breastfeeding and dirty nappies

[azkat]

Looking for some advice before an appointment with the HV. My son is 18 wks old and since birth has been very infrequent with his bowel movements. He only has a dirty nappy about once every 10 days. I queried this with the HV and she said that it is normal and he may just have an efficient digestive system and therefore no waste product. I have since brought it up with DR and he sad it wasn't partcularly normal and i should give him extra fluids. I am a bit unsure as to both of these responses as my son does have plenty waste prduct as it struggles to stay in the nappy when he does finally manage to do it! Also he is very windy and it really, really smells! It is not solid so i don't really see how extra fluids would help.
I hope someone can help (sorry if its a bit long or TMI!)
Thanks

my first would frequently go up to 10 days but then it would be a huge explosive nappy!

my second goes about 3x a day.

is he doing lots of wet nappies too?

Your doctor is talking rubbish - and that makes me furious! It is perfectly normal for bf babies to go up to 14 days without pooing - but boy do you know when they have as you say! It's because they are using up every tiny bit of the milk so not producing any waste product. As long as your baby is producing lots of wet nappies he's fine.

My DCs were both frequent pooers, but many of my friends DCs would go for about a week (or longer) while breastfed. I thought I was the odd one out! If he seems OK to you, then I would pay no attention to the Dr's advice.

Thanks. Yes he's having plenty wet nappies. I was just a bit concerned as he's now down to the 9th centile for growth and thought they may have been connected in some way.

although i hate the centile things - what was he on when he was born and is he generally gaining weight?

he was on the 25th and has followed the curve until the past few weeks. he has only been putting on a small amount each week (1-30z)

pooing irregularly is perfectly normal in older BF babies (post 6 weeks), but if your DS has been like this since birth, then it could be that there is an underlying issue that needs looking into.

Giving additional fluids won't help though as BF babies don't really need anything else.

How is his weight gain?

From kellymom

early days "Dirty diapers: In the early days, baby typically has one dirty diaper for each day of life (1 on day one, 2 on day two...). After day 4, stools should be yellow and baby should have at least 3-4 stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often--this is normal, too. The normal stool of a breastfed baby is loose (soft to runny) and may be seedy or curdy"

weeks 4-6 "Dirty diapers: Expect 3-4+ stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often--this is normal, too. The normal stool of a breastfed baby is yellow and loose (soft to runny) and may be seedy or curdy. After 4 - 6 weeks, some babies stool less frequently, with stools as infrequent as one every 7-10 days. As long as baby is gaining well, this is normal"

and some further information here

Is your HV using the standard (i.e. FF biased) centile chart? If so, remember that BF babies often follow a slightly different path (esp after about 12 weeks IIRC??). And even if she is using the BF-specific chart, I really wouldn't fixate to much on it (I did, wish I hadn't stressed so much about it!).

oops cross post about the weight gain.

Have you spoken to breastfeeding counsellor at all about this? I think you may get better information from them than from a HV or GP.

The helpline numbers are on hunkermunker's blog

dereelicte, the standard charts are based on a cross section of babies, both FF and BF, not just on FF babies. This is quite a common misconception and one I used to have myself.

There are newer charts for exclusively BF babies, but afaik not many health authorities are using them. There are exclusivelt BF charts on the World Health Organisation website though.

Thanks, will try a bf counsellor. I think it may be just the standard chart, with i think is based on ff babies. Wasn't really worried untill his growth slowed.

LackaDaisy - yes, I knew that They are FF biased though, because far more babies are FF than BF, so the 'average' weights are higher then if they were based on equal numbers of FF and BF (or even better, entirely BF babies).

ah, even clearer now

is it normal for an exclusively Bf baby to have very smelly poos though?

lol...as mud?

I'm looking forward to when the 100% BF charts get rolled out. I'm sure they would have saved me a bit of heart-ache.

10 days between poos is probably a bit long. He shouldn't need extra fluids if he is EBF. There are a couple of medical conditions that cause slowing of the bowel/ constipation from birth; Hirschprung's disease being the more common. Try seeing a different (more understanding) GP if you are concerned.
All that said it is more likely that his bowels are a variant of normal.