Ravina Sewani

If your baby has green, foamy or frothy, explosive stools and pain, it might be a case of lactose overload. Lactose overload can happen when your baby gulps a very large quantity of breastmilk either due to a long gap between the feedings or due to an oversupply of milk. Healthy babies are able to break down the lactose in normal volumes of milk. The presence of fat in the milk ensures the slow movement of milk through the gut. But if your baby consumes a lot of milk that is relatively low in fat, it can rush through the digestive system without being digested. This can cause the problem of gas causing pain and frothy stools. If you suspect lactose overload, try to check your baby's latch. Try different positions to feed your baby if you have a problem of oversupply of milk. Try frequent feeds as your baby to avoid build up of watery low fat milk. If the problem persists, you know what to do, head straight to your doctor.

Lactose overload happens when the milk is not digested properly.

Lactose Overload

Samiksha Choithani

Uneven supply of milk totally depends on mother and child’s comfort, if the baby is comfortable in feeding on one breast, the body naturally produces milk in the same breast. It is upon the mother and the child to decide whether they are comfortable feeding from one or both the breasts. If both of you are comfortable, continue the process. But, if you are willing to have even milk in both the breasts, here is something you can try:<ul><li>Babies tend to suck the breast that produces more milk; you can try to feed your baby from the slow side/less productive side. Encourage this habit to have an equal supply for future feedings.</li><li>Massage the less productive breast.</li><li>Try to pump the less productive breast after each feed.</li><li>Try new feeding positions that could be comfortable for baby while feeding on the less productive breast.</li></ul>

Do not worry about this as it will only make this problem worse.

When only one breast produces milk

When moms start feeding the newborns, the nipple often turns red and pointy instead of round and smooth. This could be due to the problem in latching technique, insert your finger into the corner of your baby's mouth to stop feeding for a while when you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola (entire circle surrounding the nipple) into the mouth. Measures to treat sore nipples:<ul><li class="ql-align-justify">When you take bath, clean the area with water and do not apply any soap. Your areola secretes oil that keeps your nipples moist. If you use soaps, these protective oils might be removed.&nbsp;Air-dry your nipples and do not rub them harsh. There is no need to clean your breasts before breastfeeding, offer your breasts as such. The microbes on your breast surface will help in the development of your baby's gut bacteria. You need to only clean your breasts before feeding if you have an infection.</li><li class="ql-align-justify">Apply few breast milk drops. Massage a few drops of breastmilk before and after the feed to heal your nipples.</li><li class="ql-align-justify">Your doctor might sometimes prescribe you creams to apply on your nipples.</li><li class="ql-align-justify">If you need instant relief after nursing, use hydrogel pads.</li><li class="ql-align-justify">Sometimes the pain is also due to blocked milk duct, massage your breasts with warm water. This will help to unplug ducts and clear the lumps, milk gets released and there is a relief in pain. Note that breastfeeding is the best way to unclog ducts, do not stop breastfeeding due to the pain.</li></ul> These are only temporary relief solutions. You will have to work on the cause of your soreness like poor latch or baby's tongue tie etc. A lactation consultant will be able to help you better. Some women face nipple structural challenges as well. Some of them have flat nipples or very large nipples. In any case, there is no need to worry as generally newborns can nurse on all types of nipple structures. Just ensure that there is a proper latch during the breastfeeding and that the baby is gaining adequate weight. However, here are a few things which might help you if you are facing a lot of trouble:<ul><li class="ql-align-justify">If you inverted nipples, they will naturally protrude out as the pregnancy progresses. Even if this does not happen, your baby will be able to latch on and feed properly. If the baby is facing some troubles, a nipple shield will be very helpful in this case. Consult your doctor or a breastfeeding specialist to help you accustom to the use of nipples.</li><li class="ql-align-justify">If you have flat nipples, they will raise with stimulation. If they don't, do not worry as long as your baby holds on to the areola apart from nipples. If along with flat nipples, you have engorged breasts, your baby might struggle with the latch. In this case, use your fingers to pull the nipple towards your baby's mouth. Your doctor might suggest you to use breast pumps in this case.</li><li class="ql-align-justify">If you have large nipples, it will take your baby a few days to have a proper latch. But if you have adequate milk supply, your baby will get enough milk and gain wait adequately. You can try football hold if you have large nipples.</li></ul>

Breastfeeding can sometimes get overwhelming, not just emotionally, but physically too. Nipple care is very important for the first few months of feeding.

