I have heard many moms talk about their struggles with breastfeeding, but they seldom go into detail about what that struggle actually meant for them. Even I’ve been quite vague about it in previous posts, but now that I’m confident that things are on track, I’m willing to discuss what’s been up these last seven weeks.
Nico had “perfect poop” for the first two weeks of his life. First he passed the meconium (the sticky black tar-like poop that babies collect in utero), then his poops went green as my colostrum came in (pre-breastmilk), and then they went to yellow when my breastmilk came in. But when Nico was 2 weeks old, his poop went from yellow back to green. Wanting to know more about why this had happened, I made mistake #1: I Googled it! The internet told me that it could be a milk intolerance, an infection, or a hindmilk/foremilk imbalance.
Quick lesson in breastmilk: The consistency of breastmilk changes from the beginning of a feed through to the end – it starts off as thin watery foremilk (to quench thirst and provide lactose) and finishes off as richer thicker hindmilk (that provides fat and calories and keeps babies feeling full). If a mamma has too much foremilk, the kid fills up on the watery stuff and a) doesn’t get the calories he needs to thrive, b) doesn’t feel as full and wants to feed more often, which leads to “snacking” and aggravates the problem (because the kid doesn’t stay on the breast long enough to get hindmilk), and c) usually has bad gas and explosive, frothy green stools, which are both caused by the high levels of lactose in his stomach.
So… armed with this info, and without consulting anyone, I made mistake #2: I decided to block feed. I still fed Nico on demand, but he could only feed on the same breast for a 6 hour period. (so, say from midnight to 6am he may feed three times, but always from the left breast. Then from 6am to noon, whenever he’d feed it would only be on the right).
This was a huge mistake because all it did was reduce my milk supply!! His stools went from pea green to a really dark seaweed green. I could tell he wasn’t getting any bigger either.
At this point I was so worried about it, I finally decided to go to a breastfeeding clinic hosted by a certified lactation consultant.
October 20, 2011: My first time at Milkface, I was a little worried, a little frazzled, and didn’t know what to expect. But meeting with Barb the lactation consultant, and chatting with the other moms made me feel so much better. Barb asked me questions about his eating and pooping habits, as well as any concerns I was having with his feedings. We weighed Nico before his feeding, then weighed him after he fed on one breast. Turns out he had only transferred 2oz of milk, which wasn’t enough and accounted for his poor weight gain in the previous weeks. We discovered that because my let-down was so strong (that initial rush of milk when a baby starts to suckle) Nico had become a complacent feeder, only drinking during the let-down and not working too hard on sucking the rest of the milk. Barb showed me how to use breast compression to get him to drink more fully throughout the whole feeding. She also told me it was very important to offer him both breasts at every feed (even if he doesn’t take the second, it should still be offered) to get my milk supply back up.
That day I felt 1000 times better. But all it took was one bad feed (sputtering at the breast from a too-strong let down, followed by major fussing at the breast and popping on and off) wiped away all of my newly-found confidence. All that week I kept thinking his stools would switch back to yellow right away. I’d psych myself up at every diaper change, hoping to find yellow poop. I was always crushed when it was still green. That week I cried a lot during feedings. I started to hate breastfeeding. I wished I didn’t have to do it. I was feeling really low (and alone). My mistake #3 was thinking things would get better overnight.
October 27, 2011: I went back to Milkface, and updated Barb on our situation. The poops were still green, and now I was dealing with a child who choked on my milk whenever he fed. Barb inspected my breasts and his latch, and told me that my supply had gone WAY up. In fact, my breasts were engorged and I was now dealing with an oversupply problem. However, I felt way better when we discovered that he’d gained 10oz that week, just by using breast compression and offering him both breasts. Barb assured me that we were on the right track and that his stools would turn yellow in the next few days.
So I went back home and waited, and tried to maintain our good feeding pattern. Sometimes we’d have good feeds where I could see him swallowing deeply and consistently. But sometimes we’d have bad feeds where he would fuss, choke and sputter, and do this high-pitch whine while on the breast. Those made me saddest of all, I couldn’t even comfort my child by feeding him (which is often seen as the surefire way to calm a fussy baby). I waited two weeks before going back to Milkface in the hopes that things would improve. But still the green poops remained.
November 10, 2011: I went back to see Barb, but because it was a particularly busy clinic (there was a lineup of moms waiting to be seen) I felt I didn’t have her full attention. She still weighed him and jotted down notes on our progress, but things felt a little rushed. Barb changed our nursing routine again: She wanted me to give him only one breast per feed, and to make sure he properly drained it by using breast compression. This was to help with my engorged breasts and would regulate my milk supply to meet Nico’s needs, and stop him from choking every time he fed. It’s important to note that I was to alternate breasts at every feed, and that I was doing this under Barb’s supervision with weekly weigh-ins to make sure my milk supply didn’t drop too low.
Again, I left feeling like a million bucks, but that night Nico was extra fussy and still needed more after his last feeding before bed. I broke down and offered him the other breast. I started not to care about green poop anymore – I just wanted to make sure my baby was getting enough.
I had begun to suspect that our breastfeeding problems was due to Nico’s latch, and that he was actually pinching off the milk flow and therefore not getting to his hindmilk. I felt like he couldn’t ever drain the breast adequately.
November 17, 2011: I put Nico on the scale myself, and was shocked to see he had gained another 12oz in one week. I could see the other moms look on with envy when Barb walked over to the scale and read his weight out loud. A lot of those moms were battling poor weight gain and low supply, and would have killed for a 12oz week. But one thing I’ve realized is that breastfeeding issues come in all sizes and colours, and they all require just as much work and attention to resolve. I made sure Barb watched me as I latched Nico on, and showed her my nipple once he was finished. She assured me that his latch was good. She said if it doesn’t hurt and he’s transferring a good amount of milk, than his latch is good. It doesn’t have to be “textbook” in order to be efficient. I told her that sometimes I gave in and offered the second breast – she told me that was absolutely the right thing to do. She reassured me that things really are getting better, and to have faith that his stools will turn yellow eventually.
This week, feedings have been much better than they ever have before. I barely have to do breast compressions anymore (maybe 2 or 3 times at the very end of a feeding). Sometimes he takes one breast, sometimes he needs two (especially in the evenings). He drinks deeply and methodically and can drain a breast in under 10 minutes. (I really thought the days – and nights – of 45 minute feedings would never end!)
November 21, 2011: officially known as “the day the yellow poops returned”. For the first time in 7 weeks, Nico had a fully yellow poop. And I was ecstatic!
So there you have it. Thanks to those who stuck with me throughout this whole post. I hope it shed a bit of light on what moms may be dealing with when they talk about “breastfeeding problems”. Breastfeeding did not come easily for me, and I made some mistakes along the way, but now I’m very confident that everything will work out and we’ll be able to enjoy many more months of happy feedings.