fore milk hind milk imbalance..any thoughts..

[Animom]

Hi..my DS is nine weeks and is EBF..he has recently started going 3 hours between feeds..since about a month now he has been having green runny poos (goes once or twice in a day)..our pediatrician ran a series of blood and urine tests couple of weeks ago, which all came out ok (thank god for that)...since DS is gaining weight steadily...the doc doesn't see any issue..

I'm just wondering if anyone else here has also faced such an issue..I have read at several places about fore milk n hind milk imbalance causing this problem..

So my question is how do I know if I have fore milk hind milk imbalnce, what can I do about it and how can it affect my baby?

Any thoughts, experiences...

[newkidontheblock]

http://kellymom.com/health/baby-health/m2m-green-stools/

HTH!

[trimbler]

Hi Animom, we had this too! For us, turned out to be a combination of oversupply (have a read of this Oversupply and Overactive (Forceful) Let-Down and see what you think?) and tongue tie which made it hard for her to persevere to the hindmilk. How is she feeding? Is she gassy or uncomfortable at all? For us, block feeding really helped with the stools, although I took some convincing as I wasn't sure that I really did have oversupply! Are all his poos green and runny?

[Animom]

Hi...thanks for your replies..yes DS has green runny gassy stools everyday (~2 poos everyday)..have a few questions about block feeding

1) DS takes one side at each feed...i tend to have more supply on my right side..so I should just offer the left side fir few consecutive feeds right?

2) also my supply tends to dip significantly during ovulation and periods...hope this will nit adversely impact that

3) what about growth spurts ...hope no adverse affect

4) also when DS is bit older n starts taking both sides hope it will not bbs problem

Its just that I don't want to be in a situation where I struggle with milk supply issues later on..so just want to know your experience

Also how quickly were unable to reduce / normalise milk supply n how quickly fid your baby's stools change...

thanks fir your replies in advance..

[trimbler]

Ok I'll do my best but suspect others with pitch in

1) I'd start by doing LLRRLL... For a few days and see what happens, but if he doesn't seem satisfied by the second feed on a particular side then you're fine to offer the other side afterwards.

2-4) as above, if he doesn't seem satisfied after a feed at any point, just offer the other side, this has been my experience during a GS. I've ended up doing alternate sides again and sometimes even offering both sides at a feed for a couple of days during the GS and then the green stools have returned so I took that as my cue to return to block feeding!

Personally, apart from GS I continued block feeding until we both got the flu a couple of weeks ago. That reduced my supply and I've had to work at getting it back up again, doing some extra pumping and switch feeding, but I think we're getting there now... But that was the flu rather than block feeding, as long as you're still giving her what she wants and she's satisfied then I wouldn't worry about reducing your supply too much. DD always had so much urine I knew she was getting plenty!

The other thing I forgot to mention which you might want to try first, is feeding in a reclined position and massaging your breasts near the chest wall before feeds, both of which can help to increase the fat content of the milk she gets. Actually my LC told me that this can often be enough to put an end to the green stools, so do give it a go. Also don't worry about the odd green one, we've had this since block feeding but less, and much less mucous, don't know if you've been getting the mucous too?

[Animom]

Thanks so much for your reply...will try the massage n then block feeding n see how it goes...yes get the mucous too..(that's what led to all the blood n urine work up :[ )

[trimbler]

Let us know how it goes, and don't forget the reclined feeding

[trimbler]

How's it going?

[Animom]

Hi...i have been doing breast massage along with reclined feeding but has not made much of difference...i have not really tried block feeding since my supply seems low atmp (seem less full n DS has been feeding quite frequently at night) due to approaching AF...so guess I would be more confident when my supply is back to normal...though with lower supply also there is no improvement in poos...makes me wonder whether its something else...

Will keep you posted once I sincerely try block feeding..how quickly did your baby's poops improve once U started block feeding..

