I need some insight into a problem with one of my moms; permission to post.
She had gastric bypass surgery in 1999. Her daughter is now 4 months old, 
gaining beautifully, happy and content, but is plagued with green/mucous 
stools. 

There is no indication of OMER. She always nurses on one-side only and 
still uses breast compressions, so foremilk/hindmilk imbalance is not the 
problem. In the archives there is a reference to 'low-fat' human milk in 
moms who have had this type of surgery. While this theory seems logical to 
me, on a certain level, in diagnosing the cause of the green/mucous 
stooling pattern, it doesn’t fit with the overall picture of an otherwise 
healthy, happy and thriving baby. 

Mom has eliminated ALL sources of dairy for the last week and has seen no 
signs of improvement. Yes, I know that the elimination diet is still in 
the early stages but I usually note at least a subtle difference within 
the first week. 

Of course the pediatrician’s recommendation is to wean and feed the baby 
Alimentum. Mom was very surprised to see that the main ingredient is 
casein (no flies on this mom) and refuses to do so. Makes no sense to her. 

I will suggest a RD to help maximize her protein/fat intake and suggest 
B12 and calcium/magnesium supplements. I will also suggest the 'kiss the 
baby' test to rule out CF. What am I missing here?

I tend to think that since the baby's weight gain is great and she is 
contented and happy most of the time, mom should just continue with 
breastfeeding and look past the green/mucous stools. 

Thoughts?

Ellen Penchuk, IBCLC, RLC

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