Constipation (long)

[timorousbeastie]

Ever since DD started solids at 6 months (she's 8.5 months now), she has had occasional bouts of constipation. Usually, I can get it to clear up within a few days by pushing prunes, prune juice, and water. Well, for the past week, DD has had really hard, painful BMs; her whole body goes rigid as she strains for several minutes, only to push out the tiniest (and stinkiest) pellet of poo. The past couple days, she has been screaming while trying to poo. The screams are to the point I'm surprised the neighbors haven't called the police. She's obviously in a lot of pain  

I've tried the usual diet changes (nothing binding, adding in lots of peas, pears, plums), giving her water and prune juice. The past few days I've only fed her (aside from breastmilk) prunes mixed with prune juice and straight prune juice. I've had her jump in her jumperoo. I've gone for long drives so she sits in the carseat for a while. I've given her warm baths. I've even taken her out to run errands without a change of clothes, because Murphy's Law clearly states that a fully loaded kid + no backup clothes = a blowout of epic proportions. Nothing. She's still just having rock hard, tiny poos that are causing so much pain. 

This morning, I took her to the pedi - and of course, we wound up with the one pedi in the practice I don't like. The good news is she said her abdomen is soft and has good bowel sounds, so she doesn't think there's an impaction. Her main suggestion for how to treat her is to breastfeed her less (she currently nurses ~6 times a day for about 5 minutes; no idea about the volume she drinks since she won't take a bottle). She said that once babies are a year old, they should only get ~24 oz of milk per day. I reminded her that DD is only 8 months, not a year, and she said I should still cut down anyway because if she drinks 6 oz 6 times a day, that's 36 oz. But like I said, I have no idea how much she actually drinks, so maybe she only drinks 4 oz 6 times a day, so she would already be at 24 oz. 

Her other suggestion was maybe I could give her Miralax - but she had to go ask to see if that can be given to a baby under 1 (which, granted, I would prefer that she asks rather than guessing and giving me the wrong answer, but still it didn't give me a ton of confidence). When asked how much, she said she gives her older kids 1 tsp in 8 oz of juice, so maybe I could try 1/2 tsp in 4 oz... Or maybe I should do 1 tsp... Or maybe I should do 1 tsp the first day, then 1/2 tsp for several days after that. She genuinely had no idea how much I should be giving her. She said if that doesn't work and she doesn't have any BMs for 4-5 days (not even the rock hard pellets), to call the pedi's office again. 

Whew, that was long. I guess my questions are:
-would you breastfeed an 8.5 month old less to combat constipation?
-have you given Miralax to a baby less than a year old? If so, how much did you give?
-any other ideas for how to get DD's butt back in shape? My heart breaks every time she tries to poo

[Deleted]

First of all no, I would not breastfeed less to combat constipation or any other reason. Breast milk is a natural laxative so that makes no sense. Secondly, I highly doubt your child is taking in a full 6 oz every time she nurses. That is a LOT for a breastfed baby to take in one session. Not to mention that while nursing they regulate their intake so she is probably taking more at some sessions and less at others. But again, they regulate it so she isn't going to take to much from the breast. That advice is awful!!

I have had good luck with ground flax seed mixed into the girls' food. It has helped to keep them regular and I add a baby sized spoonful to each meal they eat. But to get things moving from constipation I believe they advise a teaspoon or more. When they were constipated I used more.

Eta: just to clarify, even if she were taking 6oz every nursing session it wouldn't matter and I still wouldn't decrease. She will take what she needs and I wouldn't cut her off.

[heygrey]

what is the science behind nursing less to help constipation? I thought more fluids is always better for constipation?

we've been dealing with it a bit, though not to your extreme. (no screaming, but obvious straining.) my go to is oatmeal thinned with prune juice. he hates it, but I shovel it in his mouth anyway it gets us from the rabbit like pellets back to soft poos within a day or so.

[timorousbeastie]

I'm glad to see I'm not the only one who thinks cutting back on nursing is crazy. The pedi was going along the lines of milk being constipating, so give her less. Which, yeah, if she was 2 years old and her entire diet was consisting of WCM, I'd absolutely agree to cut back on how much she was drinking. But not at this stage. Especially since she won't take a bottle, and her drinking from a cup basically means me squeezing it into her mouth and hoping she swallows instead of spitting it back out, so nursing really is the best way to make sure she stays hydrated. Plus, she's a tiny little peanut - she only weighted 16.4 lb at the office today, and I'm pretty sure a good pound of that was retained poo, so I don't want to cut back on her main source of calories.

Thanks for the tips/thoughts. Hopefully I can get DD's butt moving more easily soon!

[Deleted]

Oct 24, 2014 9:46:32 GMT -5 timorousbeastie said:

I'm glad to see I'm not the only one who thinks cutting back on nursing is crazy. The pedi was going along the lines of milk being constipating, so give her less. Which, yeah, if she was 2 years old and her entire diet was consisting of WCM, I'd absolutely agree to cut back on how much she was drinking. But not at this stage. Especially since she won't take a bottle, and her drinking from a cup basically means me squeezing it into her mouth and hoping she swallows instead of spitting it back out, so nursing really is the best way to make sure she stays hydrated. Plus, she's a tiny little peanut - she only weighted 16.4 lb at the office today, and I'm pretty sure a good pound of that was retained poo, so I don't want to cut back on her main source of calories.

Thanks for the tips/thoughts. Hopefully I can get DD's butt moving more easily soon!

Uhm, yeah, cow's.milk can be constipation but not human breastmilk. That is just bad advice! Keep nursing her to get the fluids in.

[rex]

go see your regular pedi and disregard the horrible advice you were given.

have you tried a probiotic?

[ohgillian]

Would you breastfeed an 8.5 month old less to combat constipation? Nope

Have you given Miralax to a baby less than a year old? Our peds GI put my infant on something but I don't remember what. It was for constipation thought. 


- How often is "occasional"?  
- Have you used glycerin suppositories? They're magic.
- Have you considered seeing a GI? I may or may not recommend this depending on how often "occasional" means.

 

[timorousbeastie]

Oct 24, 2014 9:52:55 GMT -5 ohgillian said:

- How often is "occasional"?  
- Have you used glycerin suppositories? They're magic.
- Have you considered seeing a GI? I may or may not recommend this depending on how often "occasional" means.

 

She never had constipation before starting solids. In the 2.5 months since starting them, she's been constipated maybe 3-4 times? This is the first time I haven't been able to get it to resolve within a few days. 

I haven't tried suppositories yet. I'll keep that in mind, in addition to the probiotics others have mentioned. 

I hadn't thought about seeing a GI yet. If she doesn't get better in a few days, I'm going to call the pedi (one of the good ones, not the one I saw today) to see if they suggest anything different or if they would prefer to refer her out. Thanks for the idea!

[whitemerlot]

My daughter started to have issues with constipation at nine months. She was a frequent breast-feeder and my pediatrician did say she thought she would become less constipated if she were to nurse less. We started her on Miralax after trying every single diet suggestion I read about.

I believe she was taking tablespoon for the first week. She continues to take it daily and is 2 1/2 now. She just gets a half teaspoon a day in 1/2 a juice box worth of juice every morning.

I wish I had tried it sooner. She was really uncomfortable for a while.