Julie-Ann,

My third baby had something similar happen. He got off to a slow start, lost about 9% of birthweight in the first two days, but had normal stools initially. Then he just stopped pooping. He went 6 days without stooling. I knew milk transfer was good at that point. I was doing test weights before and after feeds and he was gaining tons of weight. His belly felt full, but not hard and there were no palpable or visible "loops" of intestines. The midwives were not terribly concerned, told me to try stimulating with a q-tip. I panicked and called one of the neonatologists I used to work with. He told me to bring the baby in. Thirty minutes before I was supposed to leave the baby had the poop to end all poops. Six days worth of poop all at once. The neonatologist said he probably had a meconium plug. The slow start in the first couple of days probably dehydrated him a bit and allowed a "plug" of stool to form and block subsequent stools. Once I started massaging baby's belly frequently and getting him really well hydrated he was able to pass the blockage. My neonatologist didn't want the baby to go a full week without stooling. 

That was my experience. Hopefully she sees a huge poop soon! It is definitely disconcerting. 

-Laura Wasielewski MS, CCC-SLP, IBCLC 

Date:    Sat, 9 Apr 2016 23:11:03 -0400
From:    Julie-Ann Toalston <[log in to unmask]>
Subject: No stool for 4 days

Hello - Looking for ideas about a dyad where the 8 day-old baby has not stooled in 4 days. Seeking info at mom's request. 

Baby boy born April 1 at 40+ weeks. Mom had uncomplicated, unmedicated birth, no IV fluids either. Her 4th baby, has exclusively breastfed them all. Days 1-4, baby produced a few large stools each day. From Day 5 on, stools have been only occasional yellow "smears" in the diaper. There were urate crystals through Day 5. Baby lost 9% of his birth weight by Day 4; on Day 7 (3 days later) he had gained back 5 oz. above that. He is urinating abundantly; he is alert, content, not jaundiced or dehydrated. Mom is responsive to his cues and has nursed him about 10 times per 24 hrs. since Day 1. I observed him feeding, and he latches and sucks eagerly, has an excellent latch with loud audible swallows. Since the stools stopped, mom
has wisely been topping baby off with expressed milk several times per day in hopes that he just has some "catch up" feeding to do. 

Happy little fellow, seems to be taking plenty of milk, but just no sizable stool going on 4 days. Would a sensitivity to cow's milk protein manifest this early? Are mom and baby gut damaged and in need of probiotics? Could a posterior tongue tie cause something this? I don't know a whole lot about those particular issues. 

Of course, the pediatrician just shrugged and told mom to give baby pear juice. Fortunately, mom knows better. 

Eagerly awaiting your thoughts,

Julie-Ann Toalston, BA, IBCLC
Connecticut, USA

Sent from my iPhone
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