Exclusive breastfeeding and constipation

[IcouldstillbeJoseph]

DD is 9mo, exclusively BF. As of the past 6 weeks she has suffered worsening constipation.

Been to see GP this morning and poor DD has multiple anal fissures . No wonder she's been screaming with every poo. Given some lactulose to try.

I have tried every other self-help method I can think of. This weekend she has consumed a large bag of prunes in a variety of forms... Massage, warm bath etc

I thought ebf babies didn't get constipated? Anyone got any ideas/experiences?

Is she really still exclusively breastfed? She should be on solids by now.

presumably she is not exBF at 9m? Surely it is more likely the solids she is having that are contributing to the problem? I'd cut back on solids and if necessary up the BF and other fluids until it improves and her poor bottom heals. We found banana and potato seemed to bung DS up.

The "I love you" baby massage might help (google it for a diagram)

Sorry I meant ebf in as much as she has no formula.

She eats well, 3 meals a day, loads of finger foods and some yoghurts etc spooned in.

Ever since she started being constipated I have given fibre rich foods. Plenty of fruit and veg and as much water as she will take.

EBF babies don't get constipation, but once they're on solids they can. Fruit and veg is good but don't give small children things like wholegrains, brown rice etc as their digestive systems struggle to cope and it'll make constipation worse.

I'd also cut back on solids and up fluids.

dont give too much fibre without enough fluids or you will make the constipation worse. Cut down bananas, rice, etc as they can also make it worse

what does she eat, generally?

ds1 suffered awfully from constipation. the biggest culprit was weetabix (he's 8 now and still gets bunged up if he eats it), followed by bananas and too much dairy.

We had something similar, my HV said to try giving warm water to drink, which seemed to help. Hope she gets better soon.

I have tried giving more fluids but she's not keen on drinking. Have tried giving water/diluted juice in bottles, cups, free flow drinking cups, a spoon etc

A typical day would be
Ready brek mixed with a fruit purée
Toast/Cheerios finger food
Grapes as a snack
Cauliflower cheese
Greek yoghurt with fruit purée
Fruit toast as snack
Meat based dinner e.g lamb casserole
Fruit and veg finger food

Does that sound ok?

It seems like a lot of food for a 9 month old. I'd cut the toast snacks and maybe just have the cauliflower cheese for lunch without yoghurt too. Have you tried more breastfeeds?

Ok I'll try that (I'll try anything at the moment). She is reluctant to bf more in the day, preferring to gawp around the place. I've tried feeding in a quiet place but I have a 2 yr old DS so that's not always easy. She has 4 feeds a day at the moment.
I was advised to up her solid food intake by Hv as she is still v wakeful overnight. I was also advised that she should only have maximum 3 bf which has gone to pot as she has at least 2 overnight too

sounds fine to me!

Prune juice or prunes? I fed DS1 prunes by baking them into sponge cake it is HEALTHY 'cos it has egg in it

If she's having less milk in the day, that's probably why she needs more overnight. Did the HV advise only 3 feeds a day? I wonder why as she can't possibly have any idea how much milk your DD gets in 3 feeds, what odd advice

Thanks
I am haunted by the image of her poor, torn bottom

Prunes in all forms! Prune juice. Prune purée. Prunes soaked in orange juice. Prunes as they are.

Yes she definitely did advise 3 feeds. In fact, she said if she was having one feed overnight then I should only feed her in the morning and evening and not at all in the day. She feeds for about 5-10mins which HV said would be sufficient. But it doesn't seem/feel right to me so I've sort of ignored that bit of advice....

that sounds totally bizarre! milk should still be her main source of nutrition til she is around one year.

but follow her cues.

Maybe the HV has special skills in guessing how much milk an individual baby drinks in any given time

Milk should form the main part of your baby's diet until around 12 months, with solids just complementing it. By 12 months it's around 50/50 milk and food, and then after that food takes over with milk still a large component until at least 2.

Look, I've found HVs to be hugely variable wrt the quality of their advice.

Unless you think this women is very very wise, I'd follow your DD's cues.