Too Much of a Good Thing
Norfolk NE USA
From: NEW BEGINNINGS, Vol. 19 No. 4, July-August, 2002, p. 129
I just changed a very messy dirty diaper, and I couldn't be happier! Yes, cleaning a dirty diaper is a welcome task in our household because having a bowel movement used to be quite a challenge for my four-month-old son, Liam. He would draw up his legs, act like he was bearing down, and then scream. He would also refuse to eat and often would not sleep well. This started after he was no longer having a bowel movement every day, around six weeks old. I knew that irregular bowel movements were normal for breastfed babies, and I had even experienced this with my first son. However, this much discomfort related to emptying his bowels did not seem normal to me. As a La Leche League Leader, I have many resources that I can go to for information, but I could not find anything related to our situation.
After several weeks of trying to deal with this problem, we decided to give Liam glycerin suppositories. Our family doctor assured us that they contained no laxatives so Liam could not become "addicted" to them. They were to act more as a lubricant and to stimulate his muscles to push.
The suppositories definitely served their purpose of helping him to move his bowels. It was a very easy fix for the fussiness, breast refusal, and sleeplessness. However, I began to do more research and found that other sources said that even glycerin suppositories can make a baby dependent on having "help." I was also bothered by the fact that all the information I was looking at concerned formula-fed babies who were constipated with dry, hard stools. I really didn't think my breastfed baby should have been struggling with having stools that were still soft. I finally decided that there must be an underlying problem, and I was no longer comfortable giving Liam a suppository.
I contacted my Area Professional Liaison, an LLL Leader that other Leaders turn to when they cannot find the answer to a problem within their own resources. Although she found very little information on difficulty with bowel movements, we were able to draw some conclusions based on what she did find. We decided that I may have had an oversupply problem. Liam was getting too much foremilk, which can lead to gassiness and abdominal pain, and not enough hindmilk, which acts as a laxative.
When I looked at the problem through the perspective of having an overabundant supply, it made perfect sense. Liam and I had struggled with too much milk in the early days as well. I was so intent on making sure that we were nursing often enough to stave off jaundice, which we'd dealt with for our first child, that I would constantly encourage him to nurse, switching sides frequently to keep him interested. He developed green, watery stools, and I backed off to just one side per feeding.
Even so, Liam would vomit, not just spit up, every evening. I could tell that it was simply from being overly full. Eventually he grew out of the vomiting, and I really thought that we were past the oversupply problem. He still spit up quite a bit, but my first child had spit up even more, so I just hadn't thought too much about it. After talking with my Area Professional Liaison, I finally decided that overabundant supply was still causing us problems, and it was time to fully address the issue.
In order to increase the amount of hindmilk that Liam was receiving, I stopped switching sides so frequently. Even though I had only been offering one side at a feeding, he had a feeding every half hour or so. I hadn't stopped to think about how often this meant I was switching sides. I decreased that to switching sides every six to eight hours. What an improvement! Liam stopped acting like he constantly had to have a bowel movement. Another three days later, he filled his diaper almost effortlessly, and I breathed a sigh of relief. We have had very few problems ever since. In fact, he even stopped spitting up as much. The only significant drawback is finding a balance between sticking to my schedule of switching sides every six to eight hours and "watching my baby and not the clock." Even though I feel as though I should know my baby's cues by now, I still have a hard time deciding if he is going through a growth spurt and needing to increase my milk supply, or if he's just fussy for other reasons. However, I would choose this problem any day over the constant struggle we had when I frequently switched breasts.
I am very grateful to my Area Professional Liaison for helping me to evaluate our situation. I am amazed at the host of problems overabundant supply can cause, yet very glad that they can be solved with a little breastfeeding management!