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He is extremely content until it comes time to pass wind or move his bowel

HI Leanne. I have a 6 week old baby who is having problems moving his bowel. He is extremely content - until it comes time to pass wind or move his bowel. With this comes a lot of groaning, clenching and distress. He manages to move his bowel at least once a day - but the build up to it can be slow - with little traces in his nappy at each change - until he finally manages to get something out. The colour is still green - has only been yellow/brown once - and my diet is very regular (nothing different eaten that particular day). My midwive has advised that I cease all dairy products - just wondering if you think this is wise - and if so, what are the best foods for me to avoid and consume? Or, do you think it could be something else (the fact that they are green and hard to release). Thank you

Answer: Hi There, Some swear by changes in the maternal diet to help with digestive upsets for breastfed bubs, but the research tends not to favour it unless you are talking about familial allergies. One of the major reasons for the caution with restricting a maternal diet is that it is so important for you to get a really good nutritious diet. Calcium is a big one when you are feeding, if you don`t get enough your body will tend to use its stored calcium (from your bones..). So if you remove a major food group such as dairy, then without any doubt you need to replace the nutrients it gives you with other sources. Personally, in all situations I recommend that anytime you take something out of a diet you must replace with an alternative. So in this case I would recommend you see a nutritionist or dietitian to have this done properly. Keep in mind that babies commonly look like they are struggling with bowel motions, they can shake, grunt and go bright red, but if the poo is liquidy then it isn`t likely to be constipation (which generally shows as formed and hard poo). It can take some months for babies to develop the internal muscles to pass a bowel motion with what seems as less stress. Also the colour of an exclusively breastfed bubs poo tends to be a mustardy yellow, though bubs being complimentary feed with formula also often have more greenish poo and also are more likely to experience constipation. I am guessing baby is exclusively breastfed? So yes in this case, you may want to look at some of the foods in your diet, I would see a nutritionist or dietitian to do this, that way you and baby will still get all the nutrients you need. The links below have pages with practitioners in different areas if you wanted to find someone near you: www.daa.asn.au www.nsa.asn.au I have a tip sheet about to come out on Huggies on Pregnancy Nutrition, I have copied in some bits from it below so you can get a feel for how many nutrients you need in greater amounts than if you weren`t breastfeeding: ----- Some healthy snack ideas might include:
  • Top of my list is a smoothie (more on this later)
  • Toasted cheese sandwich (add other fillings such as tomato, avocado, meat etc.)
  • Cream cheese bagel
  • Pot of fruit yoghurt
  • Handful of nuts, seeds and dried fruit
  • Toast with your choice of topping
  • Cup of healthy soup
  • Salt-reduced baked beans on toast
  • Scrambled eggs
  • Mezze plate (vegetarian dips, crackers or bread, olives etc.)
  • Note that each of these snacks contains protein. Protein is essential during growth phases. Ensuring that you meet your body`s increased protein demands will help you stay well and your baby to grow. Sources of protein include:
  • Animal products including dairy and eggs
  • Beans, nuts, seeds, legumes, seaweed
Many of the foods listed above are also rich in calcium. Eating about four serves of calcium-rich foods will fortify your breastmilk with calcium and also protect your own calcium stores. Of course dairy foods are an easy way to get calcium, but calcium is also obtainable from calcium-enriched drinks (120mg per 100 ml) such as soymilk, tinned fish with crushed bones, and nuts and seeds.

What about iron?

During pregnancy, your baby was busily storing iron that he or she will use for up to six months after birth. It is important that you rebuild your stocks of iron and maintain a healthy iron intake. Foods such as red meat, liver, kidney, broccoli, peas, bran, oats and enriched breads are great sources of iron and should be incorporated into your daily diet. Alternatively, vegetarians can obtain some iron from tofu, pumpkin seeds, peaches, sesame seeds or tahini. Keep in mind that vitamin C assists in the absorption of iron, so enjoy vitamin C-rich foods such as guava, red capsicums, blackcurrants, strawberries, oranges, watercress, cabbage (savoy), Brussel sprouts, kiwi fruit, paw paw, broccoli, cooked tomatoes and cauliflower, amongst others.

Iron supplements

While nursing mothers require greater amounts of iron, it`s also important to understand how much you need in order to keep your iron within a healthy range. Before taking iron supplements it is best to get a professional recommendation. More is not necessarily better. Check with your healthcare professional for the recommended brands and dosage. Most pregnancy and breastfeeding supplements will include safe levels of iron.

Other nutrients required in greater quantities

You will need greater quantities of other nutrients during breastfeeding; however, if you are consuming extra healthy food over the day it is likely you will be covering these. In brief they include:
  • Iodine ­ food sources such as salt and bread will be fortified with iodine in Australia from 2010; other sources include saltwater fish and seafood
  • Zinc ­ animal products, shellfish and legumes
  • Folate (B9) ­ green leafy vegetables are tops
  • Vitamin C ­ coloured fruit and berries, red capsicum, guava, acerola
  • Vitamin A ­ eggs, fish oils, fortified milk, dark green and yellow vegies (carrots and pumpkin are top of the list)

Don`t be tempted to restrict your diet

Restricting your diet while breastfeeding is not recommended. Don`t be tempted to go on a diet, eliminate food groups or restrict your intake of food while breastfeeding as it will likely cause nutrient deficiencies, which in turn can affect your energy and ability to cope with the challenges of motherhood. A diet that poses particular difficulties is the vegan diet, which may lead to a deficiency in B12. Vegans or anyone considering a restricted diet during breastfeeding should consult a qualified health professional about ensuring nutritional adequacy during lactation. ----- I hope that helps with your next move, always keep as a priority in your mind that you are doing an excellent job in feeding baby and bub is getting so many wonderful compounds for good health. All the best, Leanne
Answered: 15 Jul 2009