Expert: Sally Wendkos Olds - 2/9/2006

Question
My now 3-week old son was having foul-smelling watery stools and excessive gas for a few days.  I began pumping in the hospital due to latch-on problems so was mostly using the bottle to feed - he is now successfully latching on and I am combining breastfeeding with bottle feeding.  I initially had an abundant milk supply but had to use formula (milk-based) for the past 2 days because my supply decreased.  Since he has had formula his stools are not watery and he is not having as much gas - he sleeps better and is less fussy.  Another issue we had with breastfeeding was that I believe I have overactive letdown - he would have problems swallowing the amount of milk that came out at the beginning of a feeding.  My question is could my breastmilk have been causing his diarrhea - I am lactose intolerant, would this have anything to do with it?  If so, what can I do about it - I would like to continue to breastfeed at least until I return to work (when he is 8 weeks old.)  My son has gained back and now exceeds his birth weight and shows no signs of dehydration.

Answer
Dear Danielle,

First, congratulations for giving your son the best start in life by breastfeeding him!

I'm sorry to hear that you have had some start-up problems, but it sounds as if things are going well now, with  your son's good weight gain.

Even if you are lactose intolerant, as long as you are not drinking milk or eating any other dairy products, your milk should not be affecting your child. Babies are not allergic to their mothers' milk. However, sometimes foods that the mothers eat do make their babies gassy. I will excerpt some info from my book (see below) and hope that that helps.

On your overactive letdown -- it sometimes helps to express a little bit of milk first before nursing, so your baby will not get too much in his mouth at once. You can even save that milk if you put it into a clean bottle. Since your son is used to the bottle, he can take the milk a little bit later. I devote an entire chapter of my book to expressing/pumping and storing breast milk -- various other books have this information too.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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SHOULD YOU AVOID ANY FOODS WHILE YOU'RE NURSING?
If you have no food allergies yourself, most of the foods you eat won't cause problems for your baby. Some foods eaten by a nursing mother do, however, seem to affect her baby adversely.
  Cow's milk is an offender for some women. Some nursing babies who have shown symptoms of colic (more about colic in Chapter 10) experienced fewer symptoms when their mothers stopped drinking cow's milk or eating cow's milk products for a while. The same kind of result has shown up in babies who've shown symptoms other than the typical signs of colic: inconsolable crying and apparent sharp intestinal pains, usually accompanied by gas. Such symptoms as vomiting, diarrhea, runny nose, wheezy bronchitis, and eczema have all, in some cases, disappeared when their breastfeeding mothers gave up dairy products.
  If your baby is colicky and you stop drinking cow's milk for a while, try it again a couple of weeks later. It's possible that your baby's digestive system will have matured, and you will no longer need to deprive both of you of the good nutrients in milk. If you do give up dairy products for a while, you may want to check with a nutritionist to be sure that you are still receiving adequate nutrients from other foods, or if necessary,from supplements.
   Other foods that are implicated to a lesser extent include eggs, citrus fruits, wheat, and chocolate. Some allergists have commented that the foods babies react to are often those that the mother had eaten in large amounts while she was pregnant, giving rise to the possibility that the baby may have been sensitized to them in the uterus.
   Nursing babies sometimes suffer from gas after mothers eat foods from the cabbage family, such as broccoli or brussels sprouts. Others become crampy after their mothers drink herbal teas, or wakeful after their mothers drink coffee or other foods containing caffeine such as tea, cola drinks, or chocolate. One nursing mother found that her baby got sick whenever she had eaten something with garlic in it, and then she remembered that her husband suffered cramps after eating garlic, making her think that they both might have the same kind of reaction.
   One case reported in the medical literature was that of a three-month-old baby whose urine was periodically a bright pink. After the mother noticed that she had trouble removing an orange-pink stain from a plastic glass from which she had drunk orange soda, she tried abstaining from this drink -- and then trying it and watching the baby's urine. There seemed to be a definite connection, and so the mother eliminated the soda from her diet.
   All foods eaten by a mother flavor her milk, and an occasional baby with a discriminating palate may or may not like the distinctive taste. He may either nurse happily -- or reject the breast milk. However, as you'll find throughout your parenting career, children are unpredictable. In one study, a group of infants nursed longer, sucked more, and drank more when their mothers' milk smelled like garlic, compared to when that flavor was absent. These pint-sized gourmets may have become accustomed to their mothers' garlicky diets while still in the uterus.
  It takes an estimated four to six hours between the time you eat a food and the time it affects your milk. If you can establish any relationship between certain foods that you eat and reactions from your baby, it's easy enough to avoid these foods.
  You'll also want to avoid certain foods to minimize the risk of passing on any environmental pollutants in your milk (as detailed in the section, "Protecting Your Baby and Yourself from Pollutants"). For the most part, however, you can eat any nourishing food you want without fear that your baby will be affected.