Nipple care

Cholera is an infectious disease that causes severe watery diarrhoea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae. The disease is most common in places with poor sanitation, crowding, war, and famine. Causes:<ul><li>Common sources of contamination include:</li><li>Municipal water supplies</li><li>Ice made from municipal water</li><li>Foods and drinks sold by street vendors</li><li>Vegetables grown with water containing human wastes</li><li>Raw or under-cooked fish and seafood caught in waters polluted with sewage</li></ul> When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhoea. Symptoms:Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. These include:<ul><li>Rapid heart rate</li><li>Loss of skin elasticity (the ability to return to original position quickly if pinched)</li><li>Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids</li><li>Low blood pressure</li><li>Vomiting</li><li>Thirst</li><li>Muscle cramps</li><li>If not treated, dehydration can lead to shock and death in a matter of few hours.</li></ul> Diagnosis:Doctors usually take a stool sample or vomit sample to check for signs of the cholera causing bacteria. Treatment:<ul><li>Hydration is the treatment for cholera. Depending on how severe the diarrhoea is, treatment will consist of oral or intravenous solutions to replace lost fluids. Antibiotics, which kill the bacteria, are not used for mild cases. But they can reduce the duration of diarrhoea and also reduce the excretion of the bacteria, thus helping to prevent the spread of the disease.</li><li>Cholera vaccines are also available but whether your child needs one or not will be decided by your child’s doctor.&nbsp;</li></ul> Prevention:Use water that is boiled, chemically disinfected, or bottled water for the following purposes:<ul><li>Drinking</li><li>Preparing food or drinks</li><li>Making ice</li><li>Brushing your teeth</li><li>Washing your face and hands</li><li>Washing dishes and utensils that you use to eat or prepare food</li><li>Washing fruits and vegetables</li></ul> Avoid raw foods like:<ul><li>Unpeeled fruits and vegetables</li><li>Unpasteurised milk and milk products</li><li>Raw or under-cooked meat or shellfish</li><li>Fish caught in tropical reefs, which may be contaminated.</li></ul>

Here are Cholera Causes, Symptoms, Diagnosis, Treatment, and Prevention

All about Cholera

Common spices allergies are of mustard, garlic, and coriander. Out of these, allergic reactions to mustard are the most common.Common seed allergies are of sesame, poppy and sunflower seeds.Allergy to mustard causes reactions in skin, lungs, and digestive tracts and affects sinuses as well.In the case of seeds and spices, there are two possibilities – true allergic reaction and non-allergic response. Hence it becomes important to distinguish between the two. True allergy is caused by an immune response to the proteins present in the spices or seeds and can be life-threatening.Non-allergic responses are rashes, teary eyes, runny nose, burning sensation in the mouth, and coughing after inhalation. This is usually self-resolving. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:Get your child diagnosed by a healthcare expert. For diagnosis, the paediatrician will evaluate your child's medical/family history, existing conditions like asthma, eczema and other food allergies; along with a skin prick test, blood test or Oral Food Challenge. Precautions and treatments:<ul><li>Your healthcare expert may prescribe adrenaline auto-injector for children with a history of anaphylaxis. The paediatrician might also prescribe just medicines if the allergic reactions of your child are mild.</li><li>Avoid foods containing the seeds or spices to which your child is allergic.</li><li>Keep a habit of reading the food labels for ingredients.</li><li>Inform your child’s school about your child’s allergy problem.</li><li>Mustard may be used as a whole, in powdered/paste form or as a sauce in sandwiches and sesame may be used as whole seeds, as oil, or in cosmetics, and pharmaceutical products. Hence, be careful about these products.</li></ul>

Read the article to know what to look out for in case your child has seed allergy.

Seed allergy

<ul><li class="ql-align-justify">Breastfeed your baby as much as (s)he wants. In the early days and weeks, your baby will wake and feed frequently, day and night.</li><li class="ql-align-justify">When your baby is a newborn, their stomachs are tiny. Babies can physically take only small amounts of milk. They can digest breast milk easily and it soon gets absorbed it into their system. That's why babies might demand constant feeding.</li><li class="ql-align-justify">After the first few days, most young babies feed at least 8 to 10 times in 24 hours. This means your baby could be asking for a feed every 90 minutes to two hours.</li><li class="ql-align-justify">It's worth keeping an eye on the number of feeds the child has, and offering them your breast, even if the baby not asking. By breastfeeding often, you're building up your milk supply. The more your baby feeds, the more milk you will produce. This is called responsive feeding. And your baby will love snuggling into you, whether or not they are hungry.</li><li class="ql-align-justify">Do check that your baby is latched on well. Otherwise, (s)he may be nipple-feeding, rather than breastfeeding. This can make your nipples sore, and your baby may be unsettled, because they can't get a good amount of milk. Get advice from your elders or paediatrician if you're worried that your baby isn't feeding well.</li><li class="ql-align-justify">Your baby needs to open wide and take a good mouthful of your breast. Once they have latched on, the chin should be touching your breast, the nose should be clear and baby's lower lip should be evened.</li><li class="ql-align-justify">Your baby may want to feed more often, or for longer, at night. This is normal, because your body produces more prolactin, the hormone that makes milk, at night. By feeding often at night, your baby stimulates your body to make more milk.</li><li class="ql-align-justify">Over the next few months, your baby's feeding pattern may become more predictable. This can take a while to establish, though, so try not to be disheartened.</li><li class="ql-align-justify">Always keep the weight of the baby in check, to track their physical development. The track of baby’s weight will also help you to understand whether your baby is feeding enough or not.</li><li class="ql-align-justify">It is recommended to JUST breastfeed your baby until the age of twelve months and it can be continued till the age of four depending on mother's and child's comfort.</li></ul>Signs that your child is adequately breastfeeding:<ol><li class="ql-align-justify">Frequent urination up to 6-7 times a day.</li><li class="ql-align-justify">Adequate weight gain.</li><li class="ql-align-justify">A sleepy baby post breastfeeding.</li><li class="ql-align-justify">Let down reflex (Milk comes out from the other breast while baby feeds from one breast).</li></ol>

