Week old baby, breastfed, content but no dirty nappies

[Beamae]

I am breastfeeding my newborn, I feel quite successfully. We've been feeding on demand, seem to have cracked the latch now mostly, and she is feeding for anything from 10 minutes to maybe 25 minutes followed by a snooze and then often another 10ish minutes on the other side. I'm not timing her feeds at all so these are estimates. She seems really content.

Our only issue is that apart from her first two days, when we had six meconium nappies, we haven't had any further dirty nappies at all. I have been upping my fibre intake on the advice of the community midwife who has told us that if she doesn't poo today we have to do a formula top up to see if that works or be transmitted to hospital where we will be forced to put her in formula.

I'm obviously quite upset and worried now. I dint want to harm her but really don't want her to have formula this early. My twins previously were forced onto formula top ups and it was such a struggle keeping up the breastfeeding which limped along for just under six months before they finally refused the breast completely. I don't want to go down that same path again.

Has anyone else been in this situation? Is there anything I can do to avoid the formula?

How long has it been? Not pooing for days on end is perfectly normal when breast feeding, as the milk is so well absorbed by the body. I expect there's a point when it becomes a concern, but no idea what this is. A week or so is fine as long as the baby seems content AFAIK.

Anyway, and this is important, are you aware that many midwives are not breastfeeding specialists. You need advice from someone who is. I would strongly advice calling La Leche League. They have a breast feeding helpline.

www.kellymom.com is also a great source of BF info.

Her last dirty nappy was Saturday morning, so it's been four and a half days. I'll give LLL a ring this morning.

I remember both my breast fed daughters going five or six days. With first baby I took her to the doctor who told me it was fine as there simply is no waste with breast milk.

If you have no luck with LLL National Breastfeeding Helpline is 0300 100 0210. No dirty nappies with a bf baby can be fine, but I thiink you are right to talk it through with someone.

Actually although its OK with older bfed babies not to poo in a newborn its not OK.

You need tiktok she gives the best advice.

In the meantime feed as much as possible and you could maybe do some gentle tummy massage on baby to encourage a poo, always do it clockwise.

Have they weighed babu yet?

She has been weighed once and had lost 6.8% of her birth weight. I rang the national helpline on Monday and they weren't worried but at that stage it had only been a couple of days.

Can the midwife readmit us to hospital?

I'm no expert, but had a similar experience with my newborn DS recently.

I'm fairly sure that BF babies pooing less often due to very little waste is only applicable from 6ish weeks onwards and newborns should go regularly.

My EBF baby also went several days between dirty nappies when he was teeny (still does, but it's normal now at 10 weeks). Anyway, my HB was great, certainly never mentioned FF him or hospital, (surely formula wouldn't help the situation anyway, it's more likely to cause constipation than breast milk?)

She advised me to drink plenty of orange juice, eat lots of fibre and feed on one side only for as long as my nipple could take (expressing on the other in necessary). If that didn't work, she advised a small amount of cooled, boiled water, but we never needed that as he had a huge dirty nappy within 24 hours.

Definitely get some support from a BF expert as I see no need to move to formula because of this.

Good luck and congratulations on your new baby

My DS2 went for about 6 days with no poo (following the first 2 meconium ones in 1st 24 hrs).

He had a tongue tie which was clipped in case was affecting milk transfer, and I was just advised to keep feeding as much as possible.
When the poo came it was enormous. After that he still only went every 2-3 days. DS1 pooed about 8 times a day, they were completely different

four and a half days is not normal for a newborn.
This baby needs to be checked over, please ring the postnatal ward this morning

older babies post six weeks or so can certainly go a while between poos but a week old baby who is drinking plenty milk will have having dirty nappies

do let us know how you go on OP

Well that weight loss is fine, anything up to 10% is normal.

I think you need to see a bfeeding counselor to check latch and milk transfer, are you getting lots if wet nappies?

I could have written your post a few weeks ago, in fact I actually did! Even down to the previous experience with top ups.

It is not usual for a newborn to go that long between bowel movements and usually signifies that they are not taking enough milk (it can happen and weight gain is fine for some babies but this is the exception). My DD took 4.5 weeks to regain her birth weight and then put on at the very lower end of the normal range per week. Finally at 10 weeks a posterior tongue tie was spotted by a LLL leader (despite being checked previously by a GP and another breastfeeding counsellor).

If your DDs weight gain is low my advice would be to contact LLL and get the latch checked, they will probably also check for tongue tie (if you can see an IBCLC all the better). I wish I had done this earlier instead of going through the local bf group - not saying they aren't good but it's just LLL and IBCLCs especially have a great deal of training and experience.

As I said I had the same feelings as you on formula top ups as with my DS we had to give a couple of ounces after most of the day time feeds so it was tough bf, expressing and giving a bottle, and meant the convenience of bf was gone. This time round the advice I was given was 100ml (3.5oz) twice a day. I give a bottle of formula last thing in the evening and a bottle of expressed milk in the morning (I express from one side during the night while DD feeds on the other). I am much happier with that than the constant top ups and feel better able to manage my supply that way.

Sorry for the long rambling post, just had to respond as my situation was so similar!

Forgot to say my DD lost 7.7% weight at first so nobody was too worried, except for me - I always knew something wasn't quite right. Strangely, like your DD mine has always been happy and settled even though she had such slow weight gain.

Oh and like pp said no need to give formula at this stage - for us it wasn't needed until 10 weeks (just after TT was spotted and we were waiting for the appointment to get it cut). By then DD had dropped to near the bottom of the charts so I felt it was the right decision at that point.

