November 16, 2008,
C.R. asks from Piedmont, OK on November 12, 2008
Constipation in Breastfed Infant
My son is three months old and is having problems with constipation. He's strictly breastfed, and he used to go on his own every 5 or 6 days, which our doc said was normal. But now he won't go on his own, we have to give him suppositories. We went last week to a GI doctor, who said that he may be allergic to something in my breastmilk and I may have to switch to formula. He also said that my son has a small opening so I am supposed to do "rectal dilation" and stretch him out using my pinkie finger. I just want to know if anyone else has had these problems? I'm worried about my little guy.
So What Happened?™
Thank you so much to everyone who responded, you all had great tips. It's been about a month and a half since we saw the GI doctor, and I'm still breastfeeding. He may still tell me to switch to formula, but for now I'm nursing. I can definitely see a correlation with my diet. He started going about every other day when I was eating well and only drinking water or juice. With the holidays, I've slacked off a little, and now he's slowed down again, so I'm going back on my healthy high-fiber diet. =) We've also been giving him juice every once in a while. Thanks again to everyone who responded, it was nice to know I wasn't the only one who experienced this!
R.E. answers from Tulsa on November 13, 2008
Margaret gives a lot of good information. My son was very regular up until about the third or fourth month, and then he stopped going frequently. I think it's probably a normal phase infants go through. My husband is a registered nurse and he says the change in frequency and consistency of poops in young infants is related to the growth of natural flora in their intestines, the kind that digest all sorts of foods. Also, breast milk is uniquely tailored to your infant's needs - my mother-in-law was a registered nurse for years and then a nursing instructor for 16, and she says it's astonishing how the composition of breast milk changes over time to meet your baby's changing needs. Formula just can't compare. It's a good substitute if necessary, and formula-fed babies like me do just fine, but breast feeding is still the best way to go if at all possible.
When my son stopped going regularly, my husband said not to worry unless it's been at least 7 days since his last poop, and then to give an ounce or two of prune juice. We just gave straight prune juice. You may be lucky and find a six-pack of small cans in the juice aisle, so you don't end up using two or three ounces out of a quart! Anyway: constipation is determined by the consistency of the poop - if it comes out like deer pellets, that's constipation. I think part of what your son is going through right now is learning how to push thicker quantities through his rectum, as opposed to the liquidy first poops that newborns have. And that's okay. I'd worry about my son becoming dependent on rectal stimulation in order to poop, which is why I only rarely used the thermometer trick. After a couple months of infrequent poops, his body sorted things out on his own and he's been rather regular ever since.
Perhaps you could read a book like "Baby 411" which goes into incredible detail on anything and everything infant. You should know that if you switch to formula, your infant's poop may get thicker, since formula is not digested as efficiently as breast milk. The color and smell will also change. Perhaps look into changing your diet first, like reducing dairy intake or "strong" vegetables like cabbage or cauliflower. And get a second opinion, from a lactation consultant. They tend to know a lot more about breast milk than the average doctor, simply because they've specialized in that area of knowledge.
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S.C. answers from Birmingham on November 13, 2008
I agree witheverything Margaret said. DO NOT STOP BREASTFEEDING! It is the best thing you can do for your baby. I breastfed all my 4 boys for atleast a year. Keep up the good work.
Is your baby gaining weight? Is he happy? Then he is not allergic, but if he has stopped gaining and unhappy - you may need to look at your diet. Remember what we eat can affect baby too. Keep a journal of what you eat and notes on how baby reacts.
My sister-in-law (SIL) breastfed her daughter. The baby stopped gaining weight and became a bit ill. It was suggested that maybe she was allergic to dairy product - my SIL ate alot of dairy. My sister-in-law cut out dairy in her diet, continued to breastfeed and baby thrived.
Hope this helps.
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K.S. answers from Oklahoma City on November 13, 2008
Personally, I would not switch my baby to formula in this situation, but I would try to get my baby to breastfeed more often so he is getting more liquids down him to help soften his stools.
Breastmilk is the best gift we can give out kiddos. One thing came to mind though. Are you getting enough fiber in your diet... such as fruits and plenty of non-starchy veggies?
Are you drinking at least 64 ounces of water a day? Try adding more water and fiber to your diet and see if that helps.
My 2nd child also had constipation at birth. We had to use a baby thermometer to get things moving down there but everything worked out and she is 20 months now and doing great.
Keep up the breastfeeding. It always suprises me when a doctor tells a mom to switch from nature's best food for babies to formula... just goes to show doctors do not know everything.
