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Child Started Passing Stool Frequently. On Breast Milk And Bottle Feed. Is This Normal?

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Posted on Mon, 1 Apr 2013
Question: Hello Doctor,
My two weeks old daughter is passing stools 10 to 12 times a day. She is on mothers milk mostly and takes bottle milk as supplement for every two to three hours.
Is it normal? How to differentiate it from diarrhoea or any other infection?
Please reply.
Thanks in advance.

Regards,
XXXXXXX
doctor
Answered by Dr. Taher Y Kagalwala (6 hours later)
Dear XXXXXXX

First of all, thank you very much for your direct question. Let me begin by congratulating you and your spouse for the recent arrival of the stork. I am a little alarmed that you needed to begin bottle feeds so early in life. It has been my experience, and that of thousands of other doctors, health workers and care givers that babies thrive very well on breast milk ALONE and even if they do not grow as fast as bottle-fed babies, they remain infection-free and keep receiving immune-active substances through their mothers' milk.

It is a well-known fact that babies fed BOTH breast and bottle-milks quickly start preferring the easy sucking action of the bottle and start rejecting their mother's milk. Their indifference to sucking on the mother's breast turns off the stimulus feed-back that helps the mother produce more milk. In this way, the breast milk soon dries up.

It is therefore my humble and earnest request to IMMEDIATELY CEASE GIVING HER A FEEDING BOTTLE. If need be, you may supplement mother's milk with top milk, but WITH A SPOON AND CUP AND NOT WITH THE BOTTLE. If you do this, the baby will keep returning to her mother's breast and failure of breastfeeding will NOT occur. The earlier you do this, the better. (Kaal kare so aaj XXXXXXX aaj kare so abb, etc.)

Now, let me address your main query. As you have said, your 2-week old daughter passes 10-12 stools per day. Look at and smell the stool. Breastfed babies may NORMALLY pass that many stools each day, but the stools are:

- yellow (described as "golden" yellow)
- semi-solid
- appear to be like small legume-sized balls with a little yellow to XXXXXXX liquid
- passed usually WHILE SUCKLING
- passed with expulsion of gas
- smell like curdled milk

Additional cues are as follows: Usually the baby seems to be well, she has no fever, no rashes around the anus and no fever or vomiting. Also, weight gain is normal and the child continues to pass urine 5-6 times in 24 hours.

On the other hand, infective stools are usually passed with no relation to feedings, are XXXXXXX foul-smelling, mixed with sticky mucus or sometimes, blood, and cause redness and peeling of the skin around the anus.

If she is behaving in the above manner, there is no need to worry. Try and stop bottle sucking and everything else will be all right.

I hope this addresses the question completely.

With best wishes,

Dr. Taher

P.S. This is to remind you that -

a) Your baby should have already received one dose of oral polio vaccine and injectable next month or so.

b)At the end of 14 days, you should have taken her to the pediatrician for checking her weight.. It is likely that her current weight will be close to her birth weight or slightly more or less. This would be normal.

-Dr. T
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Taher Y Kagalwala (2 hours later)
Dear Dr. Taher

I really thank you and appreciate your efforts for an exhaustive and comprehensive reply.
Regarding your suggestion to completely shift to mother’s milk, we would be more than happy if it becomes a reality as we fully agree with the benefits you have suggested. Our only concern is that she is asleep for most of the time and sometimes we wake her up (with some difficulty at times) to give her food and during such occasions, she prefers bottle milk (as you had mentioned easier option) compared to mother’s milk and if we don’t give her bottle milk, she will just sleep. Please suggest on how to deal with this situation.
Also, when can we expect this frequency (10 to 12 stool passings) to reduce? How long can the baby continue to be exclusively on mother’s milk (she was weighing 2.6 kg at birth and 2.7 kg after ten days)?
Thanks in advance.

Regards,
XXXXXXX
doctor
Answered by Dr. Taher Y Kagalwala (38 minutes later)
Dear XXXXXXX

I think your daughter is trying to tell you something very important when she refuses her mother's breast; in a flash, she is conveying to you that she doesn't WANT to feed. It is normal for such young babies to even sleep for 16 hours a day! Hence, fret not. Her weight is right for a fortnight old baby. Just encourage your wife to suckle the baby as often as the baby desires. You don't need to compulsarily feed her every 2-3 hrs.

With best wishes,

Dr. Taher.

P. S. Do remember to write a review for me. Thank you.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Taher Y Kagalwala

Pediatrician

Practicing since :1982

Answered : 710 Questions

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Child Started Passing Stool Frequently. On Breast Milk And Bottle Feed. Is This Normal?

Dear XXXXXXX

First of all, thank you very much for your direct question. Let me begin by congratulating you and your spouse for the recent arrival of the stork. I am a little alarmed that you needed to begin bottle feeds so early in life. It has been my experience, and that of thousands of other doctors, health workers and care givers that babies thrive very well on breast milk ALONE and even if they do not grow as fast as bottle-fed babies, they remain infection-free and keep receiving immune-active substances through their mothers' milk.

It is a well-known fact that babies fed BOTH breast and bottle-milks quickly start preferring the easy sucking action of the bottle and start rejecting their mother's milk. Their indifference to sucking on the mother's breast turns off the stimulus feed-back that helps the mother produce more milk. In this way, the breast milk soon dries up.

It is therefore my humble and earnest request to IMMEDIATELY CEASE GIVING HER A FEEDING BOTTLE. If need be, you may supplement mother's milk with top milk, but WITH A SPOON AND CUP AND NOT WITH THE BOTTLE. If you do this, the baby will keep returning to her mother's breast and failure of breastfeeding will NOT occur. The earlier you do this, the better. (Kaal kare so aaj XXXXXXX aaj kare so abb, etc.)

Now, let me address your main query. As you have said, your 2-week old daughter passes 10-12 stools per day. Look at and smell the stool. Breastfed babies may NORMALLY pass that many stools each day, but the stools are:

- yellow (described as "golden" yellow)
- semi-solid
- appear to be like small legume-sized balls with a little yellow to XXXXXXX liquid
- passed usually WHILE SUCKLING
- passed with expulsion of gas
- smell like curdled milk

Additional cues are as follows: Usually the baby seems to be well, she has no fever, no rashes around the anus and no fever or vomiting. Also, weight gain is normal and the child continues to pass urine 5-6 times in 24 hours.

On the other hand, infective stools are usually passed with no relation to feedings, are XXXXXXX foul-smelling, mixed with sticky mucus or sometimes, blood, and cause redness and peeling of the skin around the anus.

If she is behaving in the above manner, there is no need to worry. Try and stop bottle sucking and everything else will be all right.

I hope this addresses the question completely.

With best wishes,

Dr. Taher

P.S. This is to remind you that -

a) Your baby should have already received one dose of oral polio vaccine and injectable next month or so.

b)At the end of 14 days, you should have taken her to the pediatrician for checking her weight.. It is likely that her current weight will be close to her birth weight or slightly more or less. This would be normal.

-Dr. T