Triumphant Tuesday: Breastfeeding a Baby with a Gut Disorder

Severe projectile vomiting in young babies can be the sign of a gut disorder called Pyloric Stenosis. This is where the tube connecting the baby’s stomach to their gut grows rapidly thicker until it becomes so thick that the stomach can no longer empty properly. The condition is often accompanied by constant hunger, belching, and colic. If left untreated it can lead to severe dehydration.

It is not known exactly what causes Pyloric Stenosis, and distinguishing it from reflux or gastroenteritis is hard for the novice parent. So when Rebecca, a first time mother, discovered her breastfed baby was suddenly vomiting, she was confused. When does spitting up move from a laundry problem to a medical one? When does spitting up mean something serious?

“I guess I always knew that I would breastfeed to the point where I didn't go to any antenatal classes, I just thought 'well how hard can it be'? After a long and difficult labour that ended up in a theatre-forceps delivery I embarked upon one of the most challenging but rewarding periods of my life.

Shy on support

In the recovery room there I was: I couldn't feel my legs, my baby daughter Lizzie was neatly wrapped up in my arms and I was flooded with the feeling of relief that I finally had her safe. I tried latch her on but she wasn't interested and soon fell asleep. Nobody seemed to have the time to sit with me. Nobody went through expressing or suggested spoon or finger feeding to try and get her interested. 

It was many hours later when Lizzie suckled for the first time, I had to try all sorts of tactics to get her feeding such as bathing to wake her up, feeding lying down, football hold, cross cradle hold... finally she and did it.

Once my milk came in it was hard for me to tell at first if Lizzie was getting enough milk. I was so engorged that I didn't think my breasts were being drained at all. They were constantly full to the point where my nipples were flat and Lizzie couldn't latch. Thankfully on the first weigh-in she had gained weight - not lost - gained. I was relieved. Everything seemed to be going well.

The vomiting begins

Lizzie piled on the weight until week 3 when she suddenly started vomiting. At first it was tame and could have been passed off as wind but then it quickly got progressively worse until she was regurgitating  whole feeds. I don't mean a 'happy spitter', I mean projectile vomit and loads of it. We had a major laundry issue to say the least. I kept asking family members if it was normal for a baby to be sick this much and the replies that came back were, "yes babes are sick don't worry". But I did worry. I thought breastfed babies were not this sick surely? 

One evening I phoned my mother and begged her to tell me not to worry and sought her reassurance that this was all normal. She said she couldn't give me this reassurance and suggested I take Lizzie to get weighed. So I took Lizzie to the clinic where they weighed her - she had lost weight! Half a pound! The health visitor arranged an immediate appointment at the local hospital.

At the hospital, the first doctor we saw tried to fob us off, saying that Lizzie was not being winded correctly. I knew this was not the case. Fortunately the infant feeding specialist saw us next. She agreed that it did not seem like a feeding/winding issue and put the doctor's theory to bed. 

Lizzie was then put on a drip and was not allowed anymore food. I co-slept with her in hospital that night and kept her close to me as much as I could. The next day Lizzie was sent for an ultrasound scan. As part of the scan, the doctors wanted to give Lizzie a bottle of dioralite. I refused the bottle so we cup fed instead. She vomited it all back up as predicted. The doctors then told me they had found the reason for her vomiting: she had Pyloric Stenosis.

Pyloric stenosis is when the passage between the stomach and small bowel (pylorus) becomes narrower. The passage is made up of muscle, which seems to become thicker than usual, closing up the inside of the passage. This stops milk or food passing into the bowel to be digested. The milk sloshes in the stomach often curdling before the baby is sick.

The thickened pyloric muscle can be felt, especially during feeding, as a small, hard lump on the right side of the baby’s stomach. The muscles around the stomach can sometimes be seen straining, moving from left to right as they try to push milk through the pylorus.

Lizzie was retained in hospital for a week whilst she had to undergo an operation under general anaesthetic to correct her stomach. There were no alternatives to the operation. Left untreated, Lizzie would soon become seriously dehydrated. 

The day of the op came and we pushed her down with a nurse to the theatre. Lizzie was asleep so we gave her a kiss and then we went for a walk. Although it was vile to see my babe being taken away like that, we were both relieved that it would finally be over.

I expressed my milk around the clock to keep up my supply. I had never done this before. It was daunting. No one offered support. 

Luckily I managed to keep my milk supply up (with a ruddy huge stash of expressed milk to show for my efforts!) Lizzie was able to get straight back to breastfeeding while she recovered from her operation. Within a few weeks she got back up to the weight centile that she was on previously. Phew.

Lizzie was now 3 months old, yet still feeding relentlessly every 2 hours around the clock! She would not let me put her down and was very unsettled. At the time I assumed she must simply be a high-need baby and spent the days rocking and singing to her to settle her in between feeds and naps. 

Tongue Tie

Then I started to get a blanched nipple on the one side, which was not something I had experienced before. I went to the local breastfeeding support group where the support worker looked at Lizzie's tongue and immediately confirmed she had a tongue tie. They asked if I would like it dividing. This was the first I had heard of such thing so I declined. (Big mistake). I thought I would just carry on, after all it seemed that it wasn't really her problem it was mine, and this was only a blanched nipple (little did I know!) 

Blood in her poop

I continued to feed and rock and sing until about month 5 when Lizzie started having blood in her poop. For some time she had been having a lot of poops (10 each day!) I assumed this was normal but on investigation and another trip to the hospital they confirmed it was a dairy intolerance. In order to continue breastfeeding for the next few months I had to cut out all dairy from my diet. It was horrible. I loved Tea, cake, cheese, butter, yogurts... this was going to be hard.

When Lizzie reached 6 months old we started solids and Baby Led Weaning. I was told that babies run out of iron at this stage so they need to eat a wide variety of food - and fast. But Lizzie did not like food, she gagged and wasn’t interested. I didn't force the issue and went at her pace but in the back of my mind I was always worried. She was still breastfeeding every 2 hours, all day, every day!

During this time I had family and friends suggest that milk wasn't rich enough and also to keep putting Lizzie down because she was never going to get used to being on her own if I didn't. I never acted upon this information but it does knock your confidence as a mother. I remember saying to them, please just tell me to keep going!

Even though Lizzie was only 6 months old, my husband and I decided we were ready to start trying for baby #2. However as I was still breastfeeding, would I be able to conceive easily or would it be a struggle?” Find out in Part Two next week!