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Do we have a problem? Newborn not pooping.

post #1 of 21
Thread Starter 
I need rational opinions, perspective, hugs, something.

My daughter is almost 4 weeks old. EBF, no supplements, no bottles, unassisted birth, no hospitals and all that entails. For the record, I nursed my oldest with no supplements until he weaned at age 3.

She was 7lbs 13oz at birth.

One week 7lbs 7oz

Two weeks(different scale) 7lbs 10oz

Three weeks 7lbs 10oz

Three and a half weeks 7lbs 15oz

She had meconium poops the first two days, then a normal yellow, seedy poop on day 3, day 10 and day 19. The one on day 19 I facilitated with a glycerine suppository.

She soaks very absorbent obv fitteds 12+ times a day. She is alert, happy and nurses every 1.5-2 hours. No hunger signs after nursing. Her latch isn't great (being evaluated for tongue tie Thurs - she has a severe upper lip tie) but with lots of compressions I see lots of swallowing and the typical suck-suck-pause. She is not lethargic and she has great muscle tone. She is not gassy and doesn't seem to need or want to poop.

She was jaundiced, and it presented on day 8 of life and was totally gone by day 25.

I took her to the pediatrician at 2 weeks and he wasn't at all concerned about her slow gain and not pooping. He said to bring her back at 6 weeks. Not sure how much I trust him, though, because he tried to force a copy of Babywise on me in the same visit. He's just the only pedi around that is okay with not vaxing.

I am driving myself crazy wondering if I am starving my child to death. I've never been an over producer but I did produce enough to grow my oldest. He did pretty much nurse round the clock until he started solids, but he had a good growth rate and pooped often. I have long suspected borderline IGT, based on several red flags, but I thought it would be better this time, not worse.

Do I need to be more concerned about her not pooping and gaining so slowly? Like, to the point of supplementing? I squall when I think about giving her a bottle, but I know, logically, that her being fed is most important.

We spend 95% of the day skin to skin, no exaggeration. I put her down to shower and change clothes only. We take baths and I wear her topless when we aren't nursing, which we do as often as she is willing. I keep her on the same side until she us done, wake her up by changing her and put her back on that side for another round to be sure she is getting hindmilk, compressing the entire time. Then repeat with the other side.

My diet is healthy and I drink a ton of water.

Anyone have any input?
Edited by L J - 9/27/11 at 7:58pm
post #2 of 21

I would be slightly concerned.  I'm glad you're getting an eval for TT and lip tie because that very well could be the problem. If you produce *just enough* with no wiggle room (I do, too, so I know how it is!), then your dd possibly having an anatomical problem could be the difference between her getting fewer calories than is ideal and not. 

 

Here's another thing about pooping and peeing that I learned when we were going thru TT hell.  Foremilk (the milk she doesn't really have to work for) can lead to plenty of peeing. But not getting the fatty hindmilk can mean not pooping enough, and therefore not getting enough calories.  And it takes work and proper sucking to get that hindmilk which will be difficult for a tt babe.  

 

Everything I read said that daily stooling is important up until 6 wks old.  If that isn't happening, something isn't right.  (I was in denial about this for several weeks with my tt baby, but when I started pumping to get the milk into him and supping with formula, I realized how much more pooping and peeing he should have been doing).

 

 

From http://www.llli.org/llleaderweb/lv/lvdec97jan98p123.html

Quote:

Even if urination seems consistent with the above guidelines, the absence of daily newborn stooling remains a cause for concern. According to Ruth A. Lawrence, MD in her book Breastfeeding: A Guide for the Medical Profession, Fourth Edition, page 273.

When...[daily newborn stooling]...does not happen, the physician needs to confirm that all is really well. This means a check of urine output...and urine specific gravity as well as a review of breastfeeding patterns. The purpose is to identify the potential failure-to-thrive situation before it becomes serious.

 

and http://www.askdrsears.com/topics/breastfeeding/faq’s-about-milk-supply-and-breastfeeding-challenges/getting-enough-milk-how

 

 

Quote:
While urine output tells you that baby is getting a sufficient quantity of fluid in the milk, stool output tells you about the quality of the milk, (i.e., whether baby is nursing long enough and well enough to trigger mother's milk ejection reflex, which brings the creamier, high-calorie hindmilk). When week-old babies are not producing sufficient stools, it's time to take a closer look at what's going on at the breast. Check the Signs of Efficient Latch-on and Suck and get help from a lactation consultant. Talk to your doctor to determine if your baby needs extra milk during the time he is learning to breastfeed more effeciently.

