I have a question that may sound kind of silly.... but please bear with me. I've always been under the impression that the bowel movements of breastfed babies aren't supposed to smell bad (although some people have warned me that what I eat can have an effect on it).

My (breastfed) daughter Madeleine is 7.5 weeks old and is colicky. Also, she apparently has/had an anal fissure, which causes her some pain and discomfort when she has bowel movements. Basically, this poor baby cries just about all the time.

We (DH and I, plus my ped) assume this fissure is the source of the blood streaks that appear occasionally in her bm's. However, sometimes I think her stool seems awfully mucus-y, and all of the books I have say that is a sign of diarrhea in a *formula-fed* baby -- they all say that breastfed babies don't usually get diarrhea. That's the first curious thing. Is it common or normal for a breastfed baby to have mucus in her stool? (I'm assuming that's what it is)

The other is that her bowel movements are quite frequently stinky! It suddenly occurred to me today that maybe this is a sign of a problem? I don't really know what kind of problem -- digestive/intestinal? Virus? My ped seems pretty unconcerned, but #1, it's really wearing on me to have a baby that cries all the time and to be told that there's nothing I can do for her/for her pain and #2, I'm a problem-solver and I can't help thinking about these things. :-)

BTW, I am not eating dairy products, citrus, caffeine, chocolate, nuts, or gas-producing vegetables.

Thanks for any input,
Rebecca






Dear Rebecca,

Your question is not silly at all--if it were my baby, I would be asking questions too. You are right that the odor to a breastfed baby's stool is usually not unpleasant in the least.

I, too, had an extremely colicky baby for months, so I can certainly identify with what you are going through! Dairy products are certainly the most likely cause, but, as you've seen, eliminating them doesn't always produce results. Have you taken out all dairy? And, if so, how long has it been? Sometimes it may take longer than a week to see results. Dairy products are often the culprit when blood is showing up in the stool, too. Food allergies of any type can cause these problems. It sounds like you've eliminated most of the likely causes. One other that is quite common is wheat. By the way, if foods have been eliminated from your diet for two weeks or more without results, then you can certainly put them back in.

Let me address your question about diarrhea. Diarrhea in a breastfed baby is diagnosed when a baby has 12-16 stools per day, watery stools, and an offensive odor to the stools. Just one of these symptoms does not in itself mean the baby has diarrhea. Yes, it is normal for mucus to be in stools--but not necessarily all the time.

There are medications for colic. Have you tried any of them? I often find that parents aren't using these drugs because they don't want to "medicate" their babies. These medicines are very safe--all they do is break up gas bubbles, so the baby has less pain. Using the medicines ahead of the anticipated fussy periods can really help. Sometimes you even have to use them around the clock! What I would recommend to you is that you make an appointment with a gastroenterologist (there are even pediatric gastrolenterologists). The symptoms you are describing can go along with ulcerative colitis also.

One last suggestion, it looks like you must have a wonderful milk supply since weight gain has been so good! I assume that your baby dropped some weight initially, as is normal, then got back up to birth weight by about 2 weeks (also normal). If that is so, then she has gained about 3 pounds in under 6 weeks.

Do you perceive your milk supply as being better than normal? Does your baby sometimes choke at the beginning of the feeding? It could be that she is getting too much "foremilk" which means too much lactose. Lactose can cause stomach cramps. If that is the case, the fussy periods would generally be worse in the late afternoon and evening. One thing to try is to change you feeding method so that you only offer one breast per feeding. This allows your baby to get the hindmilk sooner, which is higher in fat, so it signals to the baby's brain sooner---"I'm full. Stop eating." This way the baby takes in less lactose. For more than half the women I suggest this to, it seems to make a difference. It will generally take about three days to see whether or not it will work or not. Give it a try and let me know how things go. Good luck!

Cher N. Sealy, RN, BSN, IBCLC, LLLL





 

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