Dear Elizabeth,

I did read your original post carefully and noted that you had taken what I
considered to be appropriate steps.  Your further clarification makes it
even more evident that you've suggested a course of action that will
hopefully help this mom and baby.

I don't, however, believe that there is yet any evidence that more is going
on here than inadequate milk supply and (unfortunately) imminent failure to
thrive.  In order to start looking for more unusual reasons as to why baby
is not stooling, you'd need to show that the mother is indeed producing
adequate milk and baby is taking it.  I don't think the scenario you've
shared with us shows that at all -- once the mother is double-pumping with a
hospital grade pump, and baby is visibly taking in adequate milk (no matter
what kind), then if he still doesn't poop, I agree, you'd start looking for
other reasons.

Right now, though, such inquiry would take up valuable time that needs to
focus on the basic stuff that IS the most likely explanation.  Getting an
adequate milk supply established and into this baby will require a lot of
effort on the part of mother and baby (with appropriate assistance) over the
next several days, and I would strongly recommend that that course of action
be the ONLY pursuit for right now.

This is one instance where I *would* want to actually SEE the milk going
into the baby.  Having a scale for before-and-after weights would also be
helpful.

Mary Riley Renard, RN, BSN, IBCLC, LLLL
Vienna Virginia  USA

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