Alia, in my private practice, if I have any concerns about stooling, I watch
baby’s weight gain for the first few weeks. I think letting baby go 6 weeks
before another weight check by the doctor might be risky. This baby may be
fine or may not. I noticed that the baby was 12 days rather than 14 days
old on the date when you posted, which makes a little bit of a difference.
The weight gain of seven ounces in seven days is good (as per your message
on 1/12/06: “born on 12/31 at 8 lbs. 3 oz and is now 7 lbs 12 oz. Lowest
weight was on 1/5 at 7 lbs. 5 oz.”). However, will the weight gain
continue? It is also noteworthy that the weight loss of a little over 10%,
which is a lot, occurred during the first 5 days, when the baby was being
supplemented; and the adequate weight gain occurred during the next 6½ days,
when the supplements were not given.
I would look for a reason why this baby is not stooling several times per 24
hours. Sometimes, I have found that a mom with a superabundant milk supply
may have a baby who stools only once every few days. It’s almost as if the
milk just gushes out so there is no need for baby to suck vigorously; the
peristalsis in the tongue never gets started and it does not travel through
the GI tract; and the stool is not pushed out easily/frequently. Afterward,
the baby may not know how to extract milk efficiently, the supply may go
down, and the baby may get into trouble. If this mom’s history of low milk
supply was an accurate assessment, superabundant supply probably is not the
reason in this case. Could there be another factor causing poor
sucking/little peristaltic action? Nipple confusion due to the bottles?
Maybe a tongue tie? A medical reason?
You mention the baby sometimes is still feisty. Does mom think “waking on
his own” means when he starts to cry rather than looking for early cues?
Does the baby need to feed more often…or longer on each side, especially the
first side, to get more hindmilk? I wish you and your colleagues luck in
finding the answers to help this mom and baby.
Lee Galasso, MS, IBCLC, RLC
Lactation Specialist
Westchester County in NY State
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