Tricia,
I think it is highly unlikely that Colace could cause constipation in the
baby. Most mothers in our hospital go home on Colace without detriment to
bfdg. I think it is more likely that this baby is not getting enough milk. I
have had cases where urine output is good but there is insufficient stooling
and poor wt. gain. I would recommend checking this baby's wt. on an accurate
scale and also doing a test wt. to assess milk transfer. This baby was under
6 lb., reportedly falls asleep at the breast, mother reports no engorgement,
and he is not stooling. All these together are red flags for low milk
intake. When I see a similar situation, I do a test wt., have mom pump
afterward and then add the two totals together. If test wt. is 1 oz. and she
pumps another 1/2 oz. this equals a milk production for that feeding of 1.5
oz. If she brfd 3 hr. ago (measure from the beginning of one feeding to the
beginning of the next) I then multiply the total, in this case 1.5 oz., by 8.
This would equal a 24 hr. output of 12 oz. I tell mom that this is an
estimate since supply varies through the day. If you find supply is low, you
still need to sort out cause. Was baby always a poor nurser which resulted in
low supply or was supply low which resulted in infant becoming sleepy at the
breast. Observing the baby and the nursing can sometimes sort this out for
you. If supply is fine and baby is transferring milk well, then decreased
stooling is due to something else.
Kathy Boggs, RN, IBCLC
Mountain View, CA
In a message dated 10/2/02 5:45:37 PM, [log in to unmask] writes:
<< Hello Ladies,
I have just a minute before I run out the door, but there were two
things I wanted to mention. I'm still looking for help here, so any help
would be appreciated. I'm asking here because I think they is a very
unusual situation, so it's helpful to talk to so many wise women at
once.
The main concern of the doctors and the mom is that the baby has gone so
long between passing the meconium without having a bowel movement. So
that's the main concern here. Many of you think it's a milk transfer
problem, and I think it may be too. Except the baby does have plenty of
wet diapers. Could it just be that some baby's take a while to start
their bm's. What is the longest it should reasonably take between the
day the baby stops passing meconium until she has her first yellow bm.
My first daughter took about 6 days, and that's the longest I've heard
of. After that she had no other problems. But the mom does not seem
reassured by this. And her doctor is very concerned. He is blaming it on
breastfeeding and wanting to give formula. So my big main question was
- Has anyone ever heard of Colase causing the baby to not have bowl
movements, or sort of save them up? The baby was not constipated, but
seemed either like she was saving them for a long time, or unable to
push it out (possibly?).
One wise woman asked about infertility problems in regard to her milk
supply. The mother did have infertility. This is her first baby and she
went through 3 rounds of artificial insemination, all failed. This baby
was a surprise between fertility treatments.
Again any thoughts are most appreciated. And thank you to all of you who
have responded so far. I know the mother will find this information very
helpful.
Warmly,
Tricia Palleja
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