 Good luck with your eval!  I recommend pumping if you can so your milk supply doesn't taper off.  


Edited by homemademom - 9/28/11 at 9:26am
post #3 of 21

ETA thought I was quoting the PP's post...

 

 

Excellent post - I second the pumping for now (post feeds) to keep up supply. Remember you can supplement at the breast, and also donor milk may be an option (before needing to introduce formula), if baby needs more than you are currently producing.

 

These first few weeks are important to establish supply, so looking into some milk increasing herbs or medication and expressing some how on top of nursing may also be helpful.


Edited by PatioGardener - 9/28/11 at 8:45am
post #4 of 21
NAK
The slow weight gain would really concern me. What I did in the same circumstance was have my LO's suck evaluated (he'd already had a TT clipped), start domperidone and pump after feeds. I also supplemented at the breast with a Lact-Aid, using the pumped milk and some formula until my supply increased. I was able to get my LO on all BM within a few days of starting this regimen, weaned off all supplements a few weeks later and finally - it took a while - weaned slowly off the pump.
Your ped should have been concerned about the stooling - it's a not a problem if babe is gaining well but it is a red flag for low intake.
post #5 of 21
Thread Starter 
If I could pump, this wouldn't be quite so tragic. But, it doesn't matter what variable changes, what kind of pump, time of day, nursing and pumping at the same time, etc - nothing comes out. Nothing. I cannot exaggerate that enough.
post #6 of 21
Thread Starter 
I'm meeting with a IBCLC in two hours, and then having her evaluated at a pedi dentist tomorrow. I really appreciate the replies. I am completely freaked out; I never in a million years thought I might have to give my baby formula. Hopefully I can purchase a Lactaid through the LC and not have to wait on one to ship.
post #7 of 21
Quote:
Originally Posted by L J View Post

If I could pump, this wouldn't be quite so tragic. But, it doesn't matter what variable changes, what kind of pump, time of day, nursing and pumping at the same time, etc - nothing comes out. Nothing. I cannot exaggerate that enough.


oh Mama, I feel for you. You are not alone - there is good research out of Australia showing that some women can't pump because the milk ducts get squished. Sometimes hand expression works for these women.

 

hug2.gif

post #8 of 21
Quote:
Originally Posted by L J View Post

If I could pump, this wouldn't be quite so tragic. But, it doesn't matter what variable changes, what kind of pump, time of day, nursing and pumping at the same time, etc - nothing comes out. Nothing. I cannot exaggerate that enough.


I don't really have "over-supply" and I have to pump at certain times and such - but I can always get some milk from a pump if there is some milk to get.........Are you SURE you aren't having supply issues? I would be really worried if I could get no milk from a pump. Especially in the first weeks when I always seem to have the MOST milk since it is still getting established. 

 

((((hugs!)))))) I hope you get everything figured out! 

post #9 of 21
Thread Starter 
Annie - I don't think I have supply issues. I don't over produce, but I leak a bit and tingle every hour like clockwork. But, at this point, anything is possible. Something isn't working right.
post #10 of 21
Quote:
Originally Posted by L J View Post
 I am completely freaked out; I never in a million years thought I might have to give my baby formula. 


I know. hug.gif It will be okay.  You're meeting with an LC, that's great.  There is donor milk you can get through the facebook group Human Milk 4 Human Babies.  I had to give my ds formula and it was agonizing. I cried so hard. But afterward, when he was full and content and pooping and peeing, I knew I'd done the right thing for him. We kept working on the TT stuff and eventually, we got things sorted out.  It will be okay.  You're on top of the problem, you're getting help, you'll get to the bottom of this! Let us know how it goes with the LC.

post #11 of 21
How did it got with the LC?
Hang in there mama, I know how agonizing this is. I'd like to add, though, that supplementing may be necessary but it could be temporary. It may be a stopgap measure to give formula (if you can't get donor milk) but you may well be able to work out whether it's a supply or transfer issue and fix it. Hang in there.
post #12 of 21
Thread Starter 
Thank you so much for asking, Megan.

It went really well, and I feel a thousand times better.

The LC supervised a feeding, and said that while her latch isn't great, its good. She saw more swallowing than I did. She suggested that I undress her at each feeding to keep her awake so she will transfer more milk, and to keep up the breast compressions. She said that some of the latest research shows that its not babies that stay on the breast longest that get the most calories, its the ones that nurse most vigorously at the beginning of each nursing session. So, my goal is to make sure she's very awake when I latch her on and keep her that way - no more dozing and sipping for hours at a time.

