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Breast Feeding

Diarrhea in breastfed baby

08/25/2006

Question:

My baby is 5 months old and I have been exclusively breastfeeding since his birth. For the past 3 months, he has had bad bouts of diarrhea. His stool is watery, mucousy, and occasionally has dots of blood in it. I have cut all dairy products out of my diet, including all foods made with any milk product. I do not drink colas, alcohol, coffees, or teas, and I do not eat cruciferous vegetables. My pediatrician told me not to worry, as long as the baby is happy and gaining weight, but I am very concerned. Do you have any suggestions?

Answer:

The vegetables are unlikely to be a problem.
The next most common allergens are Soy, Wheat, and Eggs.
I would also need to know if you tend to produce an overabundance of milk.
If so, and you use both breasts at each feeding, the problem could be foremilk-hind milk imbalance, which causes an explosive, watery, frothy diarrhea (not usually bloody unless just flecks from irritation) in which case you could try using only one breast per feeding.
If that is NOT the case, we could talk about other food allergies or intolerances. Sometimes mothers end up taking enzymes so that the offending agent (often hard to pin down) is fully digested prior to entering the mother’s blood steam and hence breast milk.
Another approach is to remember that what you eat enters your milk about 6 to 8 hours later.
Hence if the diarrhea comes in bouts, you may be able to identify the problem food by recalling your meal roughly 6 to 8 hours prior to the feeding that preceded the diarrhea. Sometimes that approach requires keeping a log of your intake.
Best wishes.

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Response by:

Jeanne L Ballard, MD, FAAP, FABM Jeanne L Ballard, MD, FAAP, FABM
Professor Emeritus, Pediatrics, Obstetrics and Gynecology
College of Medicine
University of Cincinnati