A very experienced breastfeeding mother called me with concern about her 2nd child's stools.  The first few weeks of the baby's life, the stools and frequency seemed within normal limits.  Several weeks later the mother called because her child was going several days without stooling, but when she did it was not difficult or hard.  I reviewed with her the information about some baby's skipping several days but still having normal output, and the baby was still comfortable, advancing appropriately.

Now, I get a phone call with the following facts:
Baby going about 7 - 8 days without stooling. The stool did come sometimes after a suppository, and it was "thicker- more clay like".  After 7 - 8 days the baby seemed uncomfortable and seemed to be straining a lot.  The mother did try a glycerin suppository and the baby did pass a large thick stool, followed by softer stool.   Ped. ordered barium enema to rule out Hirschsprung's disease.  Came out negative.
Mother was told to add more fruits and vegts. to baby's diet.  (baby has just started on a few teaspoons of solids recently)

Referred to a pediatric GI specialist.  She told the mother to nurse less often and give the baby more foods and juices.  She thought the stool was sitting in the bowels too long.  Also mentioned that the spacing of the rectum was a little closer than usual to the vaginal area, perhaps a contributing factor.  Told her to try this for 1 week, then she would start the child on Milk of Magnesia in very small quantities as a trial.  She also encouraged the mother to do some infant massages.  She will possibly consider more testing, of the thyroid.  There was also some mention that "after 6 months the breastmilk was not as important" or some similar comment.

Mother is questioning this plan and called me to talk it over.  She plans to breastfeed this child over a year as she did her first, she is concerned that her milk supply may go down if she increases the solids too quickly.

I am asking if anyone has had a similar problem?  My thought is since Hirschsprungs has been ruled out, and the Dr. told her there is not much more they would do for a baby, is continued testing really necessary?  Why would we continue to add something less beneficial to this baby's diet when we don't know if it will work any more effectively.  Is this creating more problems?  Perhaps time will take care of this?  Any comments will be appreciated.

Evelyn Landry, RN, IBCLC, RLC
Lafayette, Louisiana
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