I thought meconium was red blood cells which is why when babies are not
eating enough they don't poop it all out and get more jaundiced. As in
recirculated red blood cells making bilirubin greater. Or am I wrong?
Jacqui, Make sure this baby really is eating well. Get a good scale,
rent a Baby Weigh from a Medela dealer, and do several test weights in a
row and make sure. Little or slightly premature babies often will eat
just a little bit. I have test weighed them to intake of only 1/2 to 1
ounces and they look satiated and satisfied!! They would have to eat
12-15 times in 24 hours when eating 1 ounce per feeding to remove enough
milk in one day to gain weight.
A baby who is removing milk well will give you back large amounts in the
diaper, say enough to have to clean up, messy and bigger than a quarter
(which is small). Large messy poops almost always means good intake at
the breast -- unless one is using formula with AHA or DHA additive which
will often cause lots of runny poop by itself.
Babies who are not gaining weight from lack of calories also will be
very sleepy and easily satiated. The baby I saw last week was way too
happy with 1.5 ounces and then when I finger fed him another 1/2 ounce,
he was totally zoned out and asleep. That baby was over 9 pounds at
birth and was still 8% under birth weight at 10 days. He should have
demanded something like 2.5 to 3 ounces and cried when he didn't get it.
Especially since the feeding I was at was the first one in 5 hours.
The lack of weight gain is bugging me. Plus how some babies look really
good but aren't removing milk worth a hoot and a holler.
Go ahead and stop eating dairy if that makes you feel better. I am not a
physician but the dairy intolerance stools that I have heard about are
slightly streaked with blood, not totally blood and the blood is often
fresh. Not totally black. The other thing I have seen is the small bits
of blood from not enough hindmilk. That could be happening here if baby
is not removing large enough amounts of milk from each breast. If he is
removing a half ounce from the right and a half ounce from the left,
this may be too little fat.
So from an IBCLCs viewpoint, make sure the transfer of milk is good. I
would want to see 1.5-2 ounces per nursing session and 8-10 times per
day for a total removed of about 15 ounces for a 5 lb baby older than
6-7 days, maybe a little less per day, but not much less, or a little
more. I would only go on the dairy allergy thing if you are sure baby is
removing or transferring milk well and is gaining weight. I don't
dispute dairy allergy, I have lived this with all my kids, but they were
still allergic to dairy and gained weight like gang-busters without any
formula. They had eczema, ear infections, snotty noses, etc.
Good luck with this. Kathy Eng, BSW, IBCLC
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