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J.H. answers from Oklahoma City on November 13, 2008
It just slays me everytime I hear of a doctor telling a woman that her breastmilk is not good enough.
First, if you're drinking sodas and teas - STOP. They are diuretics, and contain a multitude of additives that can harm your baby (and you too). Drink tons of water, and nothing but. If you need flavor and bite, mix some fruit juice with seltzer (nature's soda pop). Try to eliminate as many processed foods as you can - MSG is in just about everything we eat, and that includes ALL restaurant foods. Here is the reason why:
Just remember that your baby IS what you eat, literally, so give him the best start possible. As for pooping once or twice a week while breastfeeding, that doc is WAAAY wrong. He should be pooping once or twice a DAY. All illnesses start in the colon, so the quicker that stuff leaves the body, the better. Try a high fruit, high-fiber veg diet (Benefiber doesnt count) with lots of water and fruit juices and you should see a massive change within two weeks. If not, your baby does have a gastric issue that should be looked into, and throwing cow's milk on top of that will only complicate the problem. I hope this helps, and stay strong and firm in the face of "you're not good enough to feed your baby..."
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A.W. answers from Mobile on November 13, 2008
Do you know a good Chiropractor that works with infants?
If not, find one that uses the book Body By God in his/her practice and is trained to work with babies/children.
This worked wonders with our son.
Our baby girl (due any day) will be receiving chiro care immediately after birth.
Going through the birth canal can affect their spine in such a way that it complicates internal issues causing all sorts of things (e.g. constipation, vomiting, etc.).
Let us know what works for you.
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A.H. answers from Pine Bluff on November 13, 2008
YES!!! People used to not believe me because they said breast-fed babies shouldn't get constipated. I never was told that my babies could be allergic to something, but to be honest, my first child's doctor was the only one I talked to about it, and he never brought that up. He did mention the small rectal opening and suggested the pinkie dilation. We did that and suppositories until each child was old enough for juice - we started juice a little early, around the four month mark. With my oldest, pear juice was enough. The next two had to have prune juice. (Diluted to 50% with water). All three had to have their juice daily without fail until about one year of age or they'd have problems.
It's such a stress, but as his bowels develop he will move past it, probably around age one. I know that seems like forever, but one day you'll wake up and realize that he's regular! It's a wonderful feeling. As for weaning him from the breastmilk, I would do if it your doctor says you have to, but breastfeeding is so good for babies! I'd ask him if there were other options.
A.C. answers from Oklahoma City on November 13, 2008
mine was the same way, exclusively breastfed and still pooped yellow playdoh every four days, with a suppository. we werem't told to "stretch him out" that just sounds painful and damaging to me. his pooping got more regular as he started solids, around 6 months. that said, he also took miralax, and at five, is still pretty consipated most of the time. we didn't have to do the suppostiorties after a while, but things never got easy for him. i still give him miralax, on occasion, when he is having difficulty. we tried karo syrup, juices, everything. one of our problems might have been that he neve knew how to drink from a bottle, and had a hard time getting the liquid down.
K.D. answers from Fort Smith on November 13, 2008
My youngest had constipation also. She was breastfed and children cannot be allergic to breastmilk, told to me by Childrens Hospital!! Our Peditrician gave us a cover to a themomoter and told us to stimulate the rectum about a 1/2 inch in, in a circular motion. It always worked. Do it every 2 days. It made my little girl regular and she started going everyday.
Mother of 3 girls, Ages 5, 3 1/2, and 2!
M.M. answers from Huntsville on November 13, 2008
My niece had the same problem -- and her rectal opening was very close to her vagina. My sister used Colace for several years, the rectal dilation, etc. Bailey is now a grown woman and doing well!
I'm sure your child will cry when you do the rectal dilation, but better a little "hurt" now than constipation and much bigger problems later.
M.O. answers from Baton Rouge on November 12, 2008
C. - PLEASE DO NOT STOP BREASTFEEDING OR SWITCH YOUR PRECIOUS BABY TO FORMULA. Oh, it makes me so mad when a doctor tells a woman to switch to formula! There is no need to do that! Doctor's do not know everything, and switching to formula could do a lot more harm then good. Exhaust ALL other options first...please. Call a La Leche League Leader in your area, or a lactation consultant from your hospital. These ladies will help you or tell you where to go to get help, supporting your decision to breastfeed first without some cop-out answer "oh, just switch to formula". Look at this info...
