Fairly urgent help needed re: 6 month old bf baby weaning and constipation - HV useless. Very very long post!

[IlanaK]

Hi all,

I am in need of some advice as I tried my hv and she was useless. I can't really go and see the GP now until it reopens next week as this is not an emergency as such.

Here goes.... my ds2 is 6.5 months old (will be 7 months in about a weeks time). He was exclusively bf until 6 months and 1 week old. When I weaned him to solid food, he took to it very well. The problem is with his pooing.

He has gone from liquid explosive bf poo to more normal formed poos. But he is really struggling with going. At first I thought it was just because the sensation was different for him. He would strain and strain and cry and scream when going. SOmetimes he would produce nothing and sometimes just a tiny amount and sometimes a whole poo. I did not think he was constipated as they were normal brown formed and soft - nothing hard.

I cut back on his solids for a few days thinking this may be it. Things got a little better so I reintroduced them again and the same thing happened. I spoke to the hv yestrerday on the phone who said that it didn't appear that he was constipated and that it did not seem like a food intolreance as he would have runny poo.

However, last night when I changed him after a feed in the night there was a very hard poo in his nappy. He is straining this mornign to no avail. I would definately describe him as constipated now.

As to what he is eating..... I always make sure to offer bf first and then solids. HE has a bf on waking in the morning, and then breakfast of organix oat and fruit flakes mixed with breastmilk and additional fruit (banana or pureed other fruit). He has another bf around 11am ish or whenever he is ready for it. Then some lunch around 12 ish. This is a pureed veg and also some minced up turkey. He has another bf in the afternoon (3 ish or whenever he wants it) and then tea at 5. This is a pureed fruit (apple and pear usually) and some rice. He has another bf before bed and then again at 10pm before we go to bed. He wakes once in the night for a bf too.

The HV suggested giving him cool boiled water which I did do yesterday. HE has taken to it well from a beaker, but I do not want him cutting down on bf (although the hv didn't feel this was a problem, I disagree with her) so I am only offering the water after he has had a milk feed and his solids.

Anyway, he really enjoys his solids and I am reluctant to cut back on them again. I am being very careful about introducing foods as we are an allergic family. No dairy or wheat before 1 year old, no potato or tomatoes yet (deadly nightshade veg), etc etc. I am also conscious of not giving too much baby rice as it could bung him up - in fact, I have started giving real brown rice instead with his fruit puree as it has more fibre.

Sorry this is so long, but I am not sure what to do. I am not convinced GP will have any good advice either. It is quite distressing seeing him like this. I did not have any problems with my first ds (he was weaned at 4.5 months as guidlelines were different then). Also, ds2 is quite underweight. HE fell off the bottom of the charts just before I started weaning him. I stuck firm against hv advice and pressure until 6 months, but even GP felt that as he was so incredible active he was burning up the calories from my milk and really needed weaning. I was feeding him every 2 hours daily and 3 hours nightly before weaning and he was still not gaining weight fast enough. I am soooo reluctant to go back to that and do feel he needs and wants the solids. HE almost ripped my arm off to get the food the first time I gave him any! And he is still very keen now!

One last thing.....LLL website says that if you always offer milk first, you can be reassured they will not take more solids than they need which is what I am doing.

Sorry sooooooooo long!

my ds now one had the same problem although he was bottle fed.try a small amount of juice in some boiled water that always got my ds going.not anything citrus though.

I'm not sure I'd go along with the brown rice at this early stage - think it may be counterproductive and difficult for his gut to breakdown at the moment. Can you omit rice/cereal altogether for a few days and stick to fruit and veg, if that makes things easier perhaps reintroduce them slowly. You could try a very dilute juice (orange, prune or water left over from steaming fruit) and offer as many b'feeds as you need. It will probably resolve itself quite soon.

The reason we went with brown rice is that it has a higher fibre conent so should move things through him whereas the baby rice has almost no fibre at all.

I want to avoid juice for 2 reasons - I don't want it to be habit forming as I want him to drink water. Also, I am avoiding all citrus for allergy reasons. I know I could give apple juice, but I am not sure what additional benefit that would have over the apple puree that we give anyway.

I was a bit suspicious of the banana as a possible culprit, but we ran out of them before christmas so he didn't have any for a few days. This did not seem to resolve things so I am not sure that is the problem.

I agree that it may be a cereal issue. HOwever, if I cut them out completely and just do fruit and veg, I am worried that he may not tolerate them at all. What do I do then? He can't live on fruit and veg only.

I do offer him bf whenever he wants. The timetable I posted before is not one I have imposed on him - it is when he asks for feeds.

The prune and oatmeal jar from Baby Organix used to sort DSs out.

sympathies ilana - kiwi fruit is v good for unblocking the system. Also try some v gentle baby massage to stimulate circulation.

agree w/ lizs on brown rice - babies don't really need the heavy guns fibre - think fruit & veg enough.
sorry typing one handed w/ dd2 on lap!
hope it gets better soon

thought babies' diets should be v low fibre to start with..

