
be green. However it is much more likely
to be mucousy, and BLOOD in the poop is a very good sign that it’s a food
sensitivity issue. It is less likely to
see diaper blowouts. With my son I
NEVER saw “seedy” poops until we eliminated all problem foods. It was VERY watery.
With food sensitivities, you would notice more of a variety in babies’ symptoms from day to day. Instead of spitting up equally after every feed, you would more likely have occasional large amounts of spit-up and not as much on other days/times. You would notice the digestive issues being worse after you eat certain meals and less of a problem on other days. However, if you are someone who eats a LOT of dairy, wheat, and/or soy with every meal, it can again be difficult to tell if the issue is food-based.
With food sensitivities, you would notice more of a variety in babies’ symptoms from day to day. Instead of spitting up equally after every feed, you would more likely have occasional large amounts of spit-up and not as much on other days/times. You would notice the digestive issues being worse after you eat certain meals and less of a problem on other days. However, if you are someone who eats a LOT of dairy, wheat, and/or soy with every meal, it can again be difficult to tell if the issue is food-based.
Food sensitivities can also cause other issues such as a
rash (most typically on the face), and/or a flushed red blotchy look to the
skin after nursing. It is much more
likely than oversupply to cause weight gain issues, colic, or reflux.
Food sensitivities from week 8 will typically get WORSE over
time (from months 2-5 or longer). Some
babies do gain the ability to process the sensitive food eventually, though, so
after getting worse it can start to get better.
Hopefully this will help some Moms figure out which of these
things (if not both) is causing the baby’s issue! I will write about dealing with each of
these problems in a separate post.
