Demand feeding and Lactose overload

A crying, unsettled baby is exhausting.

As a new mum you’re often told that feeding frequently is best for your baby.

Demand feeding your baby is very important for weight gain, establishing good lactation and it’s also a great way to bond with your baby.

Feeding your baby on demand means feeding your baby whenever they cry, suck their fingers (sucking reflex) and show the rooting reflex.

However these signs are not just hunger signs.

Let’s look at these cues:

Rooting reflex:

This reflex is an interesting one. It’s an involuntary action. This reflex is present when the baby is close to the breast or their cheeks are being touched. They will naturally turn their head to that side. Babies less than 3 months of age all have this reflex present.

Seeing this reflex is involuntary it’s always present when cheeks are stimulated. Even when your baby is not hungry!

Sucking reflex:

This is also an involuntary action. Babies will generally suck anything if its introduced into their mouth and the roof of the baby’s mouth is stimulated. Babies are in what we call an oral stage. They often suck or feed not only when they are hungry but also when they are tired, in pain, distressed or for pleasure. Little babies (under 3 months) have a strong urge to suck other than feeding times to feel contented.

Hand and mouth reflex:

All babies have this reflex when they are born. It’s not until they get a little older when this is more prominent and coincides with their development. Babies under 3 months have this reflex, however it’s a little hit and miss. Once they are a little older they will put their hands in their mouth for comfort sucking and at times thumb sucking may start. Babies as young as 6 weeks can start sucking their thumbs voluntarily.

Crying:

Babies cry for several reasons.

  • Hunger
  • Pain
  • Wind
  • Too cold or too hot
  • Overtired

So recognizing these signs and acting accordingly can be the key to having a settled baby.

With demand feeding some of these signs may not be hunger signs, and even though the baby is being offered milk and will feed for comfort, a condition called Lactose Overload may occur.

The majority of babies who are unsettled, don’t sleep, are frequent feeders and struggle with gas are often diagnosed with having colic.

They then are subscribed medication such as Gaviscon.

Predominately babies then get better only because the medication is masking the underlying issue.

However in 95% of cases in one clinic I researched, the colic is from Lactose Overload.

So what could be the underlying issue and how do we solve it?

Lactose

Lactose or milk sugar is present in all milk. Lactose is the primary source of energy. Foremilk is very high in lactose.

So what is Lactose overload?

This is when breastfed babies (and sometimes bottle fed) are feeding too frequently and consuming large amounts of foremilk, which is rich in lactose.

It often happens in babies who are unsettled, don’t sleep, are windy and burp a lot and appear to be in discomfort. They have frequent green bowel motions with nappy rash and spill after feeds.

Because these babies are unsettled and are showing signs of hunger (wants to suck, is unsettled, screams and draws up legs) they are fed to help settle them.

However this becomes a vicious cycle. Large volume, a low-fat feed goes through the baby very quickly and not all lactose is digested. Then the gas, pain in tummy etc. presents again.

So what’s the best way to manage lactose overload?

Changing to a breastfeeding routine is a good way. It’s important to make sure one side gets drained first before offering the other. It even means that after your baby has burped, changed and ready for the next phase of the feed, you can put baby back on the same side. This will make sure that your baby is getting enough hind milk to settle. Hind milk has less lactose present and fatter content which helps settle babies. The other way is to make sure your baby doesn’t feed more than 2-2.5 hrs. Babies over 2-3 weeks of age and are gaining weight are best to feed 3hrly during the day if Lactose Overload is a possibility. After a while you baby will become easier to settle and can return to feeding on both sides if need be when older. However to avoid the lactose overload, make sure that you generally empty the side you started the feed on before offering the other side.

Lactose intolerance is very rare but should not be ruled out if your baby does not improve over time with change of feeding regime.

If you’re a mum that has a baby that is showing these classic signs then get in contact and we can help you for a better outcome and more settled baby.

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