Thoughts, Opinions and Help Please--newborn concerns

[poorlittlefish]

I had my second daughter on Saturday. This is the second baby that I have nursed after my breast reductioin 10 years ago. The first baby was a horrible cycle of weight loss, not enough wets, sleepy baby, pumping, supplementing, formula etc until 3 months when I was able to work up to a full supply. It was always hard to maintain that supply and she did have formula bottles at daycare a couple of times when i wasn't able to pump enough. I nursed her for 14 months.

Now, baby #2. I was fully mentally prepared to go through that again and even bought some formula so that I could be ready. She was born naturally at 9lbs, 9oz and latched on right away. Her latch is painful and is leaving me blistered and scabed but we are working on that. She latches on eagerly though and nurses often for food and comfort.

What i am concerned about is her lack of poops. She seems to be gaining (these were on different scales but, i need to accept the information at some point or I will go nuts) Her discharge weight was 8lbs, 15oz and on Wednesday it was 9lbs, 1/2oz. The home health nurse induced a poop on Wednesday but other than that, we hadn't had one in quite a while. This is her schedule since birth:
Day 1: 5 dirty, 3 wet
Day 2: 2 dirty, 2 wet
Day 3: 2 Wet
Day 4: 5 Wet
Day 5: 5 Wet, 3 dirty (Home nurse induced)
Day 6: 7 Wet
Can she be gaining without pooping? I was told not to let 48 hours go by so I might need her to poop today. The last poop on Wednesday was meconium but starting to change. Do I need to worry?

Also, I haven't done any pumping only nursing 10-12 times per day. I really don't want to but I also don't want to damage my sensitive supply. She usually nurses off one breast and then an hour later does the other. My older DD took both. I worry that I don't make enough in 1 breast to fill her up and by waiting that hour to take the other, my supply my be shot. I don't want to pump if I can avoid it but if I have to, I will.

If you made it through this email I appreciate it!

Thank you!

[rparker]

It could very well be a variation of normal. It's a good sign that she's having at least 5 wet diapers every day. Here's what LLL has to say:

Most babies, after the first few days, have two to five bowel movements every 24 hours, until they are about six weeks old. The stools should be as large as a US quarter to "count" in this number. Some babies will have more frequent bowel movements, and it is possible for a healthy baby to have fewer bowel movements. If a baby younger than six weeks has fewer than two bowel movements a day, that can still be a variation of normal provided that the baby has an adequate number of wet diapers, is known to be gaining weight at an adequate rate, and the stools produced are substantial in volume.

http://www.llli.org/FAQ/bm.html

Talking about your situation with a LLL leader might provide you with some reassurance: http://www.llli.org/resources/assistance.html

[spughy]

While it's true that there is a huge variation in how much babies poop, there definitely is cause for concern if the baby is still showing meconium in the poop at day 6. And newborns, once the milk is in, really ought to be pooping every day. Two-three weeks, sure, missing a day isn't cause for concern, but less than two weeks old - yes.

How exactly did the home nurse induce a poop? Was there a glycerin suppository involved, or a laxative...? Is the baby jaundiced at all?

What day was she discharged on? She should be gaining at least 1/2 oz per day - 4-8oz per week. It seems like her weight gain is fine...? The nurse might be concerned that her bowels are not functioning properly and not moving the stools, not that you are not producing enough milk.

However, if it is not going to damage your nipples, I would say pumping might be a good idea, just until she gets a bit stronger, her latch is perfect, and she can suck more effectively. Early damage can be a sign of a latch issue, which is typically indicative of poor milk transfer unless supply is more than adequate. Whatever you do, though, don't supplement with a bottle, as that can mess up her latch and cause further problems. Ask the home nurse to show you how to cup-feed properly or use a syringe.

[PatioGardener]

this is a great lll article: http://www.llli.org/llleaderweb/LV/L...Jan98p123.html

nak

[Megan73]

As Patio's article explains, stooling is really important because baby can be getting enough to be hydrated - as evidenced by the wets - but not getting enough milk to gain.
Have you done any test feeds to see how much she's really transferring? Renting a baby scale would be a good idea, I think, because you could do test feeds and keep a close eye on weight, too.
Are you taking domperidone?
Do you have have an at-the-breast supplementer?
I'd do a day of weighed feeds to figure out how much she's transferring and pump and supplement if it's low.

[poorlittlefish]

thanks for the replies...i am currently nursing so excuse any typos, please.

she was discharged monday with a weight of 8lbs, 15oz and her weight on weds, on different scale was 9lbs, 1/2oz.

the nurse used the thermometer in the butt to make her poop and we did it last night as well and she pooped about an hour afterwards and it was huge. dark green and kind of slimy like it still had some meconium in it.

i dont have an at breast supplementer, i will look into it, i have her first apt on tuesday and am hoping for a good weigh in. if not, i will rent a scale.

is it possible to have enough wets but still not be gaining?

i hate worrying like this. our drs office doesnt do free weigt checks and our insurance is so bad otherwise i would have already gone in.

