Are you breastfeeding and have been told to give up dairy? This advice may have come from your doctor, a good friend, or another breastfeeding momma. I hear this advice given regularly as a solution to solve certain symptoms in babies- especially in mom groups!
As a lactaion expert, this is one of the most frustrating pieces of advice people give to my clients. Gassy baby? Give up dairy! Baby spits up? Give up dairy! Fussy baby? Give up dairy!
Giving up dairy seems to be the "cure all" to everything these days- when it's actually usually NOT the answer.
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So, if a dairy intolerance in your baby isn't the solution, what is? Lactose overload. A sneaky breastfeeding problem that more of you may have than you realize.
Lactose overload can appear to many (even pediatricians!!!!) to be a dairy sensitivity in your baby. And it's not surprising why that is, they do share similar symptoms, HOWEVER when these symptoms arise, you should always seek the expert advise of a lactation professional. Doing so could save you a ton of headaches, and save you from having to unnecessarily give up cheese!
Before we get into the nitty gritty details, let me tell you a little story from yesterday.....
This is me. You're about to have a short photo journey of my own lactose overload experience.
That picture, with the big milk leak was taken about an hour after my 5 week old had nursed. I was soaked, and my milk was still leaking everywhere.
I went to my kitchen and grabbed my Medela Harmony hand pump (I love this pump by the way) because my milk was literally spraying. I squeezed the handle ONE TIME to create some suction to collect the leaking milk and THIS was what I caught......
Then, after, I nursed my 5 week old, who still got sprayed in the face.
While nursing her, I decided to text Allison (who is one of our lactation experts) and sent her these pictures. She had the brilliant idea of taking a picture of my pumped milk AFTER baby was done nursing. So I did. And I think it captures the lactose overload beautifully.
As you can see from the two bottles, the milk looks quite different. I'll explain more on that below, but first let's talk about lactose overload, and how you would know you may have it.
Symptoms of lactose overload in your baby may include :
Sudden bursts of crying from gas pain
Mucous in the poop
AND even blood in the stool
When doctors see these symptoms in your baby, especially when there's blood in the stool, the first thing typically recommended is to cut out dairy. However, dairy is not always the culprit for these symptoms, AND lactose overload in your breastmilk has absolutely nothing to do with diary consumption.
How could a pediatrician misdiagnose this? Well, there are several very similar symptoms (especially bloody stools), and a pediatrician is not an expert in breastfeeding, they are experts in pediatric disease. They may not be familiar with lactose overload, or know that a moms milk supply could be a concern at all. It happens often! Unless they are also a lactation consultant, your pediatrician is not who you should turn to for breastfeeding advise, you should always go to a breastfeeding expert.
Something to understand, when a baby is reacting to dairy (or any food for that matter) they are reacting to the proteins of that particular food in your milk, not your milk itself. When baby is having symptoms from a lactose overload, they are having symptoms from the volume of lactose in your milk, and removing dairy products from your diet will not do anything to make it better.
Lactose overload happens if you have an oversupply of breastmilk or over active let downs (OALD). It means that when you have an abundance of milk, you will naturally have more lactose (and more of all the milk). So, when your baby is nursing they are being overwhelmed by the high lactose milk that typically babies only get at the beginning of a feeding.
Is it possible for your baby to have a dairy sensitivity/allergy and lactose overload? Sure! But you'll see some very specific symptoms when dairy really is the issue; like extreme bouts of crying, skin rashes, congestion, eczema, acidic stools that cause bad diaper rashes, projectile vomiting, and these babies tend to look sickly, and are very often struggling to gain weight or are failure to thrive.
How do you know if you have an oversupply or OALD? Here are some signs.
In addition to the symptoms your baby may have, as mentioned above, you may also notice the following:
Your baby may come off the breast and choke/cough while nursing.
Nursing sessions may be very short, less than 10 minutes.
You can hear your baby swallowing rapidly/gulping.
Your breasts may feel full often, or you may experience clogs and/or mastitis.
Your breasts may leak, alot!
Your baby may be fussy at the breast, especially if your milk isn't flowing easily for them. (Usually because they don't know how to "work for the milk")
Your baby may occasionally refuse to nurse.
Your baby may clamp down on your nipple, or pull their head back when the milk flows.
Your milk tends to spray out when you have a let down.
Do any of these symptoms seem familiar to you? If so, what you're likely dealing with is not a dairy intolerance, but a lactose overload from having an oversupply of breastmilk! If you think this is you, please contact a lactation expert ASAP! You can even get in touch with us for an appointment within 48 hrs! (We support mommas anywhere with our popular virtual sessions!)
Now before I talk about this next bit I want to make something clear :
Generally speaking foremilk and hindmilk is not something you need to worry about! I've been hearing mommas talk alot about foremilk AND hindmilk over the years and there are soooooo many misconceptions.
Foremilk and hindmilk are terms coined by researchers. Foremilk describes the milk at the beginning of a feeding, and hindmilk describes the milk at the end of the feeding. They are usually not dramatically different types of milk. HOWEVER, when you have an oversupply of milk, or OALD, the foremilk can be a problem. NOT because the foremilk and hindmilk are dramatically different, but because you have TOO MUCH milk. When you do not have an oversupply, babies are naturally getting a great balance of milk, and there is no need to even put a second thought to foremilk/hindmilk.
See what happens, when you have too much milk, is your baby will fill up on the foremilk instead of getting a good balance of foremilk and hindmilk. Foremilk is more watery, and has more lactose than hindmilk, which is fattier. If your baby is getting a larger volume of that foremilk then your baby is getting more lactose than they would if you made less milk, hence the lactose overload.
The high lactose content can be irritating on baby's tummy which is what causes the symptoms listed above. It can be so irritating on baby's gut that it even causes specs of blood in the stool and/or mucous stools, and green stools.
When you have a lactose overload, your milk will look different if you were to pump. This is a side by side comparison of the milk I had pumped for the purpose of this post. See how blue and watery the milk on the left is? The milk on the right is thicker, and opaque.
So, if you're thinking that your symptoms, your milk, and your baby's symptoms sound like this, then what you're dealing with is probably a lactose overload and NOT a dairy intolerance and giving up dairy will absolutely not help your situation. If you do suspect you have a lactose intolerance, contact your local lactation consultant, or reach out to us for a private session to help you manage this and make things easier for you and your baby.
Keep in mind, there is not a one size fits all approach to managing oversupply, OALD, and lactose overload. Every breastfeeding relationship is different, and you should seek expert support. Trying to manage it on your own could make it worse, or result in a loss of milk production, which is why we are stressing that you work with an expert in lactation.
Kelly Maher, CLC, CLE