If my breastfed baby has no bowel movement for several days, should I be worried? Is my baby constipated?

The above is a common question asked by a lot of new mothers who breastfeed their babies.

Here is one question posted by a mom.

My Nina now is nursing fully, but it’s been 3 days since she’s moved her bowels. Is this something I should be worried about? I’m thinking of taking her to see my paed if she doesn’t do anything today. How long can a baby go without doing it? -Yat

And the other mothers who breastfeed their babies shared their own experiences :

Bowel – If Nina is not straining or looks uncomfortable, just sit and wait. You will be ‘rewarded’ with a big one soon. My son is also the same – sometimes poo about 7-9 times per day, then suddenly 3 days without bowel movement. All the moo-mies here will chorus – this is normal! if you are exclusively breast-feeding her. – Lilian

Not to worry! It’s normal for exclusively BFG babies do not pass the bowel very often. This is due to our super duper milk is almost 100% absorbed as nutrition by their body, thus not so much to be passed. At one time Wafiq (when he was 3 mths) did not do ‘bisnes’ for almost 10 days. Just minutes away before we went to see a paed, he gave us a surprise with long overdue bullet! – Fiz

There’s nothing to worry about. Joe Yue, now 3.5 months old, has been having bowel movement (since he turned 3 months)every 4 – 5 days. At first, I was worried like you too but after that I realised that it was normal. His paed said that there’s even a record of 11 days! As long as the poo-poo is not hard and pellet-like and your baby is not crying, it’s perfectly fine. – Christine

Tags: Breastfeeding, constipation

I think my baby is suffering from nipple confusion. Can you help?

This is what was suggested in “The Nursing Mother’s Companion”:

“If you have waited longer than a month (to give a bottle) and the baby refuses to take a bottle, be sure to have someone else try. Frequently a baby is more confused and upset by the bottle when her mother tries to persuade her. Trying to force the baby is upsetting for everyone, and rarely successful. Some parents have succeeded by offering the bottle while walking with the baby. Hold the baby facing away from you and bounce her gently as you walk. Some babies dislike the taste of formula; try breastmilk instead. Tasteless silicone nipples may be more readily accepted than rubber types. Recently I’ve been successful in getting babies to take a bottle fitted with the Avent Fast-Flow nipple or the Evenflo HealthFlow nipple. Another technique that has been sucessful for some mothers is to nurse the baby for just a few minutes, then unlatch the baby and slip the bottle into her mouth. If she objects, you can try again after a few minutes more.

The baby who refuses a bottle may do surprisingly well with an ordinary cup, particularly if she is about six months or older.”

Here is my personal experience: ( Min)

Laura (aged 3 1/2 and breastfed for 28 months) was given a bottle too early, so refused the breasts for the first few weeks until she was re-trained to nurse directly from about 5 weeks. In the first few weeks, she was fed bottle fed EBM. My mom was ill at that time, so I spent a lot of time in the hospital with my mom which took me away from her. I nursed her whenever I could and only give her a bottle if I can’t make it back in time for her feed. I was afraid she would regress and not take to the breasts again but she didn’t, so everything was fine until she was about 3 months old. My mom had to be admitted into hospital again and the admission took a long time. I was away from Laura for more than 6 hours. She refused to drink from a bottle and chose to sleep instead after crying her lungs out. Since I was and still am a SAHM, I didn’t pursue trying to get her to use the baby bottle again and just worked around her feeding time and brought her with me whenever I could.

Adam (aged 9 1/2 months and still breastfed) was born with a tongue-tie, so couldn’t nurse directly in the first month. He was cup fed EBM for 4 weeks until he could nurse directly with the help of nipple shields. He drinks a lot and I work part-time, so he has to be fed EBM by my maid while I am away. At about 2 1/2 months, he refused the bottle too and would cry before taking to the bottle again. Initially, he was fed with a fast flowing nipple and he drank a lot because he still wanted to suck after the milk had finished. I was reluctant to give him pacifier but decided to try. He refused the pacifier! With some struggle at each bottle feeding time, he eventually accepted the bottle and now knows that when he wants milk and I am around he will nurse directly. When mama is no where in sight, he accepts the bottle from Dita. He still uses a slow flow nipple which seems to fulfill his sucking needs while giving him nourishment.

Julia, perhaps you can try cup feeding your baby while trying to get her to accept the bottle again. You can either get a feeding cup (especially made for cup feeding infants) from Medela or just use an ordinary cup. Pour small amount into the cup so your caregiver won’t risk spilling your precious EBM.

Tags: Breastfeeding, nipple confusion

Can I breastfeed if my nipple is short or inverted?

Evert-It
There is this invention called “Evert-It” which deals with this problem. I bought it from the Internet due to recommendations in a breastfeeding book that I read. The verdict – yes, it helped in the beginning, but once your baby learns the correct latch-on, you won’t need it anymore. I also found that if you use a breast pump, you can achieve the same result. I use Avent Isis. – Nor Azleena

Manual manipulation
By and large this is not a problem that can’t be overcome. Once the baby is latched on, the nipple is elongated, which is noticeable when the baby comes off the breast after nursing. Pregnancy itself (especially the later stage) can alter the nipple.

However, inverted, flat or short nipples can make good latching on a challenge especially around the 3-4 days post natal when the breast is hard due to the increased blood supply (as the breast changes to making milk rather than colostrums).

Gently pulling the nipple and rolling it between the thumb and fingers during pregnancy has shown to be ineffective but doesn’t do any harm. – Eirian

Ipplette
A few years ago Avent manufactured something called an “ipplette” (about 6 years ago I bought a few in the UK and brought them back here). It worked like a small bicycle pump to pull the nipple out. Consisted of a nipple shield connected to a thin tube connected to a syringe. The research (done by the manufacturer) showed that when used sufficiently (I think a few minutes every day), the muscles lengthwise around the nipple became slightly longer. Don’t know if they still make them.

This little contraption can be made by taking a plastic syringe (probably a 10ml one), cutting off the end where you would put the needle, pulling out the plunger and putting it in the ex needle end and then using the flange end over the nipple and using a gentle pull to elongate the nipple. Don’t know if anyone who has tried this though. Whatever used should be comfortable and not cause any trauma. – Eirian

Ice cube
A wrapped ice cube to make the nipple stand out can always be used just before you try and get the baby latched on if you expect difficulty. – Eirian

This is usually a problem in the early days, once the baby (and mum) has learnt the art of nursing nipple shape and size is not an issue. – Eirian