Judy Dunlap writes:

>Kathy Dettwyler, do you have any info on the normal stooling and voiding
>patterns of infants in traditional societies?  It would be very helpful to
>know what the physiological norms really are.


Gosh Judy, I don't think I've ever come across anything about this.  I think
that most "traditional" mothers never give it a thought -- at all.  Baby
goes to breast (unmedicated, no separation from mom, no clothes) and baby
nurses and baby pees and poops and no one worries about it.  I too dislike
the whole trend toward so much quantification of infant behavior, but agree
that we intervene as much as we do, that often necessitates more
intervention to counter the first.  I do remember that when I took Miranda
home from the hospital in 1980, we had been separated for about four hours
after birth, then for another four hours in the middle of the first night,
and I didn't know if she had had a bottle of anything in the nursery, or had
had a pacifier, etc.  And I didn't know much about nursing except for going
to 5 or 6 LLL meetings.  I just put her to the breast and she nursed.  I
*do* remember that she had one big *blowout* of meconium on day two (I was
changing her diaper at the time, holding her bottom up, and she sprayed it
all over the wall), and from then on it was yellow.  Milk came it that same
afternoon, with a vengeance.

From an evolutionary perspective, one would expect that the infant is not
prepared to deal with a lot of quantity the first few days of life, as most
women's milk doesn't "come in" in any quantity til after the first 24 hours
post-partum.  I would *suspect* -- and this is just my babbling here, not
based on any research -- that a newborn's kidneys and intestinal tract are
not really ready for a big drink of formula in the first 24 hours after
birth.  I *suspect* that the colostrum is almost totally absorbed, and that
much of the variation one sees in output the first 24 hours after birth has
a lot to do with how much amniotic fluid was being swallowed during labor,
how long and intense labor was, how much fluid baby loses to evaporation, etc.

One needs general guidelines to catch those very few babies who may be in
danger (both for their sakes and for the "cover your ass" nature of health
care in a litigious society), and it may be more babies than one would
suspect if various interventions make mother's milk take longer than usual
to come in, or make baby an ineffective nurser.  I still think pumping and
giving EBM by cup or finger would be preferable to a big slug of ABM,
though, and I still worry about overstressing the infant's kidneys during
those first 24 hours.

Miranda was also very good at holding her pee/poop until she had a huge
quantity.  She could soak through a cloth diaper with no trouble, and fill
up a sleeper with poop after not defecating for a week (this is when she was
older, not as a newborn).  I think there is a problem with defining a "wet
diaper" or a "poopy diaper" especially with disposables.  I remember
changing her diaper every time she peed a few drops in the early days -- she
would have scored 10-12 wet diapers the first day at that rate, before she
switched over to holding it AND I learned to wait until the diaper was
really wet before changing it.

Kathy D.