I think you're right bundle. Fibre fills them up too quickly doesn't it IIRC? I would try apple juice and more water. I wouldn't worry about water filling him up or juice being habit forming - you don't have to give it to him all the time and more water might well do it. Dried fruit might help too, esp apricots.

some stuff here

Thanks for that link - it was very helpful. I have spoken to dh and we are going to cut all cereal and grain from ds diet for now. That link actually said not to use prune juice as it is an irritant. Very interesting. So I think we will stick to offering water from a beaker, offering bf before solids, and no cereal or grains at all. Hopefully that will help. It was also interesting in that link as to what the definition of constipation is.

Thanks again

Erm. Sorry but why is your HV useless? From your post you've only spoken to her once and she gave you advice to try. It didn't work for you - why not go back and speak to her again before condemning her. Just a suggestion - she may well be useless but give her more of a chance to prove it first.
I had similar problems with both my children (like you we are a very allergic family) DD1 needed a gentle laxative solution for real problematic constipation (which a paed prescribed after my hv referred us - she's not allowed to prescribe for constipation). DD2 just needed additional fluids and a gradual introduction of some foods. She now eats all foods with no problems as does DD1. I'd be very wary of giving brown rice as all I can see is that this will bung him up still further. Stick to pureed fruit (which worked like a dream with both mine) which will be much easier to digest and lots of fluid to help him with the rice he's had.

HTH

Marla

Hi there,

Just adding my bit having read all the other posts. It's possible that your DS is just adjusting to having solids for the first time. If this is the case he may well settle down in the next few weeks. Awful though while you're going through it. Think you've done the right thing in cutting it all back. I'm sure when you reintroduce it it'll be easier.
As for the BF 2 hourly each day and three hourly at night - you're a hero - hats off.
A better person than me - I couldn't have done it.

Mandy

hi
i used to buy tinned prunes in fruit juice. remove the stones and mouli. worked a treat a dd1 loved them.

forgot to say, heat them in a pan then allow to cool before serving. put the rest in ice cubes for future use.

Marla- I am agaisnt my hv due to previous bad advice. Ds2 is very very low weight (though totally healthy and active) and I have been under pressure from hv a lot. She even phoned me at home and insisted I bring him in to be weighed. There was talk of supplementing etc which I never would have allowed. Her advice in this case about the water worried me a little as bf advice I have read says to be careful of too much water displacing need for breastmilk. My post probably did sound a bit flippant if you didn't know the past history.

Too much bulky fibre is advised against for babies, as it can interfere with absorption of Iron and vitamin C. Also they really cannot digest it, which means it takes longer for it to get thruogh their immature gut.

We had this problem when weaning, found that dilute prune juice at mealtimes (plus prune porridge for breakfast if things were really bad!) did the trick. Sorted itself out after a couple of months.

Update - now what?

Two days of cutting out all grains and cereals has started to work. The poos are getting softer and he seems to be clearing his system out. The problem is what do I do now? He can't live on fruit and veg purees indefinately.

He can live off them for a while longer though, and let his gut mature a little.

I see nothing wrong with baby rice rather than brown rice, there is plenty of fibre in the vegetables and fruit,My ds reacted to oats initially and has started to again.

My ds practically lived off sweet potato for his first year and whilst skinny he is fine.

Hi Ilana,

If it's only two days and things are going well then I'd just leave it a bit longer. Leave it a week and then start introducing something else like baby rice at one feed to see if he tolerates this. If he does then increase it over a few days before trying anything else. Baby rice is very gentle and shouldn't cause any problems.
With your family history of allergy I'd steer clear of wheat etc for as long as possible but then you know all that having done it before. Get him into all the fruit and veggies along with baby rice - this along with the breastmilk and any other fluid should give him a really well balanced diet. I think you're doing all the right things.
Main thing with constipation in babies is to increase the fluids and fibre - fruit and veg are excellent for doing this. I suspect your ds may have been reacting to the new food - perhaps he was getting tummyache when he needed to poo. Hopefully, what you have done will sort it all out.

Mandy

I thought that meat was supposed to be very difficult to digest too. Whilst I am not vegetarian DH is and I find if we go away and I eat more meat than my body is used to then this happens to me too to an extent - It certainly slows things down, so it may have also been partly due to the turkey (i did hear from a friend who went on a whole food diet as an experiment to see if it improved his energy levels etc that he was told meat can take up to 6 weeks to get through your system if you eat enough of it - seems a bit excessive to me -I have no basis for confiming that, but it definately takes longer to digest)
I seem to remember that a lot of the stuff I saw on weaning seemed to advocate baby rice and fruit and veg to start with and to avoid things like potatoes, tomatoes, avacadoes, citrus and all gluten containig grains (wheat, oats, barley,rye) for a while too.
Hope that your ds gets on OK, but if you take it very slowly and only add one new food every couple of days you should be able to idnetify the culprit.

Well, I agree with the taking things slow, avoiding potatoes tomatoes, gluten and citrus. These are all things I am doing. I took the advice on meat from the LLL website as well as from a book on weaning. It actually suggests meat as one of the first weaning foods. He is only having a very small cube of it once a day as I felt he needed the protein. However, it is the next obvious thing to take out of his diet. Unfortunately, although I thought that he was getting better, he is not. HE is still very constipated with hard poos.

I am going to go and see a different HV at a different clinic tomorow to see if they can advise anything.

Oh, and my mum wondered if it had something to do with the fact that I am not cooking the fruit? Although everything I have read says that raw fruit is fine from 6 months, she wondered if this could be the problem.