Whenever I hear LCs and other HCPs tell moms that it is normal for babies to stool infrequently, I am terribly concerned for those babies who often will exhibit further symptoms of poor gut health down the road. Sometimes those symptoms are obvious, like in the baby you describe and often they are also mistaken for "normal" function or viewed as personality traits such as behaviour problems, skin conditions, sleep disturbances, learning disabilities or the myriad of other indications of poor gut integrity.? Pasty stools are on the most common indications I see of food allergy, especially in older babies. Milk of mag is a short-term solution--pronged use can cause reduced potassium and fiolate absorption.

I agree with Lee that the baby should be evaluated for TT and other possible problems with oral-motor function. I also agree with Judy that babies with poor gut function benefit enormously from structural work. OTOH, I would be looking into food allergies first and foremost. Expecting babies to outgrow allergies is unrealistic--no one outgrows allergies, but the gut can most certainly heal. I would suggest a thorough evaluation of the mother's diet, her gut function and indications of gut dysfunction in the baby and suggest treatment accordingly. 

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC 

 




A very experienced breastfeeding mother called me with concern about her 2n=
d child's stools.  The first few weeks of the baby's life, the stools and f=
requency seemed within normal limits.  Several weeks later the mother calle=
d because her child was going several days without stooling, but when she d=
id 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 day=
s the baby seemed uncomfortable and seemed to be straining a lot.  The moth=
er 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 Hirschs=
prung's disease.  Came out negative.
Mother was told to add more fruits and vegts. to baby's diet.  (baby has ju=
st started on a few teaspoons of solids recently)

Referred to a pediatric GI specialist.  She told the mother to nurse less o=
ften and give the baby more foods and juices.  She thought the stool was si=
tting in the bowels too long.  Also mentioned that the spacing of the rectu=
m was a little closer than usual to the vaginal area, perhaps a contributin=
g 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 encourag=
ed 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 t=
o 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 Hirsc=
hsprungs has been ruled out, and the Dr. told her there is not much more th=
ey would do for a baby, is continued testing really necessary?  Why would w=
e 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 proble=
ms?  Perhaps time will take care of this?  Any comments will be appreciated=
.

Evelyn Landry, RN, IBCLC, RLC
Lafayette, Louisiana
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