Permission to post. Mom is P2, breastfed first baby one year with no
problems. This baby born at 37 weeks, two weeks in NICU, now 3 months old.
Has received only breastmilk (no supplements), and was fully breastfeeding
by 1 month. Around two months, baby's stools changed from normal yellow to
green, with mucous, and an odd smell. Mother eliminated dairy, some
improvement in first week, then worse again. Had stool tested by ped, no
blood in stool or other concerns. Mother continued dairy elimination, also
eliminated soy, wheat, eggs, peanuts/tree nuts, citrus, tomatoes, fish and
shellfish. No change in stools. Has now been off dairy completely for 3
weeks. Mother has also noticed some symptoms of overactive letdown in last
few weeks (after development of green stools). Baby usually nurses 8-10
minutes on one breast and is done. At my visit, baby transferred 105 ml in 8
minutes from one breast (baby now weighs 12 pounds).

Baby is happy overall, normal growth and development. However, mom notes
that this baby isn't normally comforted at breast like her first. She wants
to eat and be done. At my visit, she started to fuss, mom tried putting her
to breast, she cried and refused, mom gave her pacifier which she happily
sucked and went to sleep. She woke an hour later, mom nursed her, after
finishing she fussed again until she got pacifier to suck. Mom reports baby
never nurses for comfort and rarely nurses to sleep.

No family history of any food allergies; mom has asthma. Mom is taking
prenatal vitamins (advised eliminating to see if any change) and Advair for
asthma (L3 in Hale, no ped concerns). Not sure if baby is getting vitamins.
No symptoms of reflux.

So: does this sound like an allergy issue? Should she go on an elimination
diet? (Mom is willing to do so). Is it more likely a result of
oversupply/OAL? But why would it develop at 2 months, when ok prior to that,
and given that mom is nursing one side until done and not pumping? Any other
possibilities, suggestions, questions I should ask mom?

Sorry if I am missing something obvious. Thanks for any help!

Lisa Mandell, MBA, IBCLC
Havertown, PA USA

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