Formula feeding and straining

[ohgoonthen]

Hi all,

DD1 is 4 weeks old and has been mostly formula fed since birth. Yesterday, she strained and strained all day to go to the toilet with no result. She didn't sleep at all from about 8 am till 1 am. She was quite distrssed, crying constantly and ate very little. Finally at about 4 this morning she did do a very small poo which wasn't hard but definately alot thicker than normal. Since then, she ate her normal amount and finally pooed at 10 this morning...or should I say...exploded. She seemed to be starving all day yesterday but wouldn't eat.

The doctor says that this is not constipation and that straining in FF babies is normal but surely not for a whole day!
She also has a rash on her face which the Doctor says is common, but if it persists, we may need to change her formula.

Could it be that her formula isn't agreeing with her? She also had really bad reflux at 2 weeks but that seems to have calmed down now.

This is worring me a bit and I would appreciate some advice from those who have experience. The doctor seems to think that we are worrying unduely as this is our first baby but I get the feeling this is not right.

Thankyou

Congratulations on your baby and I hope your little girl is feeling a bit better now. I am not a medical expert but it sounds to me as though she may have been a tiny bit constipated as she was straining and not eating however it was obviously not too bad if you had to deal with a subsequent explosion!

I think a bit of constipation is not uncommon in babies who are formula fed. If you are using powder, the main thing to avoid this is to watch how you are preparing the formula. Too much powder to water can cause the formula to be too dense and lead to constipation. The measure needs to be precise - level the scoop off with a knife.

I sometimes give a little bit of cool boiled water to my DS between feeds. My understanding (although to be honest I have always found the advice to be very unclear on this) is that you can give cool boiled water to babies separately from about 6-8 weeks. For starters I dipped his dummy in some water and just let him have a bit of a suck on that rather than give the water to him in a bottle.

I know the baby books say that formula fed babies do a poo every day. This has never been my experience and my DS has always gone every other day. Originally I was worried that he was constipated but he was eating well and subsequent explosions proved this was not the case. My doctor told me that this pattern was not unusual in a formula fed baby.

As for the rash - did your doctor think that this had anything to do with the formula? I think a lot of babies get 'infant acne' and it usually clears up in a few weeks.

I have never changed the brand of formula I use as my understanding is that aside from differences between soy and cows milk formula, they all have basically the same composition. I know that some people do feel that changing a brand has made a difference to their babies re issues such as wind etc though.

I hope that this helps as DS is my first baby too (he is now 5 months old) and I am also a worrier. In fact I nearly took him to hospital when he had bad wind one evening. Wishing you all the best.

I ffed 2 babies and both of mine would have had a little straining, they also wouldn't have done a poo every day. I used the same formula with both of them although I do know from various threads that it is not a hugely popular one.

Both my dds had slight rashes, dd1 had rash at back of knees, it would have looked like a heat rash, dd2 had a rash on her face on and off for months, it was baby ezcema (sorry badly spelt) and cleared up by itself. It's your first baby, don't worry about what the doctor thinks!! But why don't you give your Health Visitor a ring if you're still worried. Good luck and congratulations

Thanks for your replies.

HBsMUM - Thanks for the congratulations, being a mummy is wonderful but I didn't anticipate the amount of worry it brings over every little thing!
I have been very careful about preparing the formula as the doctor said that if I had added too much powder this could have been the cause of the reflux so I know it's not due to that. The reflux seems to have stopped mostly now as I think she was just feeding too fast and wasn't taking enough breaks(big hungry baby!)

I have been dipping her dummy in water also despite being told by everyone not to do it!
I know she is too young yet to have a proper drink but we live in a hot country so I think alot of the time she is quite thirsty and not so much hungry.

She has been pooing about 3 times every 24hrs or always at least twice, and always at the same time of day. I did ask the doctor about constipation a while ago and he told me that formula fed babies tend to do a bit of straining but she isn't constipated unless her poo is hard, which it's not. Apparently anything from 7 poos a day to once every three days is normal!
She seemed to be very distressed yesterday though and obviously in some pain. She has not pooed again today but is eating well and sleeping. She has been straining a bit but is much calmer.

I have asked the doctor about changing formula as this was the first thing I thought of when she had the reflux but he advised me not to as it would take at least 3 months for her body to adjust to it anyway and I may find that changing formula might upset her stomach more.

Wiggles rock - The doctor has told me that the rash is infant exzema and has given me creams etc to use but they have not made any difference. I do think though that the heat isn't helping and she did have heat rash under her armpits for a few days which has gone now. He said that if it doesn't clear up that we may have to put her on "hypoallergenic" formula which made me think that the one she is on may just not be agreeing with her.

Unfortunately we don't have health visitors here so I have booked another appointment with her doctor tomorrow again.

Thanks again for all your advice, it has put my mind at ease a little so hopefully I can have a peaceful hours sleep

I was told by the HV today to give my 3 week old dd cooled boiled water fwiw

Glad that you are feeling better about things ohgoonthen. I live in the UAE and so completely understand about the hot weather and lack of health visitors. It does not make things easy.

If you are making up the feeds with boiled bottled water I was also told to watch the sodium content of the brand I was using (10mg or less apparently).

My DS has always seemed quite grateful for a little drop of water especially when we have been out and about as the constant change from heat to air conditioning etc makes it easy for them to become a bit dehydrated. Personally I do think a drop of water also helps them to keep things moving internally!

Just a quick update - went and spoke to the doctor, he was still very against changing the formula as he said this was normal. However, I insisted and he recommended another one for me. She took it straight away and seems to be much easier to burp. Now pooing regularly every other day with much less stress!!!

Thanks again for all your advice everyone.

OP - glad that you are going to change the formula - your doctor was talking crap I'm afraid.

It's not a great idea to keep chopping and changing formula but if a formula doesn't seem to be suiting a DC then of course you can change.

For some proper info and guidance about formula have a look at these UNICEF leaflets especially the "one for HCPs" - lots of info in there.

Perhaps you could give your doctor a copy. .

Just being nosey - did your doctor recommend the first formula by name? If so then his/her reluctance to recommend a change is almost certainly due to him/her buying it to "myths" touted by formula companies (in order to protect market share etc). .