Green poo for 2 weeks and counting

[hattie]

My 5 wo LO is exclusively breastfed and is pooing bright green since 14 days.

I have already read on the BFing boards that it could be due to too much lactose but wondered if you could tell me some more.  Basically I have consulted with a Peadiatrician here  who told me that my LO was hungry and the poo was because of being underfed but he is gaining weight very well and shows no other signs of any kind and a second doctor I spoke to told me not to worry about the poo at all that it was normal, but it is bothering me as I instinctively feel that it should be the mustardy colored less frequent poo it once was and I would really like to get to the bottom of it!.

Since they turned green, his poos are very frequent at least 6 or 7 nappy changes per day and peeing as normal.  He is 5 weeks old and my first.  He has always wanted to feed for a long time on both boobs and in the last few days this has increased even more - at least 30 mins on each boob.  I try not to take him off before he is ready but honestly he would stay there forever if he had his way and normally after 30 mins I have had enough!!! I have also been suffering from candida in my boobs for the last 2 weeks so that has made his long feeds really tough on me!
He sticks to EASY 3 hr pretty well is very content in general and sleeps 5 or 6 hrs stretches at night but with an hour long feed or two in there somewhere.

Does this sound like too much feeding could be causing the bright green poo?  Is it harmful to him?  I am contacting a lactation consultant about it this week but wondered if you could give me your thoughts.  Thank you so much for your help.

[yaya]

does dante ever seem uncomfortable when he is going thru green poo phase? TBH i wouldnt worry too much if he otherwise seems healthy

[Samuel's mum]

An overdose of lactose (i.e. from a baby getting an imbalance of foremilk) would usually be accompanied by not-so-great weight gain (as foremilk contains much lower proportions of the fat in a feed), also increased gas and digestive discomfort and perhaps even mucus in the stools. Green stools caused by a foremilk imbalance are often described as 'frothy'.
They can also be caused by a food sensitivity but again that would be accompanied by mucus/ froth/ discomfort and even specks of blood.
If his weight gain is fine, gas is not abnormal and stools are normal in consistency and it really is just a shade issue then I agree with yaya - I really don't think you should worry. In some cases green poo just happens and it really isn't a reason to worry.

[hattie]

Thanks so much for your replies.  He IS having painful gas sporadically (like today) and then accompanied by totally liquid bright green poo.   After going down the road of worrying that he is not eating enough I spent the last couple of days allowing him to feed as much as he likes and it seems to have made the situation worse. 

[hattie]

oops posted before had finished on poo rant...

I meant to say, made it worse in the sense that he does seem to be in some discomfort and the poos are more liquidy and more green.  Anyway, I will try not to worry as weight gain is normal!

[yaya]

hmmm sounds a bit diahorrea like? E sometimes has a really runny poo and it smells funny but its only occasional and i assume its something i'm eating...but ur situation is diff in that its all the time right? by natural reasoning from ur experiement...maybe hes feeding a bit over what he needs? comfort feeding? 30mins both sides does sound liek rather a lot, have u tried to do the oppositeof ur experiment and resitric feeding to 15 mins each side or something similar? i know BF babies ergulate themselves but seeing as u experimented ine way maybe try the other??? just a though sorry not to be of more help

[Samuel's mum]

I probably wouldn't restrict his feed in terms of time on one side (i.e. x number of minutes might not mean he gets to all the hindmilk) but you could try and restrict him to one-sided feeding so he has a good chance of reaching the hindmilk. And really make sure he has drained one side before you consider offering the second (breast compressions can help with that - see the breastfeeding FAQ page).

It's very hard to judge with the gas thing because 'painful' gas is pretty normal for a young baby.

Letting him feed as much as he wants will only go off-track if he then is seeking the boob for lots of different reasons (comfort, sleepiness etc ) and REALLY feeding frequently - that might be a time when he could take in more foremilk overall.

Try to go back to the feeding routine you were using before and really encourage finishing that first breast and see where you are.

[hattie]

Thanks, I will try to keep to one breast per feed, it takes him about a half hour to finish one, or at least to come off himself so I presume the breast is finished. Is there a better way to know a breast is finished? Last night we were up most of the night with wind and tummy ache and hiccups and frantic eating and pooing but as you rightly say, this is the norm for newborns really right? I guess I got lucky in his first few weeks!! I am going to read up about breast compressions and get going on a journal so I know where I am at.  Thanks for your advice Emma, I can't tell you how much it helps.

[Samuel's mum]

The best way to judge if a breast is 'finished (milk never completely stops as it's made constantly) is when a baby comes off himself. Some will stick on to comfort suck but the swallowing will really have stopped and the sucking been more fluttery for a while. Try and pay attention to the swallowing and see if you can notice it - you'll see it slow as the milk gets thicker and then eventually they'll be lots of sucks but very little real swallowing.

You are in classic 'growth spurt' terrority at around 4 weeks. That means frantic eating and frantic eating can cause more gas to be taken in because they tend to bob on and off more. Hope tonight is better.

[hattie]

I am starting to feel like maybe my BFing is doing him more harm than good.   
His poo remains very green and completely watery and frothy alot of the time (I caught it on exit today!) but the big change in teh last few days is that while before he didn't seem to be suffering digestive problems too often (maybe once a day for half hour or so) now he is really suffering after almost every feed about 45 mins later with what looks from his body and face and the screams like really bad pain and wet hiccuping, hiccuping, gassiness.  He gets totally hysterical and the only thing that calms him instantly is more boob, though I am trying not to give in and just to sit out the screams as I am conscious that would probably just adding to the problem.

