Consistently green stools in the breastfed baby can indicate:

• an imbalance of foremilk/hindmilk, often resulting in frothy green stools.
• a sensitivity to something in the mother's diet, such as cow's milk products.
• a sign that baby has an illness. Babies with an intestinal virus or even a simple cold will sometimes have green, mucusy stools. Teething can also bring about green stools due to increased saliva (can also cause tummy upset)
• a lot of green vegetables or something with green food coloring in mom's diet.
• If baby has started solids, that could also account for the change in color (this is normal with the change in diet).

SLEEPY BABIES

If your baby is sleepy here are some suggestions to help keep the baby awake and interested:

• make sure your free hand is supporting your breast so the weight of the breast isn't on the baby's chin
• switch breasts as soon as the baby begins to lose interest in active nursing, this *may* need to be done every 30 to 60 seconds at first (the first few times you do it). You should begin to see a difference within a couple days of doing this.
• Burp and change diaper. Burping should be done with the baby sitting supported upright on mom's knee or lap rather than over the shoulder because it's also less sleep-inducing.
• nurse in clutch or "football" hold as opposed to cradle hold - it's a little less "cuddly" and sleep-inducing.
• massage the baby's head (crown) in a circular motion while nursing. Also using a wet cold washcloth and wiping back against the grain of the hair growth can help Try this for several days and see if there's improvement, and please update us as you can.
• Place baby on your lap with legs near your tummy and head on your knees. Gently supporting baby, raise in sitting position, like doing a "sit- up". Do this two or three times, then do "side to side" a couple times.
• You can also try breast compression.

You may want to reduce any outside or excessive stimulation. (bright lights & noise) Sometimes babies just need to tune out all the noise/light and they do this by falling asleep.

ACTIVE SUCKING:

If you are having problems with the baby not actively sucking, you can try breast compression, or try the following tips offered by Kathy Kuhn RN BSN IBCLC:

Allow the baby to take normal pauses in his suck pattern up to about 15 seconds. If the pause lasts longer encourage him to suck again by:

• Taking a deep breath...sometimes just that movement of your chest makes the baby suck again.

If that doesn't work try...

• massaging your breast...take your whole hand and squeeze near the chest wall (GENTLY) then squeeze midway between the chest wall and areola then squeeze near to the areola and then repeat the sequence. Stop massaging as soon as the baby sucks.

If that doesn't work try:

• stroke under the baby's chin from chin to Adam's apple with medium pressure.

If you have tried all three and the baby is not suckling take the baby off the breast. If it has been less than about 10 minutes per breast of active suck then you should probably supplement after that feeding unless all other feedings have been super.

See additional tips on waking baby at Dr Wm Sears website, Ask Dr. Sears

BITING

Teething often brings concerns about biting. It may help mom to know that the actively bf baby cannot bite during the process of nursing. It is only when baby is not actively nursing that biting may become a concern. Sometimes this can happen if baby starts to fall asleep on the breast and "clamps down" to prevent the nipple from slipping away, or sometimes the baby is "testing" out the new teeth and will bite down on the nipple. Teething babies often "gum" things, including mom's nipple to help with the teething process, not understanding that teething on the nipple hurts!

The following links have tips to help with teething, scraping of teeth, and reduce/stop biting:

http://www.parentingweb.com/lounge/bf_biting.htm