Constipation in a Breastfed Newborn ??

I am the mother of 3, ages 7,4, and 2. My first 2 had a real problem with BMs. We never figured out what the problem was with my oldest. He would go 8 days between BM's. It was scary and frustrating, but eventually he seemed to outgrow it. When my daughter had the same problem, and it lasted for several months, I got really frustrated and concerned. She also would go more than a week between BM's and was breastfeeding full-time. We tried everything from prunes to supositories. Finally her pediatrician discovered with a long Q-tip, that she was literally anal retentive. The doctor said she had never felt such a tight Sphyncter muscel before. The harder my daughter pushed and tried, the tighter it got. We ended up, much to my discomfort, stimulating her rectum whith a long Q-tip and KY jelly(purchased at the drug store) for a while. She began having regular BM's. Good luck, and don't let your doctor dismiss the problem.

Its normal for a breastfed baby to poop after every feed, its normal for a breastfed baby to not poop for up to 14 days. And of course anything in between.

I would say its the meds.... Breastmilk is a natural antacid, so nursing her in a more upright position should provide her more relief than any medication. Most peds are really dumb on breastfeeding and are quick to dole out medications. Nurse her in a semi-upright position and keep her semi-upright for about 15 minutes or more after her feed, and that should allow the breastmilk to soothe her tummy and not allow the acid to flux up and cause her pain.

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Just editing to post some websites to prove my point about breastmilk being a natural antacid, since apparently some don't believe that.... AND I never said breastmilk would make it go away, I said its a natural antacid...therefore HELPING the reflux. Meds don't make reflux go away either, and in fact most new studies show it doens't help at all. Besides, I'd rather use a natural antacid like breastmilk on my baby than any medication.

http://www.kellymom.com/babyconcerns/reflux.html
**GERD may cause babies to either undereat (if they associate feeding with the after-feeding pain, or if it hurts to swallow) or overeat (because sucking keeps the stomach contents down in the stomach and because mother’s milk is a natural antacid).**

http://www.infantrefluxdisease.com/is-baby-getting-enough...
**Some breastfed babies, after the first three to four weeks of life, may suddenly change their stool pattern from many each day, to one every three days or even less. Some babies have gone as long as 15 days or more without a bowel movement. As long as the baby is otherwise well, and the stool is the usual pasty or soft, yellow movement, this is not constipation and is of no concern. No treatment is necessary or desirable, because no treatment is necessary or desirable for something that is normal.**

http://infantrefluxdisease.com/breastfeeding-baby-with-re...
**Breastfed babies with reflux and GERD generally seem to cope better than those who are formula fed. Perhaps this is because they get more comfort from the closeness that nursing provides over bottle feeding or because breast milk acts as a natural antacid**

**It's certainly no secret, breastfeeding is best for baby, but that's particularly true for babies with reflux.**

**Breast milk is digested twice as fast as formula, this is beneficial for babies with reflux because the faster food moves out of the stomach, the less chance it has of being refluxed.
Breast milk, particularly the proteins, are more hypoallergenic than formula, especially cow's milk based formula. Reflux can—in some cases—be aggravated by milk or food allergies so providing the most hypoallergenic possibility is extremely beneficial.**

http://infantrefluxdisease.com/breastfeeding-reflux.php

**Babies with reflux can take two completely different approaches to mealtime. Some become frequent and aggressive feeders, guzzling fast and demanding more. These babies seem to get relief from the natural antacid effects of the milk**

I breastfed my daughter and she had reflux. I disagree that breastfeeding is the cure all because my child would scream and arch off the breast. She actually killed my breastmilk supply because she was in so much pain she would not nurse. So, it's a personal decision to use meds but my child has been on them since six weeks old and we haven't been able to wean her yet. My guess would be the meds causing the constipation. The meds for reflux have two major side effects: diarrhea or constipation. I participate in an infant reflux message board (www.infantreflux.org) and some of those children have problems with bowel movements too. My pediatrician told me to use gerber apple prune juice up to two ounces a day when she was your daughters age. Some kids with reflux have to be on a laxative too. Good luck with everything. Reflux stinks and I can totally relate to your predicament.

