Expert: ruth kraft - 12/31/2008

Question
QUESTION: It seems my 10 month old is straining when passing stools.  Her stools are very firm.  She has them 2 or 3 x's a day but they are small.  I am wondering if she is constipated.  My letdowns are very infrequent in the afternoons and evenings.  (I am 46 yrs old and have had problems with low milk supply). I end up having to give her about 3 oz of formula before bed.  I wonder if she is getting enough liquid in the last 1/2 of the day - maybe she's dehyidrated. But she will sometimes not take any formula or only take 1, 2 oz and 3 at the most.

ANSWER: If anything is effecting the stools it isn't the breastmilk. Formula alone is likely to constipate the baby. bcause she is 10 months old, I assume you may also be giving her some solids as well . I would imagine that it might be something in those solids, especially if you just added something new.

Its very normal that your milk goes down in the afternoon and even less in the evening as this is the way our bodies are designed to eat. We are suppose to , health wise, have the biggest meal of the day at breakfast and the smallest at night to get our metabolisms going and avoid getting too much fat that packs on at night. Our society isn't geared that way though.  but please know that is very normal.  Being 46 shouldn't have effected your milk supply in any way , unless there wasn't enough stimulation to the breasts as supply and demand is what produces more and more milk.

It could be that the baby isn't getting enough fluid but I think it might be a combination of a binding food ( often times meat as their digestive systems have a very hard time with that until they are about 18 months old )  and also water /fiber. you can get some barely cereal from the store and mix it with breastmilk and see if that doesn't help. the extra fiber and extra fluid would be good. If that doesn't work, I would offer a sippy cup that is available all day with water or some kind of electrolyte drink for kids.  shes old enough to drink from a sippy and if available all day she might be more inclined to take it as she at this developmental stage is much more interested in motor skills than eating :) she will also start to thin out and grow taller now too... so don't be alarmed if it looks like her weight plateaus and she thins out.... its suppose to happen that way :)

Hope that helped!
Ruth Kraft
www.honoringwomen.com

---------- FOLLOW-UP ----------

QUESTION: Hi Ruth,
Thank you for your very helpful answer.  I was wondering if I could add a little extra water to her formula, maybe just a 1/2 an ounce (To a 4 oz bottle).  I have been giving her about 4 oz of water a day.  I think the constipation is occurring due to her eating chicken for dinner.  Or do you think it could be the rice cereal in the morning?

Answer
I think adding a half ounce of water would be fine. she will either want it or not... I think the chicken would likely be more at the cause of constipation rather than the rice cereal. Rice cereal is rather worthless. You should try to switch to barely, it has more flavor, more fiber and more nutritious. and mix it with pumped breastmilk rather than water or milk. or mix it with applesauce or something rather then water or formula even...  Babies aren't suppose to get meat until their 2 year molars come in... the digestive system , when the enzymes to digest a certain food are present, will then kick in and let the teeth know to break through to help chew... SO babies first get their front teeth for fruits and veggies that are soft, then harder veggies when the second middle teeth come in, then meat for the molars in the back. If she cant chew it on her own or gum it to death, it will be hard for her to digest. thats the basic rule.  Babies in third world countries that don't have jar food and puree things, feed their babies from their own plates when they are ready. which is when the teeth come in... if you use the general rule, if you have to puree it for her to eat it, she probably shouldn't have it, then her issue might go away :)

I hope that helped!

Ruth Kraft
www.honoringwomen.com