Breastmilk is not "dairy". Unless mother lives in the dairy barn.
Constipation is not defined as infrequent stools, but hard pellet-like
stools. Soft stools are not constipation. If a baby is having trouble
passing soft (maybe even large) stools, several things may be at issue. One
is that the baby's anus is unusually small and/or tight. Doctors often
prescribe glycerin suppositories for infrequent stools and if the mother
thinks the baby is having difficulty, this may help the problem. Glycerin ,
melted, helps to lubricate the small or tight opening and may avoid
fissures. Of course the mechanical peristalsis is also increased with the
suppository. We don't, of course, want to make a habit of suppositories, but
for a short-term they may be helpful. The mother should be instructed on
their usage, not just told to use them. Other problems that may cause
infrequent stooling (the kind that makes a baby uncomfortable) may be
decreased sensation in the gut itself. This decreases peristalsis. This can
be Hirschsprung's or some other gut/nerve problem --maybe even including
cystic fibrosis. Irritable bowel, which can cause constipation or diarrhea,
is not usually found in babies. But it can be. The only cases I am aware of
are babies who were super-sensitive to the diet they were on (usually given
some formula). It is also a familial condition, so I wouldn't look to that
unless it runs in the family. I certainly wouldn't encourage weaning. I
don't understand why that is the first thing most doctors encourage.
Cheryl Muller, RNC. IBCLC

----


----------------------------------------------------------------------

Date:    Mon, 15 Oct 2001 11:22:59 +1000
From:    "Stephens, Nicole" <[log in to unmask]>
Subject: Milk Products and stooling

I recently had a mum with a premie -35 weeks who had stooled normally in the
nursery but once home had not stooled for almost 2 weeks at which point I
was called.The baby was obviously in pain and had the most foul smelling
wind.It was feeding well although a little irritable and piling on the
weight despite all this.
Enemas worked wonders and relieved things for several days but then it would
start all over again. The baby had a biopsy which showed a very high white
cell count in the bowel. The peadiatrician said to the mum that it was a
rare form of a colitis in response the cows milk protein in her diet where
instead of the baby having diarrhea it gets constipated. The baby had been
given 2 supplements of formula when in hospital.Mum went on an elimination
diet with dietician guidance and supplements but still her baby didn't stool
and is still having to give enemas.We have refined her diet furthur to
really make sure that it is being specific enough -not just the dairy
products and if that doesn't work the peadiatrician is strongly recommending
a hydrolysed formula as the only other option.The mum and I discussed this
option but she will still keep expressing during the time she is using the
formula if the diet doesn't work to ensure she still has her milk up her
sleeve should she need it at a later date in case of more allergies.It seems
so against everything we know that a formula could possibly help a baby
stool better than breastmilk!!!!
Sometimes we do have to be careful as practitioners and spread the message
to the midwives who are sending women home with the advice of what is normal
stooling in a newborn.This mum had gotten the message that a breastfed baby
never gets constipated and didn't seek help earlier.
We definately need to keep in mind the babys age and the whole breastfeeding
picture and investigate a little more closely why a newborn breastfed baby
of a few weeks of age is not doing lots of little amounts often or at least
one or a couple of big poos a day -this may highlight a breastfeeding issue!

Nicole Stephens
lactation consultant
Infant Feeding Support Service
Frankston Hospital
Peninsula Health
email: [log in to unmask]
Ph. 9784 7476

> -----Original Message-----
> From: Automatic digest processor [SMTP:[log in to unmask]]
> Sent: Sunday, 14 October 2001 14:04
> To:   Recipients of LACTNET digests
> Subject:      LACTNET Digest - 13 Oct 2001 (#2001-863)
>
> There is one message totalling 53 lines in this issue.
>
> Topics of the day:
>
>   1. Breastmilk considered Dairy? (long)
>
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> Date:    Sun, 14 Oct 2001 11:06:00 +0800
> From:    Joy Anderson <[log in to unmask]>
> Subject: Re: Breastmilk considered Dairy? (long)
>
> >This is the original message (June '01) from a friend that is nursing her
> >(then) 11 month old.
> >After this "diagnosis" Rachel (the mom) continued nursing as before, just
> >added more veggie and fruit to the diet, mixing it with Milk of Magnesia.
> >Today, October 13, you'll see her message as to where her now 15 month
> >old is doing.  (Still nursing as before)
>
> Patricia,
> My first thoughts on reading this situation is to investigate food
> intolerance, possibly *via* the breastmilk, or the solids. Does
> Rachel (the mum) eat a lot of dairy (real dairy ;-)? Is there is any
> history of intolerances to this or other foods in the family or in
> mum's past?
>
> My experience was a little different to this scenario, in that my
> second-born became constipated when she completely weaned at about 26
> months. We now know that she has food intolerances, but not to dairy
> - rather to certain fruits. So constipation like Rachel describes is
> familiar to me! We never used milk of magnesia (never suggested) but
> did use a product that contains paraffin oil, that is
> chocolate-flavoured (and kids like!). This worked well for quite a
> while, except you get orange stains on underwear if the child 'leaks'
> (which is common in this condition).
>
> The fact that my experience has been problems with *fruits*, brings
> me to question what the fruits and juices SJ consumes are. Just
> something to consider if she might have an intolerance to one of
> these.
>
> Reassure Rachel that continuing to breastfeed is probably the *best*
> thing she can do for SJ. If my experience is anything to go by,
> weaning may make it all worse. Besides, *we* all know that
> breatfeeding is very unlikely be at fault here.
>
> Good luck to Rachel in being the detective to sort this problem out.
> I know how frustrating and stressful it is to see your beloved child
> suffering like this.
>
> Joy
> ******************************************************************
> Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
> Australian Breastfeeding Association counsellor
> Perth, Western Australia.   mailto:[log in to unmask]
> ******************************************************************
>

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