Q&A: breastfed baby poop

Rachel writes:

"My daughter is one month old, and her pooping schedule has slowed fromthree or more dirty diapers a day to one every few days to one a week to what we have now, which is a week and a half and counting. She has tons of wet diapers, and lots of stinky gas with sometimes the tiniest bit of poop leaked, but just no real poops. When she does poop, it's a huge amount, and it looks like a typical breastfed baby poop, just lots more of it.

With my first child, who pooped all the time, I remember reading that breastfed babies sometimes poop as little as once a week, so I knew this was a possibility. I did some looking online recently and found the same thing, with people saying breastfed babies are almost never constipated and can sometimes go a week between BMs (one site said, in extreme cases, three weeks, though I didn't see that elsewhere). Overall my daughter is very healthy. She's been gaining weight, she sleeps well, and she's not really fussy (I know, I'm very, very lucky). She is a lazy eater and often latches off in under five minutes, but because of the weight gain and the fact that she just looks great, the lactation consultant said she thinks my daughter is just one of those babies who eats quickly (again, I have no idea how we got so lucky). She fusses on the breast a lot in the late evenings before bed and does seem to scrunch and grunt when passing gas, but other than that, she seems perfectly fine.

My problem is this: my pediatrician wants to give the baby some suppositories or other constipation remedy if she doesn't poop in a day or two. I really don't want to mess with her system if it's not necessary, but I also don't want to deny her treatment that she needs. My husband is between jobs and we are without insurance for a few weeks, but we could pay for the visit/treatment if she really needed it, but the be honest that's another reason not to do anything unless it's truly necessary.

Since my other child was a constant pooper, I'd love to hear from readers who have breastfed kids who pooped rarely. How long would your kid go between BMs? Did it ever cause problems? Are there any home remedies we could try before sticking something up her bum? I've cut out dairy for a few days just for lack of any other ideas, but no movement so far. Any other things I could be eating that could be causing her digestive problems, if this really is a problem? Did your kid's BMs ever increase in frequency? Was constipation a problem when solids were introduced?"

I already answered Rachel privately, but let me just reiterate here that frequency of poop is not an issue for breastfed babies. Because different babies absorb the nutrients in breastmilk in different ways at different times, going a long time between poops is not necessarily a cause for concern. What you do want to watch out for is the consistency, color, and smell of the poop. If it's still that same brownish-yellowish-orangish-greenish soft or seedy poop, and it has that smell that I always thought was a lot like elementary school paste, you're fine. If it smells really foul (like the baby's sick) and is hard or in nuggets and is black, that's a problem and you should call your doctor. (Green poop can be caused by anything from your eating lots of spinach to having a foremilk-hindmilk imbalance to the baby's having some kind of little cold or virus. It basically means the poop is going quickly through the baby's system, and if it doesn't seem to be accompanied by any other problems it's not a problem in and of itself.)

I'm actually rather concerned that Rachel's doctor wants to give a perfectly healthy baby suppositories. It shows a lack of understanding of one of the basic facts that anyone working with a decent-sized breastfeeding population should know. (By that I mean that the average breastfeeding mom only really knows her own kid's patterns, but someone who deals with lot of breastfed babies certainly ought to know what the range of normal is.) I'd be extremely hesitant to give a healthy baby anything that's going to interrupt his natural bowl functioning. If her doctor is truly insistent, she should call her LC or local La Leche League leader, who can pull any available literature on the range of normal for pooping.

Now to the anecdotes. I've said it thousands of times here, but both of my kids changed pooping patterns every time they went through a growth spurt. I think the longest time either of mine went was 3-4 days. Of course I'm not going to pretend that I didn't start to get worried about it, but my worry was mostly that we'd be out somewhere and 4 days' worth of poop would all come out and cause a poopsplosion somewhere I couldn't really deal with it.

Another friend of mine said her daughter routinely pooped once a week for months. Said child is going happily off to college at the end of this month.

Anyone else with tales of poop? I posted this question mainly because I wanted there to be a bunch of data points gathered in one place, so any other moms frantically Googling at 3 am could see what's actually normal.