Ridiculous advice from midwife! Fibre you eat will have absolutely no bearing on anyone's bowels but your own - fibre does what it does because it stays in bowel rather than being absorbed or digested.
As long as baby is happy and had passed mec I'd watch and wait (and wait, and wait - as you'll probably find becomes a normal pattern for your baby). Weight is normal so no indication for top ups at all.
And no, MW can't force readmission!!

Beamae sorry you are worried about this, and even sorrier that you have had such poor support from the midwife.

No poos in a baby of this age is always a sign to investigate more - especially weighing. Her weight loss was well within normal but she urgently needs to be weighed again to check she has stopped losing weight and has started to gain. All may be well - while it is very unusual for a baby not to poo in the first week without there being an issue of intake, it is not unknown, and some babies are just fine...but you do need to find out.

It is outrageous that the midwife suggested fibre - how on earth can the fibre you eat affect the breastmilk in any way at all??? She needs to have a basic biology lesson - the sort they give in about Year 3 :( Really, this sort of thing makes me cross and if you feel up to it, you can challenge it.

Giving formula is also unhelpful - of course some extreme situations need formula where bf is not sufficient but if the midwife thinks your baby needs more breastmilk (and this may be the case) then it's easy enough to do this....all you have to do is to offer a breastfeed more often than she seems to 'ask', and to make sure you use both sides at a time at least (this means switching sides back and forth, when the baby seems to lose interest in one side). There's no info in your post about how often you are feeding, and the fact your baby is content is not really a sign...she could be a very laid back baby who actually does need some pro-active breastfeeding. How many times do you think she comes to the breast in 24 hours - how many times yesterday, for instance?

Hope this helps - but do get her weighed today if you can.

When I was ebf-ing my baby regularly went 10 - 15 days between dirty nappies. It really worried me. Midwives, health visitors, and doctors all just smiled indulgently at me and assured me that was perfectly normal. So long as you are getting plenty of wet nappies it is fine.

Sorry: please listen up, everyone who says it is normal for babies to go several days between poos.

It is not normal in a newborn.

It is normal in a baby a few weeks old.

In a newborn, it can be the first sign that something needs to be done about intake - and quickly.

www.nct.org.uk/parenting/whats-your-babys-nappy

Thanks for clarification tiktok :)

(For anyone who doesn't know, tiktok is a BF expert, we should listen to her!)

If it's a supply issue, what would you recommend? Is it the usual advice n upping feeds, i.e. go to bed and just hang out there doing skin-to-skin with your baby for a couple of days, offering loads of feeds (take a good book or DVD!) or is more needed than that?

Advice to check tongue tie is sensible too isn't it?

Yes, check for TT, yes, up the feeds....upping the feeds has the dual benefit of increasing intake as well as increasing supply :)

You don't need to retire to bed always, though, with or without DVDs :)

That's lovely to do, but it's only a means to an end ie making it easier for the baby to feed more often and to stay in close contact.

Thank you. Am on my way in to hospital to see the lactation consultant to get the baby and our technique assessed.

We have plenty wet nappies. Really heavy ones. Enough to leak.

And we are feeding every two to two and a half hours. Last night she fed less often than previous nights, so we did three feeds between 10pm and 7pm but lasting about an hour each, with some snoozy breaks in between. I've been doing the one breast til she loses interest, switching and then switching again. Am feeding until she seems properly satisfied and comes off by herself or falls asleep.

Hope all is well, OP :)

I have had the same thing with both my DDs - meconium poos in the first two days... then nothing... in both cases it took a week for the next poo and a mega poo every 4-7 days from then on. Listen to tiktok, do get the baby checked out and get the latch checked but if you have acceptable weight gain and wet nappies I would not bother with formula top up. First time round midwife had me giving teaspoonfuls of orange juice to dd in order to help make her go... it made absolutely no difference! This time, I had her weight well monitored and just let nature take its course. It's stressful and not entirely normal, but it does happen and doesn't necessarily mean something is wrong. But just get her checked out to make sure. The growth spurt at 7-10 days should prompt a clearout, be ready for it! Congratulations on your baby too!

Is the growth / weight curve for BF babies? It is different to a FF baby. I had similar comments from my doctor with my first and my midwife (a bf specialist) plotted his weight and all was fine. The current curve is from the 70's and slightly out of date for bf babies.

With regards to poo - as long as there a plenty of wet nappies its fine. My second only pooed once a week for the first 4 months! He's making up for it now tho.

Don't be persuaded to top up with formula until you have spoken with LLL or similar.

space, there is no growth chart for a baby of this age in use in the UK...it does not begin until the baby is 2 weeks old. There is a notional line in the printed charts, that's all. No baby of a week old (like the OP's) is plotted on the chart - the weight is recorded at birth, then usually a few days on, and maybe again if there are seen to be possible issues (as there are here).

The current curve is not from the 70s - it is up to date, and comes from data based on bf babies, and it is in every PHCHR ('red book') in the UK now and has been for some years. In fact, there is not much difference between the current charts and the older ones, until the age of about five months. Up to then, bf and ff babies grow v. similarly.

It is not 'fine' as long as there are wet nappies - poo matters in the first weeks :) Some babies don't poo often in the newborn stage, and some of them are ok, but they all need checking out to make sure. A proportion of them are simply not taking in sufficient breastmilk.

Hope you get some good advice, might be worth complaining about the advice from the community midwife...sounds like they need to update their bfing knowledge- shocking.