Holly wrote:

"Infant is currently receiving an estimated 22 oz. breastmilk daily. Mom is not 
limiting amount of breastfeeds or breastmilk. Baby is gaining by leaps and bounds.
Baby began to have hard pebble-like stools after introduction of cereal which
the mother has since discontinued. She makes her own baby food and has a good 
working knowledge of nutrition.  Baby has been getting 2 Tbsp of yogurt daily
for several months but no problem with constipation until intro of other solid
foods. (oatmeal, veggies and fruits twice daily). Mom wanted to introduce prunes
but pediatrician said "don't feed them daily because baby would develop a dependency"
(as one would to laxatives??). Instead he wants mother to give Milk of Mag every 
3rd day.  Mom breastfeeds when at home and feeds pumped milk when at work.  I 
suggested since the baby was gaining well to D/C the solids temporarily and see 
if the infant's stooling pattern changed.  Than reintroduce solids one at a time
and slowly. "

I would wonder what a "good working knowledge of nutrition" means if the mom has been 
giving her baby cow milk products since since at least 4 months of age. long before he
should have ever have had any solid foods at all. Cereal is also a poor choice for 
an early food, so overall, his introduction to solids has not been a healthy one. Also, 
if mom is making her own baby food, I suspect baby is being passively fed mushed food and 
not feeding himself--makes me wonder if he is ready for solids at all.

While I would not want to feed a baby prunes and ignore the underlying problem, I am 
curious--as you are--we are concerned about a baby becoming dependent upon prunes, but 
not on milk of mag!!?? Are we serious? So, we should not all be "dependent" upon whole 
foods to maintain normal gut function, but rather we should take meds for that purpose? 

How do we know baby is getting 22 oz of milk? Mom would only know how much pumped milk
baby is getting. Baby does not seem to take a lot of solids and is growing well, so why 
do we think only 22 oz? That seems unlikely. Is it in any way possible that the baby is 
receiving more solids at daycare than mom is aware of? Possibly even foods she is not aware 
of--more likely to happen when family members who think they know better than mom are
caring for the baby. Has anything else changed--baby or mom has been sick, anyone on meds 
or new supplements, mom eating unusual foods?

Could be baby is allergic to cow milk products and the recurrent exposure has been more 
than he can handle. Could be baby really is not nursing as much as needed or getting as 
much milk as needed. What were stools like before this--maybe they were not normal already
and have just gotten worse? In that case, mom's diet would be important to consider.  

I agree with you--switch back to all breastmilk--esp ditch the yogurt and oatmeal. 
See what happens after a couple of weeks. Also review appropriate signs of readiness for
solids and self-directed vs passive feeding. 

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




 




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