She suggested that I go to the pedi for a before and after weight, because her scale wasn't sensitive enough.

They got me right in, and she was up to 8lbs1oz!

I had nursed her from 12:30 until 1:45 or so, so she wasn't quite ready to nurse again at our appointment at 2:30, but she still transferred 1oz.

The doctor said he thought that was great, considering she had just nursed, and he does not think I need to supplement.

He wants me to give dd 3/4 teaspoon of milk of magnesia every day until she is stooling regularly. I haven't done any research on this, but off the top of my head I can't think of any reason why it would be a bad idea.

I am supposed to take her back in one week to talk with him about how things are going.

I am still going to keep her appointment with the pediatric dentist tomorrow, because I want to talk to him about how her upper lip tie will affect her teeth if nothing else. (My oldest had to have dental surgery at age 3 to fix two fused teeth, so I would like to avoid anything I possibly can with her.) The LC doesn't think she has a tongue tie, but I will appreciate the second opinion.
post #13 of 21
Great news, Laura!
IMO, I'd hold off on the milk of magnesia - from what I've read, the lack of stools is a concern because they may be a sign that baby isn't getting enough milk, not because it's a problem in and of itself (unless the LO is really constipated - ie stools are hard, unlikely to be a problem with BF babies). I get the worry though - I've dosed mine with prune juice and wish I'd left well enough alone given both were gaining well at that point. I've since learned LLL recommends against it.
post #14 of 21

yay! I am so happy for you!

 

I did not know that there is research showing some woman can't pump........learn something new everyday I guess thumb.gif

 

That is also interesting about the nursing vigorously at the beginning - my youngest was the quickest nurser I have ever seen, but she gained well.......shrug.gif

post #15 of 21
Thread Starter 
I went to Target tonight to buy some, and they were sold out. I'm going to take it as a sign, and hold off for now. smile.gif
post #16 of 21
Thread Starter 
I may start a new thread about this, but I wonder if the infant probiotics would do her some good? The guy at the hfs was pushing them on me the other day, said they would be good for her. At $35 a jar, I would think so! Has to be more gentle and natural that MOM.
post #17 of 21

I'm glad you had a good visit with the LC. So, she thinks your babe has been sleepy and thus not taking in as much as she could?  Did she think that the poops would increase once you made sure she was wide awake? If so, I would hold off on anything to induce her to poop. It will come if the milk is there, especially since breastmilk poop is so soft.  

 

I'm glad you're keeping your dentist appt, too. I don't mean to be a downer but two LCs, my ped and my mw all thought my babe's latch was good, though a little shallow.  In reality, he had a pretty severe posterior tongue tie and lip tie (his poor little lip was glued to his upper gum and he couldn't flange it at all!).  Hopefully, the dentist can give you some good information.

post #18 of 21

I guess maybe I am the odd one out, but I don't see anything wrong with her pooping schedule as long as she has plenty of wet diapers. My son was the same way. He just weighed in at 20 pounds at 6 months, so I think he is fine. Some breast fed babies just do not poop a lot. Breast milk is tailored to fit your baby's needs, so they absorb almost all of it. As long as she has plenty of wet diapers and doesn't seem uncomfortable or like her stomach is distended, I would not worry. I would become concerned if it went longer then two weeks between.

post #19 of 21
Quote:
Originally Posted by Katarianna View Post

I guess maybe I am the odd one out, but I don't see anything wrong with her pooping schedule as long as she has plenty of wet diapers. My son was the same way. He just weighed in at 20 pounds at 6 months, so I think he is fine. Some breast fed babies just do not poop a lot. Breast milk is tailored to fit your baby's needs, so they absorb almost all of it. As long as she has plenty of wet diapers and doesn't seem uncomfortable or like her stomach is distended, I would not worry. I would become concerned if it went longer then two weeks between.



That is only the case for breastfed babies older than 6 weeks though.  

post #20 of 21
Quote:
Originally Posted by Katarianna View Post

I guess maybe I am the odd one out, but I don't see anything wrong with her pooping schedule as long as she has plenty of wet diapers. My son was the same way. He just weighed in at 20 pounds at 6 months, so I think he is fine. Some breast fed babies just do not poop a lot. Breast milk is tailored to fit your baby's needs, so they absorb almost all of it. As long as she has plenty of wet diapers and doesn't seem uncomfortable or like her stomach is distended, I would not worry. I would become concerned if it went longer then two weeks between.


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