Karen
With your case I am thinking oversupply issues. Often, these moms have more
frequent bouts of mastitis. You also say the baby is thriving, and often
these babies have abundant weight gain. Also you said "Settles reasonably
well with a quick feed" which might mean that there is a sort of cycle going
on where baby is fussy and given a feed and then fussy again and fed again,
etc. This might be super-stimulating her supply. Also could he be teething?
He might be getting alot of comfort feeds for this, again overstimulating
her supply.
For most moms, I think giving these quickie feeds and comfort feeds is
totally good and not a problem. But for a few, maybe, it overstimulates the
supply. So the treatment would be the usual oversupply measures like keeping
baby on one breast for a time, getting more hindmilk, etc.
The explanation for oversupply is that baby gets a relative 'lactose
overload' but is not intolerant to the right amount of lactose. In my
recollection as an nicu nurse in the past, certain stool tests react
positive in the bf baby because lactose will be present (reducting substance
test?). This does not equate to lactose intolerance.
The antibiotics in mom could possibly have changed baby's gut as well, but I
think the oversupply care plan may work best for this mom. Perhaps you could
inquire further about supply, letdown, early weight gains etc to see if this
might be the culprit.
Laurie Wheeler, RN, BSN, MN, IBCLC, RLC
New Orleans Louisiana, s.e. USA
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