2 week old is gaining weight but not pooping

[Gracecody]

Hi there,

I have a full term baby boy, born a day before his due date weighing 8 lbs, 14 oz.  I have two other children that I have nursed to 3 years of age each with no issues at all.

I have big nipples this time around and as a result we have been having latch problems since the very beginning.  My baby was down to 8 lbs, 6 oz at three days postpartum and then 8 lbs, 3 oz at six days postpartum.  During this first week he only had two poops but had seemed to expel all of his meconium.  He did most of it one day in a GIANT bowel movement.  We started really focusing on his latch and I began nursing him more frequently at the six day mark when we saw he wasn't regaining.  Then we had a big shock when, four days later, he had lost almost another pound. At that point he was down to 7 lbs, 5 oz.

So under our midwife's guidance we began a routine every 2 hours around the clock of nursing for 5 min each side, followed by my husband giving the baby a bottle of expressed milk while I pumped with an electric pump. After a few of these feedings he had another bowel movement. This is now day 4 of the 2 hour routine and he hasn't had another bowel movement - so it's been three days this time.  He gained 3 oz the first day and 8 oz the second day, we no longer have a scale so I am not sure where he is today but I believe he is continuing to gain. His latch has gotten a lot better, he still gets very tired at the breast though so it will be awhile yet before he is strong enough to get all of his calories directly from the breast. He has been getting around 16 oz a day from the bottle plus whatever he is able to get from the breast, so I think his calorie intake is where it should be for his weight.

He is having 6+ wet diapers a day so that is a really good sign.  Just worried about the bowel movements and hoping we won't have to take him in to the germy pediatrician's office. Just wondering if any of you have experience with less than daily bowel movements. He is 2 weeks old now. Thanks!!

[Megan73]

Poor you! I know how exhausting it is to nurse/pump/supplement around the clock.
The reason why lack of BMs is a concern is they're a red flag baby may not be getting enough milk and weight gain needs to be monitored closely. If baby is gaining, it can be their normal pattern - it has been for both my babes.
http://www.llli.org/llleaderweb/lv/lvdec97jan98p123.html
That said, I would suggest you see a lactation consultant and rent a sensitive baby scale to make sure your baby is actually transferring milk. I'm not a professional but I'd be concerned about a term baby who isn't "strong enough" to nurse well. Has he been checked for tongue tie? Have you talked to your doctor about why he's getting tired out at the breast even though he's now getting enough calories?
I'd also ask the LC about whether supplementing at the breast or using another feeding method (fingerfeeding comes to mind) might be a good idea to avoid flow preference.
Good luck, mama.

[etsdtm99]

yes, i would also be concerned about why he is getting worn out at the breast - that seems like a red flag for tongue tie or a suck problem if he can't transfer milk but you are able to pump ..  have you tried biological nurturing (aka laid back breastfeed) ? skin to skin contact etc... i would also see a LC about what could be making it difficult for him to transfer milk

[Gracecody]

I am not sure there's any problem beyond my large nipples.  He is able to open really wide and I am now able to get a much better latch with him, it just takes some persistence. I think that in some ways we have to bide our time and get through until he has more energy and also until his mouth grows a bit. :)

Today we have had MUCH better nursing sessions, longer and more energetic. I can feel the let down and hear him getting some good swallows which is a vast improvement. He has also had more awake/alert periods and a stronger drive for food when he wakes. So I *hope* a great poop is around the corner.

[MarineWife]

4 days without a bowel movement isn't something to be concerned about unless he seems to be in pain or constipated. It can be normal for BF babies to go as much as a week, maybe longer (can't remember for sure without looking it up), without having a BM. I, seriously, wouldn't worry unless you see other signs that he's in distress.

[Gracecody]

Thought I would post an update, that he finally pooped and it was giant! He pooped last night which was four days since the previous poop, and there were five days without a poop before that one. We went to the ped yesterday and he has regained a pound (!) in only four days which is great. Hopefully we will be back at birth weight before too long - 9 ounces to go. :)

Thanks for the thoughts and advice!