Hello, Micky.
In this condition, a section of the bowel is "dead"--no contractions to
push the feces through, so the waste backs up and there are very few stools.
And yes, when it backs up enough, the entire intestine above the dead area
and the stomach remain full, so there simply is no more room for more food,
and yes, the baby is in quite a bit of discomfort and refuses to eat because
there is nowhere for the food to go.
It is treated by surgically removing the dead portion of the bowel. The
situation I worked with, there was a large enough area removed that the
baby's good upper intestine was attached to the "outside" through a colostomy.
The upper and lower good portions were allowed to grow until the baby was 12
months old, and then they were reattached and the colostomy was closed. Baby
continued to breastfeed and was very healthy once the initial surgery was
performed. I don't know if it is possible that there might be less severe cases
where only a small section of bowel is dead, where perhaps they could just
take out the bad area and reconnect the remainder immediately rather than the
interim step of a colostomy.
Of course, breastmilk is best for any baby who undergoes surgery. The
easy digestibility of breastmilk is especially important for a baby who has
intestinal surgery of any type.
I have also seen babies react in a similar distressed manner for another
reason. If testing determines this baby does not have Hirschsprung's, you
may want to refer this mother to a pediatric chiropractor. I have worked with
several babies who had varying degrees of this problem. The worst was a
baby who would only eat for 2 minutes out of every 20 around the clock. Baby
had 20-25 nickel- to quarter-sized (U.S. coins) spots of BM in the diaper/day.
Each time this small amount of stool was released, baby had enough room to
eat for 2 minutes. This went on around the clock. At two months, mom was
exhausted. Since mom worked so hard to meet baby's needs, baby's weight was
fine, so pediatrician proclaimed there was no problem. It turned out that, in
this case and in several other less-severe cases I have seen, a vertebra in
the lower back had twisted and was riding on the nerve that controls the
intestines, so the intestines were not getting the message to empty properly. A
few weeks of treatment with a pediatric chiropractor corrected the problem,
turned the vertebra back to proper position, and then these babies stooled more
normally and could eat just fine.
Yes, baby will begin to eat once the problem preventing it is corrected.
Babies still get hungry and nature has implanted in baby a drive to
survive, so he will want to eat. However, he may need coaxing back to breast, if he
associates the delivery system with his pain. If he accepts a bottle, mom
can try (after correcting physical problem) to give him 1/2 ounce less than
his usual feeding, and then try offering breast as a "finisher", so that he
might again begin to associate the breast with comfort as he, hopefully, drifts
off to sleep there. Then, as he becomes comfortable with that, she can
gradually offer less in the bottle, and move him to breast sooner in the feeding.
When she is giving only half the amount by bottle that she used to, she
might want to try initiating the feeding at the breast, as long as she hasn't
waited so long that he is already frantic for that particular feeding.
Dee
Dee Kassing, BS, MLS, IBCLC, RLC
Collinsville, Illinois, in central USA
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