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From:
Kershaw Jane <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 6 Jan 2009 10:49:16 -0600
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I have an issue with the block feeding recommended by many lc's.  If you read the research on milk supply done by Hartman's researchers - you will see that there are a group of women who are true over-producers.  These women will continue to build milk volumes with lower and lower fat ratios in the unnursed breast.  When the baby nurses on that breast - they get a load of low-fat milk with high gut-transit time.  I have had much better luck with these moms having them nurse Both breasts, doing the latch-on, detach, latch-on, detach, latch on and stay on, mom on her back no more than 30 degrees elevation, baby self-attaching. IN difficult situations wanting quick relief, pump to determine total milk volume, pump off first 1/3 of volume, then let baby latch.  There's more to this picture than the simple solutions offered on the internet.  Doing creamatocrits on the milk can give a more accurate picture.  Plus before and after weights.   

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Alicia Burgett
Sent: Monday, January 05, 2009 7:35 PM
Subject: re-visit bloody stool, but w/twist

Dear experienced ones,

Okay, i've searched thru the archives going back to 2000.  i've reviewed my own files and researched some new ones online. Hopefully, this will be a quick
question:

(permission to post) - Recently, i've had two moms within two weeks of each other present their newborns with copious bloody stools before 4th week of age.  Both moms exclusively nursing, in constant contact w/newborns, in normal health, w/good support systems at home.  Both immediately followed the dairy elimination protocol, (not so quick to eliminate soy).  Neither one had started vit. D supplements w/baby.  Both of them reported improving diapers within first two weeks, to the point of no visible blood, dark or bright red.  
Everyone is happy.  Then, suddenly, two to three days of copious bloody stools again.  (That is the question, for those who don't want to read all the details, lol!).

As the first mom put it, 'it definitely got worse before it got better'.  Her baby is now seemingly healing, happy, and mom is now totally dairy and soy-free in her diet.  She is about 2+ weeks ahead of the second mom in this timeline.  

The second mom is just now struggling with day three of this second round of bloody stools, although she admits today is much better than before.  She has not given up soy yet, but says she is starting ASAP.  Assures me of compliance on the dairy issue.  She is really wanting some explanation as to why it gets better, then worse, then hopefully better. Plus, she has had no support from her ped.  Feels guilty for not immediately putting baby on formula for one week.  She is now doubting herself a bit for deciding to have faith in her milk.  By all accounts, she is in great, normal healthy postpartum, she has no allergies herself, no medical issues. 

The only thing i wonder about is comments i've heard about 'healing crisis', or possibly the gut going through a 'house cleaning'.  Just getting rid of the 'remnants' perhaps?  (There's my question!, :-))

BTW, both babies have normal hemoglobin, good weight gain overall, lots of wet diapers, of course.

Both moms do have OAMER, and within first week, were practicing block feeding, and both very aware of making feeds easier for babies.  Explosive, frothy stools abated almost immediately.  I would imagine that that issue may not be as likely a cause of renewed bloody stools if both moms were feeding like they say they are?

I am including all this info so as to clarify that i've been thorough with these two moms in particular (at least, i hope!).  The crux of this post is, what's up with the second round of bloody stools?  Any cases out there you would care to share?  Okay, sorry this wasn't so quick after all!

Thanks in advance, and i am so grateful for Lactnet!

Alicia Burgett, IBCLC in PP
Spokane, WA (still snowed in!)

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