Dear Jennifer,

Have to chime in here as well.  I had two children - one with severe food allergies, one  with none.  The one with the food allergies fed very frequently, slept poorly and gained slowly; he eventually developed asthma.  The one without the allergies fed less frequently, slept well and gained lots of weight and never developed any problems that one could link to an allergy - very healthy, happy kid.

The kid with allergies always stooled several times a day.  The other stooled once every five days.  My theory would be that the child with allergies would naturally stool more frequently since there would always be elements within his waste products which would be irrititating to his system and stimulate faster passage and elimination - in fact, his stools were often mucousy and green or yellow-green.  The non-allergic child had non-allergic stools which could be held in the body for longer periods without causing irritation and thus, elimination (she had soft, yellow stools).  Sounds good to me.

No offense intended, but I think that this is a case where you may be trying to massage the facts in order to fit a theory which you think makes a lot of sense.  Probably many babies can be induced, through various interventions, to stool more often.  Does this make it normal?  We know that there are some breastfed babies who do quite well nursing only about every 4 hours - not often seen, but still within the norm.  If it ain't broke, don't fix it.  On what basis do all of these holistic practitioners declare that this is not nomal?  One of the things that I have noticed about most holistic programs (BTW, we list a naturopath among our health care providers and use herbs, Tai Chi and diet to try and maintain good health), is that internal cleansing is almost always a big part of their treatment - fasting and then the use of various herbal laxitives to induce elimination, the belief being that one of the reasons that we get sick is that toxins in our stools are held within the body for too long a time.  It does not surprise me that most or all of the holistic healers you know would hold this view - it is intrinsic to their basic theory of health and illness.  Again, I would say, where is the evidence for this view?

I think that we do a disservice to moms if we intimate to them in some way that their babies, who may be doing very well in all other areas, have some type of problem when they are not stooling daily.  It was such a relief to me to have a baby that was so "easy" compared to the first - I can't imagine being sent on some wild goose chase to find the reason and treatment for her infrequent stooling.  While I am not trying to insult or disparage anyone who thinks this way, I am asking that you think twice before presenting this theory to a client.  I don't believe that it is a theory that is, as yet, supported by any good evidence.  And while I know that we do a lot of things that are not as yet "evidence-based" I am concerned anytime when we are making a mother think that her child is sick or "not normal."  Why bring this anxiety into the life of  a family which is in every other way, doing very well, especially when there is more evidence to date that this is a normal thing for many breastfed babies rather than the opposite, that it is an unhealthy condition which needs to be treated.  Please give it some thought.

Respectfully,
Sharon Knorr, BSMT, IBCLC
Newark, New York

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