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Both of my kids have, while babies, gone through periods of being fine during the day and being fussy, gassy little wrecks at night. Things are much better in general around here, but I’m still working through an elimination diet (see below). These days, S(8mo) lets me know that he’s having a rough night by latching on to nurse and then almost immediately unlatching and fussing (repeat until I wake up enough to figure out that nursing is not going to solve this problem).
After a (now unusually) rough night recently, I reflected on how much I know now that I didn’t know before – especially the first time around! And I thought I’d share what’s worked for me in hopes that it helps some other babies & parents get some more much-needed sleep. (And if you have tips from your own experience, please feel free to share in the comments!)
Things to try for short-term relief
- Bicycle legs (With baby lying down on his back, bring each knee up to his belly, alternating legs. As if the baby were riding a recumbent bike.)
- Gripe Water (Water with fennel, ginger, baking soda, and some sugars; though not cheap, Mommy’s Bliss works well for us & has no weird ingredients. Gripe water helps both expel the gas and settle the digestive system.)
- Lavender Oil (1 drop mixed with some almond oil or other carrier oil, rubbed onto baby’s belly. Only had to do this once when gripe water wasn’t enough; it was pretty amazing how fast & how thoroughly it worked…)
- Chamomile and/or Fennel Tea for Mama (Both will show up in breast milk & are good for baby’s digestion; if milk oversupply is or might be an issue, don’t drink fennel tea, since it increases milk supply.)
Every baby will have a rough, gassy night here and there. If those nights are most nights, though, the gas and fussiness are accompanied by green poop and a red “allergy ring”, and especially if there’s a lot of mucous, blood, and/or a marked foul odor, it’s time to look for the cause.
Possible causes and long-term solutions
– Foremilk/Hindmilk Imbalance or Oversupply – Gas, green poop (especially if it’s foamy), and fussiness in a breastfed baby can be caused by a foremilk/hindmilk imbalance – the baby is getting too much “skim” foremilk and not enough “cream” hindmilk. Block feeding is a way to rebalance things. If oversupply is also an issue, it might also be necessary (as it was for me) to pump some of the foremilk off before nursing (even if you’re block feeding)! (No need to spring for an expensive electric pump if you won’t be pumping daily – I have an AVENT manual breast pump and it’s been perfect for my infrequent pumping needs.)
[Addendum: See post comments for more info & a helpful link with another take on foremilk/hindmilk imbalance and oversupply.]
– Dairy (cow’s milk protein) Intolerance – If the baby is exclusively breastfed but the problem isn’t oversupply or too much foremilk, then it’s probably something you (mom) ate. Dairy is the most common culprit. While it’s lactose (milk sugar) that usually causes gas in adults, in babies, it’s the casein or the whey protein in cow’s (or goat’s or sheep’s) milk that shows up in mom’s milk and that baby then has trouble digesting. Butter is often not a problem because it has so little protein; ghee is even less likely to be problematic since it is butter with the milk solids removed. Hard cheeses, on the other hand, have a lot of casein, and everything else is somewhere in-between. Some babies will be able to tolerate their mothers’ consumption of sheep’s or goat’s milk, cheeses, etc., or dairy as an ingredient in baked goods. Others won’t; make sure to read labels for “hidden” dairy. A baby’s intolerance for mom’s dairy consumption will often resolve within his first six months to year.
– Intolerance to Other Foods – If cutting dairy out doesn’t solve the digestive issues, the next step is an elimination diet. You can try cutting out one thing at a time (wheat, soy, eggs, nuts, and citrus are likely culprits). Or you can try the Sears’ elimination diet, which takes the opposite approach – eliminating everything but the foods most likely to be tolerated and then gradually adding in foods. I found this to be a helpful chart to use to track an elimination diet (whichever approach is used). Another mom’s more in-depth take on breastfeeding elimination diets can be found here. And yet another mom’s success story about using an elimination diet to address the needs of a gassy, fussy baby who’d stopped gaining weight & had severe eczema.
– Whatever you do, don’t turn to soy formula. If you need to wean for some reason or to supplement with formula, there are formulas in which the milk protein is partially or extensively broken down. Soy is difficult to digest and its hormonal effects are still not well understood. Using soy formula can also contribute to the development of a soy intolerance/allergy.
Finally, speaking just as a mom who’s read a lot, the more serious the digestive issues (especially if there have also been ear infections, recent or multiple courses of antibiotics, chronic eczema, or asthma), the more I would consider postponing any scheduled vaccinations, and spacing them when they’re resumed. The gut and its bacteria are intimately tied to both the immune system and, via neurotransmitters found in the gut, the brain. Serious digestive problems indicate an immune system that right now may not respond appropriately to vaccination. (Vaccine-induced encephalopathy is the particularly serious possibility.)
I also highly recommend probiotics – we’ve used them with three of our four babies and have seen a dramatic difference in gassiness levels. I have to think having the extra good gut bacteria has to have helped. We like HLC neonate powder (recommended by a homeopath friend) which is fairly inexpensive and available online.
I’m so glad you covered the oversupply/foremilk thing! In my experience, almost no one knows about that, and it was definitely a problem for me. Could have saved me a lot of fussy-baby nights with my firstborn if I’d known!
Thanks for the probiotics recommendation, Arwen! I wanted to recommend probiotics in the post, but realized that though various types have helped my own digestion and another kind cleared up a chronic diaper rash for M., I really had yet to find one that noticeably helped baby gassiness/digestion (only tried two infant kinds so far). HLC neonate looks like a great option – I’ll probably be ordering some today!
Hello! Thanks for linking to my blog. I also have a whole post that explains oversupply and the reasons behind it — it might be helpful. My clinical experience does contradict some of what you suggested here in your post, however. I also link, in this post on oversupply, to a writing of Nancy Mohrbacher, a widely respected IBCLC, that deconstructs the foremilk/hindmilk misperceptions. I caution against block feeding as a primary measure of resolution because in many cases, babies of mothers with oversupply have ankyloglossia/tongue tie, and work to reduce milk production can seriously backfire when baby is unable to appropriately stimulate mom to sustain milk production after it has switched from endocrine control to autocrine control.
Here is my post on understanding oversupply. I hope you find it as helpful as you found the other links!
http://dianaibclc.com/2012/06/15/understanding-oversupply/
–Diana
Thanks for your response & the additional info, Diana. It does remind me that oversupply and resulting foremilk/hindmilk imbalance were pretty obvious in my case since I was painfully engorged, would nurse enough to reduce the engorgement, and then I would Fill Right Back Up practically immediately. I hadn’t pumped or manually expressed at all at that point, but there was no chance of emptying one side during a feeding, let alone both sides – there was just too much milk (& from reading Arwen’s blog, I know she had a similar experience!). Pumping off the foremilk (pumping milk long enough to have the expressed milk be thoroughly white instead of a skim-clear) & block feeding completely resolved poop color, gassiness, and engorgement for me & S. within 24 hours, and my milk supply was well regulated within a couple days. (S. did later on show symptoms of dairy intolerance, but that was weeks later…definitely possible that there’s a connection between the two, but my going off dairy wouldn’t have resolved the immediate oversupply crisis as quickly as pumping & block feeding did.)
I’m glad that your post points out possible causes of hyperlactation & includes tongue-tie as a possibility. I haven’t read much about tongue-tie simply because I haven’t had to deal with it – I just know it’s out there!