This is a nice study which looks at normal stooling - kudos to Magda
Sachs who pointed it out to me! It's not exactly a 'big' journal, and
it would have passed me by.
Griffin, A and Beattie, RM (2001) Normal bowel habit during the first 6 weeks
in healthy, term infants, Ambulatory Child Health 7:23-6.
ABSTRACT
Objective The bowel habit in the first few weeks is relevant in the
assessment of symptoms which are often nonspecific and may or may not
be indicative of underlying pathology. There is very little available
data. We therefore undertook a study to investigate the normal bowel
habit in healthy, term infants.
Design, setting and sample Infants were assessed by the health
visitor at the initial contact (10-14 days) and at the 6-week check.
Details of feeding method and bowel habit were
collected by simple questionnaire.
Results A total of 238 infants were recruited after 14 exclusions;
87.3% of babies passed meconium within 24 and 99.2% within 48 hours
of birth. The majority of infants at 2 weeks passed at least one
stool every day (95.3%). At 6 weeks most babies (87.8%) continued to
pass a daily stool, although the range widened, with 98.3% passing a
stool within the range three or more per day to once every 3 days.
Implications for practice This study suggests in the first 2 weeks of
life that most infants have a daily bowel motion. By 6 weeks,
although the range has increased, 98.3% will have a bowel motion at
least once every 3 days. This means a bowel frequency of less than
every 3 days is unusual and requires consideration of underlying
pathology.
*************************
I would take issue with their assumption that less than every 3 days
is a sign of pathology - far more likely to be a feeding issue. I
mean, which is more likely in culture who's forgotten how to bf,
Hirschsprungs, or ineffective bf because of poor support and
information?
The paper makes no mention of feeding challenges, and it is really a
'count 'em up' study that nevertheless gives support to anyone trying
to say that long periods (more than a day) without stooling is not
normal, ***in the first weeks***. I think experience strongly
suggests that more than a day without stooling should prompt the
carer to look at the feeding.
This is not done routinely in the UK, and I do come across situations
where the mother and baby are clearly having a bad time with
breastfeeding, and have been inappropriately reassured that even
several days without stooling is normal...one mother's baby was 10
days and had not stooled for 5 days and the doctor said 'fine' and
the midwife suggested a bottle of boiled water : ((((((
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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