Melissa, I know you already know what I am going to write. I go by what 
is in the Breastfeeding Answer Book (and no, I don't own stock in this 
since I have quoted it twice today!). On page 158, it says "At least 3 
to 4 bowel movements the size of a US Quarter (2.5 cm) or larger (Shrago 
1998) is a good indicator that the baby younger than 6 weeks is 
receiving enough calories."

It then talks about the first week and goes on to say this:
"If the mother reports less frequent bowel movements during her baby's 
first 4-6 weeks, this may be a normal variation (in which case the baby 
will be gaining well) or it may be a sign that the baby is not nursing 
long enough to get the fatty hindmilk, which is rich in calories. Less 
frequent bowel movements may be normal in an older breastfed baby, as 
long as he is gaining normally. Some babies have bowel movements only 
once a week without signs of constipation (hard, dry stools). However, 
if the baby is not gaining well, this may be a clue that he is not 
getting enough hindmilk."

The Womanly Art of Breastfeeding, 7th edition, says on page 307 "Later 
on, when they are more than six weeks old, they may have only one bowel 
movement a day or one a week or even less. If a baby has infrequent 
bowel movements, they are usually quite profuse. All this is well within 
the realm of normal."

So depending on the baby's weight gain, and older than 6 weeks of age, I 
might or might not be concerned if baby is not stooling every day 
depending on the weight gain. And I would agree that there is no medical 
testimony that few bowel movements equal neglect in this situation. I 
would want to know the birth weight and weight before the latest 
"illness" or whatever it was that prompted this court case. I would only 
be concerned if baby had not reached birth weight by day 10-14 and then 
gained about 6 ounces per week. For a six week old, I would like to see 
4 weeks of gain so 24 ounce gain. If I had a six week old that was 100% 
breastfed and gained two pounds already, I would not worry about the 
lack of poop. Usually a baby who is gaining this good is stooling, though.

Other reasons for an older than 6 week old baby to stool infrequently 
are formula usage, lack of hindmilk in an older baby, and food allergies 
-- besides lack of calories.

Good luck on this! Kathy Eng, BSW, IBCLC

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]