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Forum Name: Pediatric Topics

Question: Severe Constiptation in Breastfed Infant


 ColoradoMom - Tue Sep 23, 2008 8:40 am

I'm worried about my 7 month old son. He's in the top 95th percentile for height, but less than 25th for weight. He hasn't gained any weight in more than 3 months. He has been constipated since he was 4 months old. At first, his pediatrician told me that he couldn't be constipated, since he was exclusively breast fed. When I started him on solids, last month, I was told that this was the cause of his constipation. Three weeks ago, he became so constipated that he couldn't keep food down, and began choking on vomit. At the emergency room, it took two suppositories and two enemas before he could have a bowel movement. His bowel movement was firm and dark and the next day became black and almost flaky. After that, he stopped going again. They gave us two suppositories to take home, in case he became constipated again. So, a week later, I used one, with no effect. I used the second one and twelve hours later, he finally had a bowel movement, and then several more that same day. Now it's a few days later. He's less interested in eating, so my milk supply is waning. He's peeing fine, but no bowel movements. He's spitting up more, which he always does - the longer it's been since a bowel movement, the more he spits up. He's trying to move his bowels, but it's not working. I've been told that he can't have an impacted bowel, because every few weeks, he'll have a very hard, pellet-like poo. He is primarily breast fed, with only 2 - 4 ounces of baby food or juice per day. I'm giving him watered down prune juice and apple juice every few days to try to help. I've tried Karo syrup, too. I don't give him constipating foods, such as squash, carrots, or bananas. The emergency room doctor advised me to discontinue his iron supplement and all iron-rich foods (including rice cereal). He has checked out fine at all of his routine check-ups. His pediatrician seems concerned about his lack of weight gain, but doesn't seem interested in the constipation issue. I think that they're related. I’m especially worried now that he is less interested in food, and my milk supply is affected. Please help. Thank you!
 Debbie Miller, RN - Fri Oct 03, 2008 9:54 am

User avatar Hello,
I agree with the pediatrician that the constipation is not likely causing his low weight gain. Did he start out on the low end and is the growth curve consistent or are you seeing a sudden drop or move to a straight line on the graph? The important thing in weight gain is that it continue to be consistent along his own graph line.

If you continue to feed the baby as you are, these issues will probably resolve eventually. He may have a sluggish response to the urge to move the bowels. As long as he is able to have movements maybe 3 times a week, this can be fine. pediatric glycerine suppositories can be used occasionally in addition to the other dietary treatments such as cereals, strained prunes, apricots, or spinach.

If there were blockage you would probably see some liquid leaky stool coming around the blocked bowel. Also, if he seems to become lethargic, loses muscle tone or seems weak it could be a symptom of botulism. These conditions would be cause to take the baby to the doctor right away.

Patience is probably the most important thing here. In time your baby's musculature will make it easier for him to push the fecal matter out through what may be a somewhat tight anal sphincter. Unless he actually becomes impacted, constipation won't harm him.

Best wishes.

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