Lactose intolerance?

[Lallas' Mum]

Any suggestions, advice or comments in regards to breatsfeeding a lactose intolerant baby?

With my first son, I was told he had a slight lactose intolerance. So we experimented with lactose free diets for me, lactose free formulas for bub, lacteasy drops in EBM. Nothing was terribley effective in calming down his projective poos and constant wind. He was however diagnosed with a urinary infection a day later and we were told that his intolerance was probaley due to his infection as he seemed completely normal within a couple of weeks. He went on to be completely breastfed with no special diets needed.

Second bub is here now and oh the trouble we are having!! He has explosive poos that projectile out rather constantly. He wiggles and cries and screams when he passes wind (which is usually accompanied by a splatter of poo). He will only sleep if elevated. All in all it is looking like he may have an intolerance. The CHN has suggested a go on a lactose free diet as well as avoiding the wind trigger foods such as chocolate and cabbage etc. She also suggested expressing the first 30mls of a feed to remove the high lactose containing foremilk and letting bub feed on mainly the hind milk.

Has anyone tried these things that have been suggested and if so did they work? Does anyone have any other suggestions or ideas. I have seen a paed about the problem yet has we are going to trial these things for a week before we decide what to do next.

Tracey
Mum to Alec 19 months and Zak 3 weeks

PS bub is gaining weight very well despite his problems.

[xkwzit]

Hi Lallasmum
Maybe less foremillk / more hind milk is a good bet.

My DD1 also had projectile poos and my paed and lactation consultant recommended against feeding on both sides because of this. They both think that if you feed both sides, baby gets a second dose of that high lactose foremilk, which can upset them. So they recommend feeding only on one side at each feed to ensure that baby gets that really helpful, creamy hind milk that does wonders for weight gain. I am not sure what your feeding regime is, but offering only one side may also help the balance of fore and hind milk.

(I was amazed at the many different tricks my lactation consultant had about breast feeding - I had no idea how many subtle variations there were on such a simple thing as offering a breast to a baby)

Cheers

[Milly]

Hi there!

Here is a link to a great article from the Australian Breastfeeding Association on Lactose Intolerance.

Lactose Intolerance is often frequently misdiagnosed in babies and is actually extremely rare. If your baby is thriving and gaining weight well, it is probably unlikely that he is lactose intolerant.

Anyway, the article explains it all and could be of some help and offers some great suggestions to help you. Here is the link:
http://www.breastfeeding.asn.au/bfinfo/lactose.html

All the best!

[Lallas' Mum]

Thank you Milly for that very helpful link.

I really think that I need to see the paediatricians about bub. We have only fed him on Lactose free formula since yesterday evening and we are starting to notice a few changes already. Bub is getting to be less windy, irritable and defineatley is passing a lot less watering projectile poos. In fact he hardly poos at all now. I have been expressing in the meantime to keep my supply up and so we can use lacteasy drops in them. I have been getting 120mls in less than 10 minutes on one breast. I don't know how much is too much or too little. But I am very keen to get back to the CHN next week and give her the results.

I keep getting such conflicting advice that I really think I need to have a better medical opinion. Especially since reading the article on the Australian breastfeeding association website.

Once again thanks for the advice.

Tracey
Mum to Alec and Zak

[lil monkey]

Hiya,

We had exactly the same problem with my bub after she was 7 days old - the screams of pain and kicking of the legs with wind and projectile poos, the irritability and crying etc etc. I tried to have no chocolate, cabbage and wind producing foods or dairy an that didn't help. We went to the paediatrician who said it all sorts itself out at around 3 months but perhaps she has reflux and indeed she did have it because as soon as we started on the medication she showed dramatic improvement. Sometimes reflux isn't always obvious and the signs for us was the gulping noises she would make - like I said they weren't obvious signs for gulping but it did happen!

[Milly]

Hi again!

Glad that the link was on some help. It is so frequently misdiagnosed that it is amazing, so it is great the ABA has that article.