Worried about whether you are feeding the child enough? Look for the signs that your child gives.

Breastfeeding Schedule

The first yellow milk (fluid) produced in the breasts is called colostrum. It is the first stage of breast milk production. Colostrum is thicker than your usual breast milk. Colostrum/yellow milk lasts until the transitional phase or mature milk is produced i.e. till the second or fifth day after the birth. Colostrum is like a child’s first immunisation, it is full of antibodies, white blood cells and other immune properties. Benefits of Colostrum for the baby are:Builds a strong immune system.Creates a tough layer on baby’s stomach and intestines to fight with germs that cause illness.It serves as a laxative that helps your baby pass the first dark stool/poop.Prevents jaundice.It is a perfect blend of nutrients to make the child’s brain, eyes and heart strong.Prevents low blood sugar in newborns. A baby should take 1-4 tablespoons of colostrum per day. Note: Do not give honey or any other food substance during birth, the first yellow milk is a great source of nutrition.

Colostrum has multiple benefits for a baby's health and should be the first food give to a baby after birth.

Colostrum and its benefits for Babies

As per the doctors’ recommendations, a child shouldn’t be given anything till 6 months. Child should only be breastfed till 6 months. This is applicable for masses. But this can be customised depending upon a child’s health and under parental supervision; a child can be introduced or can be given liquidised food and water from 5 or 6 months. Liquid foods should be those which are culturally acceptable. These include – fruit juices, vegetable soups, daal or moong water, non-veg soup, etc. Children should be encouraged to drink adequate amounts of fluids. While introducing new foods, parents should keep 2 things in mind: <ol><li>Never introduce 2 foods at the same time. If you are giving daal water today, do not give fruit juice on the same day. It helps in identifying any consequences/allergic reactions or adverse effect due to new foods. Let the child get habituated to a new thing for at least a week and then introduce a new food item.</li><li>The quantity also matters. On the first day start with 2 spoons of say daal water, on second day 4 spoons, likewise keep increasing quantity gradually for a week and if the child is able to digest it all well. In the second week you can introduce fruit juice along with daal water. Keep the quantity in check and ultimately know how much is enough for your child.</li></ol> Please note:<ul><li>Children’s appetites may vary, not only from day to day, but also from one meal to the next.</li><li>Children have smaller stomachs than adults so it is important to consider portion size when plating food.</li></ul>

Introducing food at the right age will make your child habituated with eating all kinds of food.

Food at the right age

Following are the guidelines to be followed regarding the milk intake of a child: <ul><li>Ideally the child should be compulsorily breastfed till the age of 1 year.</li><li>In case if the mother’s milk is not enough or if she’s a working mother and is unable to feed the child, external milk can be given.</li><li>As external milk, give formula milk. You can give formula milk based on your budget and child’s nutrition requirements. Formula milk is rich in proteins and DHA which help in brain development. There are several formulas for milk available - STANDARD formula like Lactogen and Dexolac. PREMIUM formula is also available in market which is very similar to the mother’s milk with DHA and ARA like Enfamil and Nan Excella pro.</li></ul> <ul><li>In any case, DO NOT give animal milk to your child before one year. The proteins in animal milk and human milk are completely different which can lead to consequences. A child can be given animal (cow/goat/buffalo) milk after 1 year.</li><li>A child can be given semi-skimmed milk after 2 years of age. However, do not give complete skim milk to a child under 5 years.</li></ul> <ul><li>There is no age limit for breastfeeding. A child can be breastfed till one or two years or even more than that as long as both the mother and child are comfortable. But sometimes it so happens that even after one year, the child considers mother’s milk as the sole source of food and does not intake any external food.</li><li>REMEMBER that after one year, the child’s nutrition need should be fulfilled 70% by outer food and 30% by mother’s milk.</li><li>When the child feeds on mother’s milk for a while, his/her hunger is satisfied but the child does not get enough nutrition. Hence, such a child can stay malnourished and can lose weight. In such cases, doctors can advise the mother to wean off the child at least during the daytime so that the child starts eating properly and gets proper nutrition.</li></ul>

It is important to breastfeed a child till 1 year. It is not advisable to give formula milk before the age of 1 year.

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