Expert: Sally Wendkos Olds - 9/30/2007

Question
I breast feed. My 3 month old baby is currently 15 lbs.  He used to feed regularly every 3 hours and eats around 3-4 oz each setting. (I know since I pump)  In the past 2 wks, he seems to not want to eat at the scheduled time.  He cries when I tried to feed him he cried and screamed until I stop feeding him.      His bowl movement slowed down so much that he goes once every 5 to 7 days.  Is this normal and what can I do?

Answer
Dear Peggy,

First, congratulations for giving your son the best start in life by breastfeeding him!

On his bowel movements, it is not unusual for a baby your son's age to go several days without a movement. I am attaching an excerpt from my book (see below) about this. And for the other problem, I am attaching another excerpt that seems to describe your baby's rejection of the breast, with suggestions for resolving this problem. I hope they help!

Good luck.

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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1) Remember that your baby's bowel movements and habits are quite different from those of a bottle-fed baby. A grandmother or friend used to bottle-fed babies may look at your baby's stools, become worried about his health, and alarm you. So put their minds and your own at ease.
  Your baby may move his bowels quite frequently, possibly after every feeding during the first month. After the first month, he may move them infrequently, possibly even going more than ten days without a movement. Breastfed babies tend to excrete less waste than formula-fed infants, because human milk is digested so completely.
  The bowel movements of a breastfed baby are usually soft, seedy, and yellowish. They've been described as being like soft-scrambled eggs with a little water around them or like a mixture of cottage cheese and mustard. Sometimes there's only a stain on the diaper; this is not diarrhea. Sometimes your baby strains a bit; this is not constipation. All these patterns are normal and healthy.
  Your baby's stools may become looser in response to something you have eaten -- large quantities of fruit juice, for example, or certain foods in the cabbage family. Try to discover the offending food and avoid it. Do not take any strong laxative, because this can give your baby diarrhea.
  While constipation is rare among breastfed babies, some babies do go a long time without moving their bowels -- after the first month or two, never before this time. If your baby goes a week or even two weeks without moving her bowels, this is nothing to worry about. But be forewarned: when the baby begins again to move her bowels, a great deal of soft, unformed stool may appear in several diapers in a row.
  If the stool is hard, this does signal constipation. This is, however, unlikely to occur in an exclusively breastfed baby. However, if your baby seems to be in pain when she does move her bowels, there are several things you can do. One is for you to drink six ounces of prune juice or eight ounces of apple juice once or twice a day. Another is to eliminate cow's milk from your diet. If neither of these steps helps, call your baby's doctor.
  To prevent infection in either you or your baby, wash your hands after diapering and before nursing him.
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2) Sometimes in the first few weeks after birth, but more often between four and ten months of age, a baby will nurse a couple of minutes, then arch his back and cry. Nothing the mother can do will induce him to go back, and yet it's obvious that he wants something. What's wrong? And what can you do about it? As with so many other childrearing issues, you have to look closely at your own baby and see what is going on in his life. The following suggestions have worked in some situations, and Box 15-10 lists several possible causes, along with some specific solutions.
  * If you want to continue nursing, don't start to give bottles now. Doing that may make the problem worse, and chances are that this "nursing strike" may last only a day or two, and your baby will then go back to being an eager nurser.
  * If your baby has begun to eat solid foods, increase her portions of these for a few days to tide her over. If she has been eating large amounts of solids, however, this may be causing the problem. She may be too full of food to be interested in nursing.
  * Express or pump your milk and give it to him in an eye dropper, a teaspoon, or a cup, until he resumes taking the breast.
  * Keep offering your breast. The most effective time to do this is to pick him up while he's asleep or very sleepy; he won't remember to reject the breast, and once he's back in the routine of nursing, he may decide it's pretty good, after all.
  * Vary your nursing positions. Your baby might prefer one you haven't used yet.
  * Nurse in motion -- in a rocking chair or walking around.
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  BOX 15-10  WHEN AN OLDER BABY REFUSES THE BREAST
  * Has your baby turned against the taste of your milk? It may have changed because of a cream you're using on your breasts, a new food you're eating, a new medicine you're taking, a new strenuous exercise program you've begun, a developing infection in your breast, or because you may be pregnant. Explore these possibilities, one by one. Keep a log of what you eat and what your baby's reaction is, so that you can identify and eliminate an offending food. Schedule nursing sessions before exercise sessions, as suggested in Chapter 7. If you feel a lump in your breast, first treat it as a clogged duct; if it has not healed in a couple of days, see your obstetrician.
  * Is she teething? If her gums are tender from the pressure of new teeth coming in, it may hurt her to nurse. If she bit you, she may have been startled by your cry of pain and be afraid to nurse again.
  * Is he wildly hungry? If he can't seem to wait for the milk to let down, try picking him up about 15 minutes before you would ordinarily feed him, or express a little milk first to give your let-down a chance to work.
  * Does she have a cold? She may be having trouble breathing through her nose. Use a vaporizer in the room where she sleeps or ask your doctor whether nose drops would help.
  * Does he have thrush? This mouth infection, described earlier, can make nursing painful. If you suspect it, treat it immediately, first to relieve your baby and also since the infection can spread to you.
  * Does she have an earache? If so, she may find nursing painful.
  * Is your baby consistently refusing only one breast? If so, see your own doctor, since this may signal a medical problem that should be explored.
  * See the suggestions in the section "Helping the Older Baby Who Isn't Gaining."
  * Are you under tension? If you're going through a particularly difficult time emotionally, your feelings may be coming across to your baby, who in turn becomes too upset to nurse. Make a conscious effort to forget about your cares, at least while you're nursing. You'll enjoy these oases in your life and your baby may be calmer, too.
  END OF BOX