Breast milk is a natural laxative; however a breastfed infant may become constipated due to the introduction of foods or formula. Formula in particular is constipating. The single best remedy is simply more breast milk! Generally, reasons for constipation in a breastfed baby are the following:
1. Illness that requires medical care
2. Formula consumption
3. Starting solids
You should know, while the amount and frequency of a breastfed baby's wet diapers and bowel movements can be a valuable indicator of his well-being, there is a wide range of normal in infant stooling patterns. (That's info from the LLL website)
Many parents wrongly think that their breastfed baby is constipated. This false thinking may be attributed to one of the following reasons:
1. Parents do not understand the difference between constipation and infrequent stools. Constipation is defined as hard, dry stools. Constipation is not infrequent, soft stools. Most babies will grunt and visibly strain to pass stools. This is not an indicator of constipation either.
2. After 6 weeks of age, an exclusively breastfed infant's stooling pattern changes. Up until this point, a breastfed infant generally exhibits the gastro-colic reflex, meaning he tends to have a movement several times a day, often after each feeding. After the early weeks, his intestinal tract develops more, and this reflex subsides. After this point, it is perfectly normal for a breastfed baby to go more than a week between bowel movements.
Mom Tip: A warm bath can help stimulate bowel movements.
(That is info from kellymom.com)
R.F. answers from Fayetteville on November 13, 2008
I had this problem with my first son and we figured out he was lactose sensitive (not allergic, just sensitive)by following the pediatricians recommendation and I began cutting out certain food groups for a week until we figured out what could be causing his constipation. Well, we figured out it was all the cheese i was eating, so...gulp...I had to give up cheese, or at least high amounts of cheese, until we had to switch him to formula later (which had nothing to do with his lactose sensitivity, we had other health complications).
C.H. answers from Oklahoma City on November 13, 2008
I feel for you. I went through these same problems about 3 months ago with my sweet baby boy. When these problems started occuring with my son, we went to the Dr. and they also sent us to a GI specialist. We had the same results, small rectal opening. Our Dr. said to do the same thing. I was worried about doing this. My husband did what he was supposed to do.
Let me tell you things are better now. We no longer do the rectal dilation. We did have a few set backs when our son started solids. He began having problems again. We had to resort to suppositories, to get him going again. Now our son is old enough to get 1 tsp. of miralax in his morning bottle. This has helped tremendously. He now has a BM everyday or every other day. He is still on breastmilk and doing great. Believe me I never thought their was going to be a light at the end of the tunnel, but there is!!! Have faith that things will get better and they will.
S.C. answers from Fayetteville on November 12, 2008
Dear C., I have never heard of anything like the small opening. But I did breast feed all 3 of my children and they did get constipated quite often. Here is a little trick that helped me so much and I didn't learn of it until my 3rd child. Buy the little jars of Pear Juice in the baby isle at walmart and give one a day sometime during the day. Do not substitute your feeding, just slip it in their somewhere. I am assuming that he will take a bottle as well as the breast. I forgot that I also supplimented with formula so my babies would take a bottle too. Anyway, I hope that this helps because it was a God send to me. By the way, the only nipples that my babies would take while I was breast feeding were those little cheap ones that go on the regular glass or plastic bottle. We tried all those new fandangled ones that cost lots of money and are shaped all different ways and are supposed to do all these special things but none worked as well as those plain simple little nipples. Best of luck and enjoy him because the grow up so very fast. Mine are 19, 17 and 9. S.
M.E. answers from Jackson on November 13, 2008
My good friend had a child just the same, her lactation consultant told her to pump once or twice a week, put it in a bott,e and put 1-2 tablespoons of prune juice in the bottle. Works every time!
C.T. answers from Little Rock on November 16, 2008
Honestly, I thought the problem I had with my son having constipation and difficulty pooping was because I quit breastfeeding him and started formula. That poor child had such an upset tummy and cried. I had to use suppositories to help him poop etc.
I am exclusively breast feeding my daughter now and am doing wonderfully. I will have to say I completely agree with those who have said to watch your diet. If I have caffiene in the morning I pay for it later through her crying in the evening. If I eat too much sweets it shows in her skin, she will get pimples. I don't drink soda but my weakness has always been tea so I am drinking decaf now (and will probably always from now on) and have cut coffee out completely (learned coffee can stimulate cervical dysphasia even decaf) and will continue to fight that craving too. My daughter poops at least once a day. She used to poop with every feeding but has slowed down over time (thank goodness lol)