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Children's health

DS 14 weeks only has a bowel movement every week. GP prescribed lactulose. What do you think?

40 replies

JudyBlume1019 · 08/07/2009 20:30

When he was born he had a bowel movement on day 1, and at least once a dfay for the first two or three weeks, then i9t slowed down a lot and he started to only have one on average once a week, sometimes up to 9 days, and occasionally 4 days apart. It hasn't worried me as I've asked HV and friends, and posted here, and the general consensus seems to be that if it goes in to double figures see GP.
I kind of forgot to count last time, becasue I though he'd started to do one every day, but it was only two or three days, but I thought it might have been as much as two weeks since his last one so I went to GP yesterday.

He is completely bf, feeds fantastically, and on demand (very regularly), his poos are pretty much the same as normal bf poo, but not as creamy and without the little grainy lumps. They're a deep yellow colour, and not at all solid or hard. He was born on 75th centile, and has been 96th/98th ever since. He is happy and smiley, but does seem to start to struggle with (extremely smelly ) farts for a day or so before a movement.

I had got used to it and stopped worrying, but GP called paed at hospital, and they described him as having a 'sluggish bowel', and suggested lactulose and a glycerine pessary. I feel like I've lost confidence in my judgemnt. Instinctively I don't want to give him lactulose, and he seems to be on my wavelength because he's spat out everything I've given him, but otoh if there is an underlying problem, then we need to find out.

I feel like I have no confidence. Where I could tell the difference between a tried or hungry cry, I suddenly doubt even that.

What do you think, or am I worrying about nothing?

Sorry, if anyone actually bothered to read through all that, then I really appreciate it.

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becks57 · 08/07/2009 20:39

it does sound like he's constipated, do you give him water inbetween feeds? maybe if you boil some water, let it cool for half an hour, put it in a newborn bottle with the slowest flow on it in the fridge, let it cool and try to give to baby in between feeds may help, as it did with my baby girl. i do agree with you about lactouse, but it will help to get the poos going again, otherwise it may really hurt for baby to poo and then baby may keep it in as it hurts. all the lactouse will do is soften the poo to come out so it doesn't hurt. i really do recommend the water, but not filtered water, as this has salts in it. hope that all makes sense. and never doubt your judgement, you are the mum and you know your baby.

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mosschops30 · 08/07/2009 20:47

Why dont you want to give lactulose? Its one of the best 'laxatives'
Although it doesnt really make you go more, it just makes your stool softer by drawing water back into the bowel thereby making it easier to pass.
So from what youre saying it doesnt sound like the best option, but then Im not a doctor. Maybe you could ask for a paeds referral.
FWIW I only 'go' every 2-3 days, but am constantly on lactulose at the moment due to pregnancy. But the ideal is once or twice a day!!
Sorry if ive been no help, maybe you could go back and ask your GP why he's chosen lactulose and what other options you have

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sarah293 · 08/07/2009 20:48

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woodlands35 · 08/07/2009 20:54

i had to give my dd lactulose when she was 4 months old , it did her no harm what so ever , but it can take up 2-3 days to work ,
hope your little1 is better soon

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Tambajam · 08/07/2009 21:00

Hang on!
He is ebf and only poos once a week or so. This is utterly and completely and totally normal for some bf babies. You are simply dealing with health professionals who lack experience with bf babies.
I am a breastfeeding counsellor. He does not have constipation. He does not need to be given anything - lactulose, water, nothing.

HE IS NORMAL

I could post a ton of links here.
Here are a couple:
www.drjaygordon.com/development/pediatricks/poop.asp (penultimate paragraph)
www.drjacknewman.com/help/Is%20My%20Baby%20Getting%20Enough%20Milk.asp

For the healthy normal infrequent pooers a laxative is utterly pointless. Their digestive system is dealing with the breastmilk so effectively that there isn't any poo there. It's not like they have a bowel full of poo not going anywhere.

Call La Leche League. Call the breastfeeding helplines. Email Dr Jack Newman. EVERYONE with any experience of dealing with bf babies will tell you this is normal.

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Tambajam · 08/07/2009 21:01

And Jack Newman treated a healthy baby who went 21 days between poos.

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mears · 08/07/2009 21:02

Well, to be honest I don't actually agree that he does need lactulose. Unless he has problems passing stools (which it doesn't sound like), your baby is just one of the breastfed babies who has dirty nappies infrequently. It is not unknown for breastfed babies to pass few motions.

Since he is otherwise well I don't really think it is an issue. It would be interesting to see what Tiktok says.

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weegiemum · 08/07/2009 21:03

My dd2 did this - ebf, pooed about once a week to 10 days.

TOTALLY Normal - luckily I had managed to extricate myself from the HV by then!

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mears · 08/07/2009 21:05

Crossposting there!

another link here supporting long intervals between poos

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blowninonabreeze · 08/07/2009 21:07

My DD2 was the same - again totally breast fed. As long as it doesn't bother him when he does go, I'd go with your judgement and leave off the lactulose.

