A young woman comes to your office for a lactation consultation complaining that her 1-month-old baby has colic and slow weight gain. Her baby requires 6 to 7 diaper changes each day and suffers from diarrhea. She tells you that she allows the baby to nurse equally on each breast; she is desperate for help and asks your advice on what to do. A 24-hour diet history provides the following information about her eating habits.
Breakfast:        cereal, milk, banana, and walnut pieces; sometimes she has eggs
Lunch:             peanut butter sandwich, salad, and grapes with a glass of milk
Dinner:            fish or chicken, vegetables, potato or rice, applesauce, and milk
Snacks:            change daily but she likes trail mix because it is easy to eat when nursing

What is likely happening to this baby and causing the diarrhea?

Question

A young woman comes to your office for a lactation consultation complaining that her 1-month-old baby has colic and slow weight gain. Her baby requires 6 to 7 diaper changes each day and suffers from diarrhea. She tells you that she allows the baby to nurse equally on each breast; she is desperate for help and asks your advice on what to do. A 24-hour diet history provides the following information about her eating habits.
Breakfast:        cereal, milk, banana, and walnut pieces; sometimes she has eggs
Lunch:             peanut butter sandwich, salad, and grapes with a glass of milk
Dinner:            fish or chicken, vegetables, potato or rice, applesauce, and milk
Snacks:            change daily but she likes trail mix because it is easy to eat when nursing
 
What is likely happening to this baby and causing the diarrhea?

Quizplus · Accepted Answer

The baby is likely getting too much foremilk and not enough hindmilk. This can happen if the mother is switching breasts too frequently or not fully emptying one breast before switching to the other. The high lactose content of the foremilk can cause diarrhea in the baby. The mother's diet does not seem to be the cause of the baby's symptoms. A lactation consultant can help the mother work on achieving a better balance of foremilk and hindmilk for her baby.

A Young Woman Comes to Your Office for a Lactation