Also, it is actually a big myth that you have to be particular about what you eat when breastfeeding and all those alleged 'gassy foods' like cabbage and chocolate garlic and spicy foods actaully have no effect on your baby. It is an old wive's tale. If you ate those foods when you were pregnant, your baby would have already have been introduced to them via the placenta. So, don't panic about that too much. Also, explosive poos are not that unusual, and does not nesessarily indicate a problem and many healthy breatfed babies have explosive poo. It is quite normal. Additionally, the other symptoms appear to be that of Colic, which is usually a result of overstimulation. Babies don't need much at all to be overstimulated. If you read either Dr Harvey Karp's "Baby Bliss" (aka "Happiest Baby on the Block") he talks about 5 easy ways to soothe a colicky baby or Dr Howard Chilton's "Baby on Board". So, that could be all it is too. My DD had expolsive poo and appeared to have a pain in her gut in the early weeks, but it was just a bit of Colic and removing her from stimulating situations to a quiet dark room usually did then trick. The baby has come from the warm cosy womb to the outside world, and it is a very big shock, so that is a contributing factor to Colic. The minutest amount of stimulation can make them irritable. A newborn baby has not yet learnt to self soothe. Also, you will find that around 3 months the colicky symptoms will almost disappear overnight. They grow out of colic as they have learnt to self soothe.

Your baby does seem to have some mild reflux too, but this can be easily fixed too whilst still maintinaing breastfeeding. Here is another ABA link that could also be of interest in that department. http://www.breastfeeding.asn.au/bfinfo/reflux.html

Have a good chat to your peadeiatrician and if you are really concerned, see about getting into them before the 6 week check up. I hope that all is okay and that your worries can be simply fixed. Anyway, just some suggestions that could be of help.

[mimi]

Milly is SOOO right in what she has said! also, lactose remains constant in breastmilk regardless of what you eat - Lactose is necessary for brain development, warding off bugs etc etc etc, so that is probably why! If bub has lactose intolerance it would be a very rare condition and you will know very soon - with weight loss etc. I would probably check out the pages Milly has posted and also see the paediatrician if bub is loosing weight and you are still worried!

[mimi]

Forgot to mention that many exclusively breastfed babies with colicky or reflux symptoms do very well if mum removes all cow's milk from her diet - a reaction to the cow's milk protein going through the mum's milk into the bub causes the symptoms and they are stopped when the offending protein is removed! Easier said than done, but quite worth it. there has been research done on this so it is not some 'new fangled idea' I just came up with LOL !

Good luck with it all.

[Lallas' Mum]

Just thought I'd take a minute to thank everyone for their advice and to give an update on bub's health.

Bub was diagnosed with a milder form of intolerance and mild reflux. The reflux isn't too much of an issue as keeping bub elevated after feeds and having a thickener added to his milk keeps things in line. He does however suffer terrible bowel discomfort from lactose hence his screaming when passing gas and explosive poos. He has been on a lactose free formula for three weeks now and whenever breastmilk is reintroduced the pain and discomfort starts again.

There is hope for the future as he should be able to cope with some dairy later in life but will probably be able to "clear the room" (so to speak) if he has too much dairy. One of the consultanting paeds at the hospital said that he has a slight intolerance to lactose and just gets a bit windy if he overdoes the dairy. So I am holding out hope all will be well for Zak's future.

I was considering giving him a breastfeed once a day to offer the benefits that BM brings but it just upsets his tummy too much and is doing more harm than good. So I have admitted defeat and decided to have a healthy and HAPPY formula fed baby.

Once again thanks for the advice.

Tracey
Mum to Alec and Zak

[mimi]

Hi again

Good to see things are improving for you, Tracey!

I thought I knew most things there were to know about lactose intolerance - but it seems there is always something new to learn!! I never knew that one could be born with such a thing as a 'mild intolerance'.

I was told that my son had lactose intolerance and also, probably reflux, but I soon learned that that was nonsense! [the difference with my boy being, he didn't have a really bad reaction to breastmilk alone, as yours does, and it was only after we introduced solids at 6 months that they suggested lactose intolerance. I later discovered that breastmilk has much more lactose than cow's milk - and the thing he reacted to was the PROTEIN in cow's milk ... not the sugar!! silly doctors!!]. It seemed weird at the time, as all I had read told me that only 0.1% of babies were born with this - though 70% of the world's population [and 100% of some races] are lactose intolerant by the time they are about 5 yrs of age - we no longer need breastmilk to survive by then, so don't need the lactase anymore apparently! So I thought we were pretty unlucky, especially as there was no history of it in either family. Oh and the reflux possibility was ruled out too, once foods with cow's milk in were removed from the diet!

My GP is also lactose intolerant [not born with it tho'] and she can eat a small amount of cheese and yoghurt with no problems - just can't go overboard!

Hope your little one keeps doing well! Best of luck.