At 8 weeks DD2 had had the same number of poos in her life as DD1 used to have in a day at her age! It was bliss - especially with reusables.

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JudyBlume1019 · 08/07/2009 21:08

Thank you for replies. I suppose that I think I'm being a little precious, he's only ever had breast milk, so to be giving him medicine doesn't feel right, especially as I don't really think he needs it. It doesn't seem to hurt him to poo, I've watched him do it, but the wind does seem to cause him discomfort. That's what I was wondering mosschops, the poo that he does do is as liquid as a normal bf baby poo, it doesn't look short of moisture. I guess I should get a paeds referral.

I suppose I'm wondering if some GPs are more interventionalist iykwim, and actually imo it might be best to see how he gets on, rather than actually intervening. It doesn't really seem to be causing too much of a problem. He did do some poo in the waiting room, and if he' done it an hour earlier, I doubt I'd even have gone to the gp.

I think they're trying to rule out other problems he might have by seeing if the laxitives work, but if like you say mosschops, they only work by drawing moisture in then I can't see how they'd make a jot of difference??
Also, surel;y the fact that he did have 'normal' bowel movements for the first couple of weeks suggests he's OK???

Thanks Becks, I really don't feel like I know what I'm doing re this. It's thrown me.

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PacificDogwood · 08/07/2009 21:09

Yep, just another vote for "this can be normal in BFed babies", nought wrong with him, NOT constipated, no need to give anything.
Lactulose and supp will not do anything about slow bowel transit time which is constitutional.
I've heard big infrequent soft poos of milk fed babies called "mud slides", LOL !!

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neolara · 08/07/2009 21:09

My dd who was exclusively bf used to poo about once a week or once every ten days at around 3 months. Nothing wrong with her gut.

Her brother, on the other hand, used to poo more frequently (every 3 - 4 days?) but used to be in terrible pain beforehand for a few days (screaming then farting for hours). But I think he just had general tummy problems anyway as he used to throw up endlessly.

So, (in my completely non-medicalised opinion) I don't necessarily think going long periods between poos is a problem but if your ds is experiencing pain when pooing, then their might be.

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JudyBlume1019 · 08/07/2009 21:10

ooh, great lots more replies, x posted, will check links now, thank you so much.

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JudyBlume1019 · 08/07/2009 21:13

really good to read your posts. I have felt really like I wasn't being true to him or me by giving him the lactulose, and when he spat it out, my reaction was along the lines of "that's ma boy" rather thn anything else. Funny how a GP can make you lose the plot!

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bigstripeytiger · 08/07/2009 21:15

What you have described sounds normal for a BF baby. My DDs all went a week/10 days between bowel movements when they were that age.

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spicemonster · 08/07/2009 21:18

My bf baby went 10-14 days between poos - I think that's pretty normal

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frogs · 08/07/2009 21:18

What mears and tamba said. Bf babies' rate of pooing slows down dramatically once their systems get used to digesting bmilk. Mine got to the point of pooing about once every 10 days by the time they were 4 months or so. The only downside to that is that when they do finally go it will be an up the back job, and you will need a large supply of wipes and a complete change of clothes.

No way on gods earth would I give lactulose to a fully bfed baby just cos they were pooing once a week. It's the GP who's full of shit, not the baby. Fnar.

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hellsbelles · 08/07/2009 21:19

another vote for 'completely normal in BF babies' - my DD went from once a day to once a week (with the stinky farts!) so in a panic I googled it and came to the conclusion it's fine...I mentioned it to my dr and he was also fine with it as long as the stools were of normal consistency.

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kalo12 · 08/07/2009 21:20

rather than try lactulose which can make a baby extremely uncomfortable ( i took it whilst bfing and my baby had really bad colic as a result, and green frothy poo) you could try taking bifidabacterium infantis powder - from good health food shops. its expensive but it just helps ease indigestion or stomach problems.

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PacificDogwood · 08/07/2009 21:21

@ frogs - GP full of shit, not baby!!

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oodlesofpoodles · 08/07/2009 21:28

my ds is 16 weeks and goes 10+ days without a poo. He has 'failure to thrive' though and the pead seems to think its abnormal to not poo every day but every time he is examined they say poo is not backed up in his bowel. They think I am starving him.

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deleting · 08/07/2009 21:30

yes, normal. all mine were breastfed and once a week, sometimes went to ten days. as long as it's soft when it comes out it's fine.

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JudyBlume1019 · 08/07/2009 21:43

he checked his tummy and couldn't feel backed up poo! Right, lactulose going in bin NOW! Thank you mn. Just needed to refind my confidence on it.
Just wondering, for those whose dc were the same, what happened when they went on to solids?

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bigstripeytiger · 08/07/2009 21:46

The frequency of bowel movements increased a lot, up to more than once a day.

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