 Feeding from one boob only the poo is still green but definitely better consistency though he is still gassy.
I have seen improvement in poo consistency and colour the couple of times I have been able to pump pre-feed but it's not always possible for me to pump for practical reasons, in fact, it is downright difficult.

My question now is, will I always have this problem when I BF and always be giving him too much foremilk despite my best efforts and need to be scrupulous re which boob he eats from and pump pre-feed or is this just a phase?  Another question is, should I offer the second boob after he has gone as long as he wants on the same boob or just stick to one? 
Feeds from one boob are still mega long with him, he moves to the fluttering stage at about 30 mins.  I am still having problems knowing when he is finished eating, often he screams when I take him off even after he has been on 25 mins but then stops screaming very quickly within seconds making me think he was full but I then have paranoia that I haven't fed him enough and offer the next feed too early probably and make things worse probably....

The thing is, I don't have boobs that spray or leak so I don't know for sure that I have an oversupply but it is my instinct that I do and I have alot of the other symptoms - frequent blocked ducts, strong almost painful letdown - gassy unhappy baby with green poo!!  Will things ever right themselves?

[Samuel's mum]

It's really early days yet. In the vast majority of cases oversupply does level out at around the 6-8 weeks mark (not for everyone though).

Your instincts are right - more feeding to comfort can compound the problem as he can get another dose of foremilk rich in lactose which can cause the frothy and gas. However it can work if you only use one side religiously and if he's desperate to feed again ONLY go back to the same side. Do not offer the second side. If you are confident about your latch a paci/dummy might help in this situation.
And if you offer the breast too early - that can also mean more foremilk if he isn't hungry enough to really reach the hindmilk.

You do need to be scrupulous about using only one side in my view. In some cases LCs will recommend 'block nursing' when oversupply exists which means the next feed is also from that same side (rather than the usual alternating sides).

I know you've spoken to doctors and peds but I would also recommend an LC or breastfeeding specialist. They can talk you through this whole oversupply thing and give you some techniques that really can make ALL the difference (like block nursing which I mentioned).

Don't give up hope. Everything you describe could be down to this oversupply/ foremilk imbalance issue and it really can be managed. Your bfing is not doing him 'harm' - you just need some support which makes you like most of us

[yaya]

throwing in hugs, ur so determined..well done, u'll get there in the end. I think my supply with emily 'evened out' around a month in (with T it never did, i had no BF info and had a lot of issues)

[Dee-An]

My son's poo was green for  awhile when he was very young, and I realized it was from too much fore milk and not enough hind milk.  What I was doing at night was compounding the problem, I would have him suck a bit from each side to alleviate my engorgement, but then he would get full on fore milk and not reach the hind milk.  I think you have to make sure he's getting the hind milk. And by all means keep at it.  Your breast milk is doing way more good than any formula will.  Babies have gas.  It's natural.  Though you might want to note if your intake of onions, or peppers, or broccoli etc has any correlation to his gas.  I know my son didn't like certain foods I ate.

[hattie]

Thanks so much for your support and I have been trying to watch what I eat to see if there are any obvious connections but there is nothing that pops out at me now, I haven't changed anything since I was pregnant in my diet.   I know for sure it isn't a lactose intollerence because when I gave that formula supplement on the advice of ped the other week his poo went back to mustard colour instantly....

I spoke to LC for a long time on the phone yesterday but yet to see her in person due to her schedule (hopefully seeing her monday) she backed up your advice Emma suggesting to pump pre feed but also said not to deny him boob if it calms him when having gas pains as she has never heard of too much feeding causing probs in BF babies and believes the problem is not in the stomach but in the intestine. I agree that the prob is in the intestine but I do feel that giving more boob just compounds the problem.

On my own initiative I have been offering the same boob for two feeds in a row (and not pumping pre feed) and he still goes 3 hours between feeds most of the time with this system but ladies, the green poo just won't shift!!! It is still there and he is still having intermittent bouts of painful gas ending in the green champagne poo explosion!!!!!!!!  Could it be that I am barking up the wrong tree and there is another problem altogether?  Also, sometimes the poor little guy is hungry after just two hours post feed and I don't know whether to offer him the same boob as I offered before or anticipate the next feedby an hour and offer the very full boob - does that make sense??  I gave him full boob two hours after 7am feed this morning because he wouldn't settle for sleep and seemed hungry still and then sure enough an hour or so later bad gas and reflux. 
When this is over I'm sure I will look back and laugh over my poo obsession....

[Samuel's mum]

You are offering the same boob to level out a possible foremilk imbalance but you may not get immediate results in his system. I would continue what you are doing for a couple of days before you decide something isn't working.

After 2 hours I'd probably try first with offering the old boob and if he still isn't satisfied you can move onto the next one.

It sounds as though he's getting gas from somewhere. I would also look at your latch and positioning and think about whether there's any area for improvement there. Hopefully the LC can help you there.
I'm not sure I agree with her about offering the boob for comfort as we do know about the links between a foremilk imbalance/ extra lactose and feeding very frequently not in response to hunger cues. He may be reacting to extra lactose in the foremilk but that isn't the same thing as a foremilk intolerance. But if your LC is saying differently then perhaps she will have something else to offer and you should go with the person in 'real life' who is able to observe him and observe a feed.

Think back to 2 weeks ago. Were there any chances in the way you manage feeds? e.g you moved to double-sided feeding from single-sided?

The bottom line is - green poo is normal for some babies and it's not the end of the world. Liquid poo is also normal and even the odd explosion. But if poo is constantly explosive and frothy and accompanied with gas pains it's worth a bit more investigation.

But as I say - give anything you try a couple of days. Pumping first, one-sided nursing, block nursing. Don't expect things to change in one day. It might take a couple at least.