Hello R.,

I have a 5yo, 2yo, and a 6 month old. My 6 month was premie and was getting fortified breast milk (we had to add formula to her breast milk)until she gained enough weight/body fat to stop the fortifying. Anyway, she would sometimes go 5-10 days without a bowel movement! yet she never seemed uncomfortable nor was her stool hard. The doctor said it was unusual but b/c she wasn't struggling, we were not advised to do anything. When I would feel especially nervous, I would use the rectal thermometer to trigger a BM. Then my husband gave her a really good, long tummy massage (going in clockwise circles, almost following the large intensine. She had a BM and has been regular ever since. I think she had a slight kink in her hosing, so to speak. He gives her massages regularly just to help with gas.
I know this is different from your situation. Your daughter seems to be legitimately contipated and it sounds like you did the right thing taking her off the meds. Have you noticed an improvement? I just wanted to offer my story so that you hear from someone who had a baby who was not "regular." If your daughter was uncomfortable, then you need to address that first. And perhaps you will need to weigh the pros and cons of treatment for the reflux vs. the constipation.
Best of luck! K.

The medicines that are usually used for reflux like famotidine, ranitidine can cause constipation. Both the reflux and constipation are odd for a bf baby. My guess is the anti acid for the reflux. Have you tried any non-medical things for the reflux. Such as keeping her upright after feedings, slightly elevate one side of her bed? I have heard horror stories of acid reflux causing babies to gasp and have difficulty breathing so I can understand why you would want to use meds to fix it. I know my doctor told use to give diluted pear or apple juice for constipation. I didn't need to because my daughter never had constipation, but giving the juice can be an issue if you strictly bf and haven't introduced a bottle yet. Hope this helps. Keep us updated.

My son would do that, I would usually bring him and myself into the chiropractor and usually a day of so after he would get his coxis adjusted (low back/tailbone area) he would have more normal movements...sometimes we would go twice a week, therefore no meds were administered.

Just wanted to add, I was not informed about treatment options while my son was suffering with reflux, but know better now! In addition to the chiropractic modality, you might also persue homeopathy. I've read in several places that NDs give calcarea carbonica for reflux with good success, though I don't have personal experience with it. See The Homeopathic Treatment of Children by Paul Herscu.

Hi R.,

I haven't heard of a breastfed baby going that long without a BM. I know that the redface strain is common for a baby at that age no matter the fluid intake because I believe at that age, they're little muscles are not fully developed so they do have to push pretty hard to get results. With that, I'd be worried since it's most likely a side affect from the medication. I know that steroid medication can turn stool black at times, and high iron in a diet can cause stool hardening. I'd be concerned too. I'd call your doc. Usually breastfed babies go a few times a day and they are usually pretty soft. Perhaps she is so blocked up that she can't get it out. I'd watch for her straining and see if she's attempting to BM.

I wouldn't worry about it. Breastmilk is absorbed very easy so sometimes there just isn't any waste left over. Your daughter could be learning how to control her sphincter right now and that's why she seems like she's straining. Was the stool hard or was it just more formed than you've seen it before? If she's been really hot, she could just have less moist poops because she's using the fluids to cool herself rather than just passing it as waste. Try not to worry. Really! :-)

First of all I would like to disagree with the previous poster about breast milk being a natural antacid. If a child has reflux, no amount of breastmilk is going to make it go away. And it's not ok for any child to go 14 days without a movement and then have a hard one like that. Breastfed babies can go a while but it's still supposed to be soft.
Both of my girls (breastfed) were allergic to milk protein and that caused them to have severe constipation. My oldest was breastfed until 4 months when we couldn't handle her being tortured by constipation and gas/bloating cramps anymore. She literally cried 24/7 for those 4 months. Then I put her on soy formula and she never had another problem. My younger daughter started doing the same thing so at 4 weeks I switched her but she was also allergic to soy and needed Nutramigen.
Anyways, constipation should be taken seriously because it can cause a tear in the colon. My youngest struggled with constipation because of low tone until she was 2 years old. At 10 months she got a tear and ended up having to get a transfusion because of all of the bleeding.
If I were you I'd check with the Dr. again to see if maybe she just got backed up and needs a suppository to get regular again. We used to use the Glycerin ones. You could also give more water and pear juice works great. I wouldn't think the Zantac, if that's what she's taking, would cause that. I've had 3 kids on that and it didn't do it to them. The only other thing I can think of would be a diet change that you might have made.
Best Wishes,
J.

I didn't have breast fed babies, but I did deal with constipation. I talked to the doctors about an over the counter remedy called "little tummies". They have a laxative. When I asked her about it, she said "oh, its an all natural, and very ok to use. Basically its concentrated prune juice. My sister in law used it with her breastfed baby just a few months ago, when they would pass the 5-6 day point without her going. She would put a few drops the one bottle a day she got of expressed milk, and within the next few hours she would go, hard, and compacted. She talked to her doctor as well, and he said with the hard bm like that, it was ok to give the little tummies, and he agreed, that it was an all natural.

Good luck getting your little ones tummy troubles under control!!!