I guess I'm just wondering if anyone else has a baby who does't fill his pants very often. Would you be worried, in spite of everything else looking positive?
Generally speaking if your baby has a minimum of 6 wet diapers a day, is gaining normally, and not showing symptoms of constipation, however much he poops is totally normal. I'm actually a little confused as to why your midwife is so concerned.
He doesn't show signs of constipation. When he does poop, they're normal. Was your son like that from the start, or do you recall him going more often in the beginning?
Edited to fix autocorrect.
I just can't imagine what could be wrong with it if everything else checks out. There were a couple of times in the first weeks with my son when he actually was constipated and I didn't realize it. What I've always done when I suspect constipation in a small baby is just rub their tummies clockwise and then gentle press their knees up into their tummy. That seems to help them quite a bit. But if you're certain he's not constipated at all I honestly wouldn't worry. You'd know if it were something serious like a blockage.
"David Geller, pediatrician
A newborn can have as many as eight to ten bowel movements a day, but as long as she is having at least one, she's probably all right.
One day without a bowel movement is usually no cause for concern. As long as your baby is feeding well and wetting her diaper five or six times a day, then she's most likely getting enough to eat. If she starts to become uncomfortable or has a persistently swollen abdomen, then she may need some help with pooping, and you should speak to your pediatrician about how to facilitate this."
We pretty much had it drilled in our heads during LC training that at least 2-3 decent sized poops a day for newborns (the first 4 weeks) was necessary to tell that the baby is getting enough hindmilk. Lack of poop may be due to not enough hindmilk.
I honestly would see a Private Practice IBCLC and have her do a few pre and post feed weighs. Urine output is OK for older babies, who can go a few days without stooling and then have a huge blow out, but newborns really should be having 2-3 or more stools a day of at least the size of the palm of your hand.
The hardest part about tandem nursing is making sure the newborn gets both enough foremilk (high in lactose for brain growth and antibodies) and hindmilk (high in fat for growth and satiation.
Your baby may well just be a reluctant pooper. Or, if his one or two poops a day are really huge (like blow out diaper huge) he may be of course, getting enough of everything he needs. Does he stain the diaper with most feedings? How big are the poops?
I'd advice a visit from an IBCLC who will do pre and post feed weighs and will check his mouth and the latch, just to be on the safe side. It's easier to deal with any problems now than to try to play catch up later.