[trimbler]

It could well be something else... But it's so hard to tell isn't it? I was convinced I didn't have oversupply and yet block feeding was very effective, however I didn't have the confidence to do it until I'd seen an LC, who also diagnosed tongue tie and silent reflux. Getting the latter two sorted meant that DD was much more comfortable during feeds and so she could more easily get to the fattier milk further on, however I started block feeding before the tongue tie was divided and that had already made a difference. Do you think either of these things could be an issue for your DS? My LC said she'd known at least one baby whose green stools disappeared the day after a tongue tie snip! I was so surprised by the tongue tie diagnosis as I had never had any pain or discomfort, but DD had never seemed that happy at the breast and I'd always thought her latch was a bit shallow.

I can't remember exactly but I think it was pretty much the day after first block feeding that the poos began to change, ie the time taken for the fattier milk taken that day to come out the other end! I didn't completely end the mucous and we still had green stools but far less frequent. Also I guess you'd expect the mucous to take a little longer to go as it can be a sign of irritation and it could take a little longer for the gut to heal.

I should say I don't see myself as an expert, just been there with green poo! But I'm sure one of our lovely mods would jump in if I'm leading you in completely the wrong direction

[Animom]

Thanks so much for sharing your experience trimbler...one thing I have noticed over last 2-3 days (since low supply) is that few stools have been more yellow than green though muocus is there (but like U said that may take some time to go)...My DS is due for vaccination this week n I will surely ask the doctor to check tongue tie...

Never had this  problem with DD1...though she had silent reflux, she was a good eater..so this is just new for me..lets hope block feeding changes things..will surely keep you posted once I try it out...

[trimbler]

Ah that's interesting, we also had much yellower stools when we both had flu and af on top so I knew my supply was low. My DS also had silent reflux and fed very well, normal stools and soared through the charts! If you think tongue tie may be an issue, do look it up yourself first (sorry I know there are links on here somewhere and there are others, I'll have a look...) and see what you think, just be aware that many doctors don't have the expertise to diagnose it, some LCs may even miss it (the first one we saw did, but we'd already booked with another anyway who was the one to diagnose) so if you think there's an issue, don't be afraid to get a second opinion.

[Animom]

Hi...just wanted to update...

our pediatrician referred us to another specialist reg the green stools and we consulted him yesterday...he says most likely it is fore milk hind milk imbalance and told me to block feed n just to be bit more relaxed while feeding n not to think about it while feeding as it affects quality of milk...he says if there is no improvement in 10 days then he will put me off dairy..he has also given some probiotic for DS...also he says that the green stringy thing we see in his poop is actually bile and not mucus...

my AF is almost over and I thought of starting with block feeding from today morning..bt DS has got a cold since yesterday night n is not feeding that well...i was thinking of pumping my milk...should I do that on a regular basis till DS gets better n starts feeding like his normal self
..or should I just express only when uncomfortable...

I think Timbler was in a similar situation..any suggestions?

[trimbler]

Glad you've been able to see a specialist. Well, extra pumping with oversupply is not really recommended if you can help it, but by all means do so if you're uncomfortable. But of course if you think you're not producing enough at the moment then you could pump, best to offer him an extra feed here and there and try not to worry too much, but when it was me I did pump and didn't manage not to worry - didn't need to though Actually my supply seems to have dipped a bit recently, assuming af on it's way but I've only had one so far so not regular yet. But I've only pumped a little for cereals. Just been offering both sides as she wants. If you think fore milk/hindmilk is still an issue at the moment you could always try pumping after a feed to get the fattier stuff, then try giving it to him in a bottle before offering the breast next feed. I was given that advice previously but DD wouldn't take a bottle...or a syringe, or finger feed! Sorry hard to advise remotely...

[Animom]

Ok..I've just been offering the breast whenever he is interested in taking it...though he is not taking much at a feed due to the cold...have just totally stopped watching the clock for today n trying to go by his cues..

Pumping after feeds to get hind milk is a good idea...though have not tried a bottle so far...may be once the cold settles down n if things don't improve with block feeding I could give that a go..was thinking of introducing a bottle of EBF at 3.5-4 months anyway ..thanks for the suggestion..

BFing was the only thing right with DD1 (she had reflux nbhence lot of sleeping issues n was a touchy baby) and I was so confident that this would be the one thing that ibeoukd be able to easily manage with DS2...but guess every baby is different..may b it will take some more time..