Posted w/permission:  

A five-week-old female, delivered vaginally at 38 weeks, has stooled three
times since Day 2.  Birthweight 7-3, dropped to 6-5, had an LC consult to
improve bf at 5 days, back to birthweight at 14 days.

At three weeks ped recommended home administration of Fleet enema.  No
opinion on bf.

Mom then called IBCLC, who is working with her on further increasing
breastmilk supply and transfer and improving bf. LC suggested returning to
MD for further consultation rather than home administration of enema; at
pt's request MD used glycerin suppository in the office to induce stooling.
Stool was soft.

By week 5 baby's weight was 8-3.  The baby is now six weeks old, gaining 4
oz/week, which is on the low end of normal--total stools since leaving the
hospital on Day 2 stands at three, for a lifetime total of four poops.  All
3 stools mom has seen have been soft.

Information which may/not apply:  Baby was conceived in Africa, in an area
where disease and parasites are ubiquitous, but mother tested negative for
intestinal worms while pregnant.  The infant has a Nigerian father (although
conceived in another country) and an American mother.  

Question:  How often do other Lactnetters see stooling once every two weeks
in the normal, healthy, breastfed neonate?  I'd like to get a feel for how
uncommon this is.

Question:  Should she travel to the big city for a second opinion, to r/o
any disorders such as megacolon, Hirschprung's, or other anomalies?  Or in
the absence of obvious other symptoms or indications, should she just accept
this as a normal variation?

Would especially appreciate input from MDs as this is potentially a medical
problem.  I seem to be the most concerned person on the team, and want to
know if my concerns are unfounded.  Meanwhile mother is continuing to work
on improving milk transfer.

Arly Helm, MS, IBCLC



 

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