[PatioGardener]

Originally Posted by poorlittlefish

is it possible to have enough wets but still not be gaining?

yes, this is possible.


do you have access to public health services? here in canada they do wt checks for free. la leche league is also a great resource.

hang in there!

nak

[poorlittlefish]

no, I don't have access to public health services, i have her Dr.s apt late Tuesday afternoon and hopefully will know more at that point.

I tried to reach a LLL leader and she basically just emailed me back, I might ask if we could meet in person but he didn't seem to want that.

Thank you for all you replies.

[Hannah32]

Don't have any answers, but wanted to let you know that you are not alone. My little guy, five days old today, hasn't pooped at all since a rectal stim on the day we left the hospital. That wasn't much more than a smear and it was Sat morning.

Plenty of pee, but no poop. Nurse came and listened for bowel sounds....all good thank god. He's active, vigorous and passes gas pretty regularly. I've been feeding him about every two hours, and even pumping one breast for some bonus liquid. I'm sore from feeding, but it's manageable and he seems to have a good latch. We did work through some positioning issues last night that I think were making him pop off too soon. Three good feeds in a row today.....

It's scary, esp as a first time mom, but we head to the pedi today.

[sosurreal09]

my DD didnt poop for nearly 2 weeks after the first couple days and i was FREAKING out but then i started taking probiotics and she started pooping normally. have you tried a little stimulation with a thermometer?

i must say i admire you for keeping with it with all your previous hardships! you are a strong mama!!

[PatioGardener]

how are things today?

[poorlittlefish]

Still no poop. We did the rectal stim thing last night and nothing happened. But, like the previous poster, she passes a lot of gas so I feel like things are "working" down there....I don't know. I guess I will find out tomorrow at her ped apt. I wish I could get in today instead but gotta wait I guess.
Thanks for checking in...I will update when I learn anything.

[Hannah32]

Well, my kid took two massive craps about an hour after I wrote that post. I never thought crap could bring me so much happiness. It was transition poo, very dark brown, but not mec. It was quite reassuring.

The peditrician wasn't worried when I told her about it either, though it was post poo, so that is expected. She did suggest massaging the belly gently if it happens again.

I'm sure the same thing will happen for your baby......sending good vibes to you.

[poorlittlefish]

Just got back from my appointment with the Ped.
She listened to her belly and heard bowel sounds, so she is "working" down there. She also felt her belly and it didn't feel hard or distended. She isn't too worried about it.

Her janudice levels have increases slightly but she isn't concerned because they are still low--she just suggested getting her outside a bit.

As for weight gain, she has gained an ounce and a half in 6 days. Not great but not horrible. Yes, the weights were all on different scales but I will be having another weight check next week and I will get the same scale.

So, plan of attack--she has been going 3-4 hr stretches at night and then not eating well when she does. She also has been going a 3 hour stretch at least once during the day. So, going forward, I will not let more than 3 hours go by between feedings at night and no more than 2 during the day. She is a bit sleepy so that will take some work. Hopefully, we can make some gains between now and next week's appoitnment.

Does anyone have any other thoughts on what I could do to amp up the weight gain between now and next week or thoughts? ALso, she is a snacker, she sucks a few times, then nibbles for 5 mins. How can I keep her actively sucking?

Thanks!

[poorlittlefish]

She pooped! She pooped! Maybe the every 2 hours thing is working already....

[ShwarmaQueen]

DS didn't poop for days and was still gaining, but in hinesight, it was related to him not getting enough fluids due to being tonguetied. When we had it clipped and his volume increased, he began pooping multiple times per day. So, I wouldn't say it was always normal, but it can be. Weight gain is a more measurable standard.

[PatioGardener]

YAY for poop!

Try breast compressions to keep baby sucking. When she stops (but is still latched) squeeze the upper part of your breast - just grab it with one hand and squeeze. The milk will squirt into baby's mouth and get her to keep going.

http://www.nbci.ca/index.php?option=...lips&Itemid=13 has compressions on it.

[poorlittlefish]

Hi Ladies!
Just got back from my weight check at the peds...in 7 days she has gained 6oz!! She is within 1 oz of her birth weight and she is 17 days old today. I am so excited and can't believe that my body is atually doing what it is supposed to do this time around. In the past 7 days, she pooped only 2 of those days but they were massive so maybe, this is just how her little body works.
I am going to order more Fenugreek today though, just to keep up my supply.

The Dr. said that I can let her go 5 hours at night if I want to. Would you all suggest, given my circumstances that i keep getting her up sooner than that (currently doing 1 4 hour stretch and then 1 3 hour)?

Thanks ladies for all your help!

[PatioGardener]

Originally Posted by poorlittlefish

Would you all suggest, given my circumstances that i keep getting her up sooner than that (currently doing 1 4 hour stretch and then 1 3 hour)

yes - i'd go that way for 1 more week and if wt gain still good would back off. well done Mama!!!