Expert: ruth kraft - 1/8/2010

Question
QUESTION: My daughter is just about 6 weeks old and weighs approximately 10 lbs. She was discharged from NICU at about 7.5 pounds 10 days after she was born. So she's gained 2 pounds in the past 4 weeks.  She has done really well with breastfeeding and is really a very easy baby! The past 3 nights she has slept for over 6 hours and not wanted to nurse, even when I wake up to her noises and offer it.  Do you think this is ok since she's so young.  She is quite content and nurses about every 2-3 hours during the day so sort of has been cluster feeding just before going to bed for the night.  prior to the past few days, she sleeps through the night anyway, but still nursed every few hours; occasionally lasting about 4 hours. My other concern is about her gas and associated pain, which is fairly inconsisent.  I haven't noticed a pattern in my diet that may be affecting her.  Any suggestions? Thank you.

ANSWER: Sounds like her weight gain is fine. So as long as she is having 8 wet diapers a day and a dirty diaper now and again , acts otherwise normal during the day, then I would not worry. I would also be happy to have a good sleeper and hope it lasts :)  before 6 weeks I would wonder but after 6 weeks I wouldnt worry so much as that is long enough to know if a baby is thriving usually.

She is 6 weeks old now and between 4 and 6 weeks, the colostum that works as a laxative in their system goes away. because of that right around  6 weeks usually the baby will start pooping alot less than she did as a newborn. she might go a couple times a day or she might go a week between poops.My son went 10 days once without pooping. that is PERFECTLY normal IF you are exclusivly breastfeeding. meaning NO other suppimentation. breastmilk is just that digestable.

You will also notice that she will strain harder to poop and her face might get red and she concentrates and he gas is much smellier. This is also very normal as her bowels get used to this new stage. She isn't constpated. this is a baby's way of the first steps to learning how to control their bowels. How to make it come and how to stop it from coming... she is learning how to use muscles she never had to before. this is what will stop her now from pooping while she is asleep :)

sounds like your on the perfect track! GOOD JOB MOM!

Hope that helped.
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---------- FOLLOW-UP ----------

QUESTION: Thank you so much for the information and words of encouragement. This brings up another question.  When they began tube feeding my daughter in the NICU, it was by chance that I was there and suggested to the on duty nurse that we needed to start with the colostrum I had pumped as she was about to use milk I had just pumped.  When we came home I discovered that the nurses hadn't been giving her my milk according to its date. She was born 11/28 and I have milk dated starting 12/1.  I pumped a ton of milk during those days and I'm not sure that it is of as much use as I hoped, because I have read that her nutritional needs are much different now. The hospital lactation consultant suggested that I mix it (colostrum and transitional milk) in with fresh milk when we started practicing with bottles.  Any thoughts about if that milk will meet her nutritional needs now.  Thanks again!

Answer
Hello. Yes in my opinion, it will meet her nutritional needs now. I also had a NICU baby who was preemie and their needs do change. However, that older milk is PERFECT for the in my opinion because any baby  who has had a nicu stay was there for a reason that likely caused stress. Stress weakens the immune system. The first 4-6 weeks has colostrum in it and therefore will help build that immune system up. She isnt far past 6 weeks, go ahead and feed her your oldest milk first and then go from there. Don't throw it away. If you for some reason end up with more than you can handle, you have 2 good options, buy a deep freezer so it will keep for a year, OR donate it to a milk bank and help the sick preemies out there.  just don't throw it out :) my suggestion would be use it. your nursing sometimes during the day , she will get all she needs. :)

hope that helped!