About a month ago we saw a lactation consultant on the advice of our Maternal & Child Health Nurse (MCHN). Since birth, PartyPie had only fed for a maximum of ten minutes on one boob and wouldn’t ever take the other side. I know that size of boobs is irrelevant to milk supply, but the girls were really cranking – PartyPie would often pull away and streams of milk would shoot either across the room or into her head.
By the time she was two or three weeks old she was having tummy pain. The lactation consultant was ace, and said that I had an oversupply of milk which caused lactose overload (something often confused with lactose intolerance). What this means in terms of PartyPie stomach pain is fairly simple. Breastmilk is lower in fat at the beginning of a feed, and this low fat milk is also very sugary. This is often called the ‘foremilk’. Once the baby gets through the foremilk, the milk becomes creamier and fattier – this is called the ‘hindmilk’. It is the hindmilk that really satisfies the baby and fills them up.
Being a newborn, PartyPie‘s tiny stomach could only hold about ten minutes worth of my mega gushing milk – and so she only ever got the low fat sugary foremilk. This went through her very fast, and made her hungry again soon after feeding. It also gave her horrible stomach pain. She was having up to maybe 15 wet nappies a day and scary, fizzy poo. The pain in her tummy would make her scream – and generally being a pretty chilled out baby, having her screaming in pain, writhing and trying to climb up our chests was truly awful.
The lactation consultant suggested that we do ‘block feeding’. This just meant that instead of swapping boobs from feed to feed, I was to keep her on the same boob every time she ate during a three hour block. Then swap, and do the same thing. This also meant that my milk supply wasn’t being stimulated so often and it would thus settle down, and that she would be getting to the hindmilk.
This settled things down within a day or two. The scary poo stopped. The stomach pain stopped. In retrospect, the oversupply persisted, but we didn’t recognise this at the time – and I went back to sort of a mix of block feeding and swapping from one boob to another each feed. Things then got worse – instead of scary poo PartyPie began straining desperately to make poo. She would groan and whimper in her sleep, and wouldn’t be able to stay on the boob during a feed because she was straining so hard. She became a farting machine. (I have to point out here that it’s fine for breastfed babies not to poo for weeks at a time – this wasn’t the problem – it was the straining and pain that was the issue.) The pain was very cyclical and would disappear and she would go back to being a happy little button.
When she did manage to poo it was not an issue, and it was not hard or weird. She was not constipated, she just had terrible gut-acheing pain with straining. The MCHN suggested tummy massage, warm deep baths, massaging her legs and, if this didn’t work, some warm water with a bit of brown sugar in it. The last suggestion is for constipation, so we didn’t try it. Massage helped a little, but not really. At our six week check up with the GP/Obstetrician on Wednesday I was taken off dairy, nuts and iron supplements. I admitted to eating a plethora of sashimi, and so was taken off raw fish as well [sob]. An appointment was made with a paediatrician next week. It was suggested we video PartyPie‘s tummy pain in case she didn’t turn it on when she was examined
Yesterday, after a night of PartyPie being really distressed and screaming with pain, we called the birth centre she was born at – they said if we were concerned, we should bring her in to the emergency department. We jumped in the car and spent the next 90 minutes sitting in emergency at Casey Hospital in Berwick. We were seen by a doctor. Naturally you can’t expect doctors in an emergency ward at 6am to be breastfeeding specialists, or even baby specialists – but you could reasonably expect them to listen, evaluate and not be instantly dismissive when told about the previous diagnosis of oversupply.
This doctor did not take one minute to listen to what we told him. He shook his head when I told him I had been taken off dairy, etc, and said that PartyPie was obviously lactose intolerant. M explained that this was not the case, as PartyPie was thriving in every other way – putting on weight, lots of wet nappies, reading the newspaper every morning etc. etc. The doctor told M he was wrong, and if that we didn’t want to listen to him that it wasn’t his problem. What we needed to do, he said, was put PartyPie on to lactose free formula. We looked at him blankly. Que?! He repeated that we needed to put PartyPie on to lactose free formula. M explained again that it was lactose overload and the doctor said we were basically idiots who had become too friendly with google (well, he didn’t actually say it, but he didn’t need to…).
With this suggestion he fulfilled all my suspicions of the medical profession dealing with babies and reinforced all the reasons why I chose to have a waterbirth in a birth centre attended only by midwives. Casey is supposed to be a baby-friendly hospital, but he wasn’t even people-friendly, and definitely was not going to listen to anyone other than himself. Arrogant fucker. I want to hunt him down, kneecap him, and make him read this, among other things.
We left, and sneaked on up to the birth centre to ask some midwives for their opinion. They said that as they only dealt with newborns, they couldn’t give medical advice; they were, however, horrified at the suggestion to whack PartyPie on lactose free formula. We talked to them for a while, and they were nice enough to even call us when we got home and make a few more suggestions.
Of course, during this whole time, PartyPie had been model baby and had not fussed or screamed or groaned at all and we definitely appeared to be over-anxious freaked out first parents. I had completely forgotten the advice I had read which said “If you go to the emergency department with your baby? Always tell them it’s your third child so that you’ll be taken seriously.” D’oh.
Anyway, M and I sat down and tried to nut out the problem. We came to the conclusion that we had probably not persisted long enough with the block feeding, and despite the fact that PartyPie no longer has scary poo (when she deigns to produce some) that her oversupply problems were still present. We returned to evil google and found a description of oversupply which listed 21 baby symptoms – 16 of which PartyPie has. The site did not say how to treat it, as it cautioned that a correct diagnosis needed to be made before going ahead with treatment.
Then I found an article in the International Breastfeeding Journal called Overabundant milk supply: an alternative way to intervene by full drainage and block feeding. The case studies it used were interesting. It suggested draining both boobs by pumping before commencing a block feeding regime. So that’s what I did (and using a breast pump is very weird, btw, and it took me ages and lots of deep relaxing breaths). This was at 2am last night.
The article mentioned that often when the baby feeds immediately after the breasts are emptied they get a decent feed of the fatty hindmilk and then go to sleep full and happy. This is pretty much what happened. So far, PartyPie has not had any tummy problems and has been sleeping well. We see the paediatrician on Monday. I’m keeping my fingers crossed.
The reason I have gone into such elongated boring detail is to record it for myself, but also to help any other desperately googling overly milky person with a baby with a sore tummy – just in case it helps. And if you’re interested, this is a really cool article on colic from Dr Jack Newman’s site. I can’t believe I just typed that last sentence. Sigh.
M wants me to add that he still wants to move to the highlands of Papua New Guinea where it takes a village to raise a child and these sort of problems [i.e. colic] are relatively unknown. He also wants me to link to The Continuum Concept – a book he’s been going on about for around a billion years.