In a message dated 12/15/01 12:11:25 PM, [log in to unmask] writes: >The paper makes no mention of feeding challenges, and it is really a >'count 'em up' study that nevertheless gives support to anyone trying >to say that long periods (more than a day) without stooling is not >normal, ***in the first weeks***. I think experience strongly >suggests that more than a day without stooling should prompt the >carer to look at the feeding. I agree with this statement and am especially glad that Heather chose to highlight "in the first few weeks". I do, however, have a concern with the "numbers" of stools expectation given to parents for the FIRST WEEK. In this area, parents are discharged with the idea that the stooling expectation should roughly correspond with the number of days old the baby is, ie. on day 4, baby should have 4 and that this applies until the milk comes in or continues at roughly 4/day. As a VNA nurse I see the majority of my clients at day 3-5 and most often, particularly for primips that are nursing (of course!), the baby has diminished his stooling pattern over the 24hrs. or so prior, very often the babe hasn't stooled at all for 12-24hrs. On further investigation the Moms milk is either just becoming more abundant or has done so over the last 12-24 hrs. I explain to the parents that for the day or so before the milk comes in, the babie's body is starting to require more volume then the breast is offering, the meconium is largely gone and there just isn't enough there to move through. Although some of these babies may have been feeding much larger volumes for the previous 12hrs. or so, I explain that in this case, it just hasn't had the chance to move "all the way through" and to be patient. IME, they are never prepared for this. IF these parents were not to see me, they probably would then feel concerned enough to call the pedi office, where more often than not, they will not be asked about the "state" of their milk supply or the adequacy of their feeding but will be instructed to suppmt and or offer some rectal stimulation. This is a particularly cruel irony as it is about the worst time to suppmt, when all is about to come together! The very reason why I emphasize assessment of intake, ie sucking/swallowing vs. output . Lynn Shea Rn,Bsn,Ibclc Franklin,Massachusetts *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html