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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

My 3-week-old son is strictly breastfed and has not had a bowel movement in three days. How long is normal and when should I start to be concerned about constipation?

There are many things to consider. First of all, if he is wetting six to eight heavy wet diapers, and is content and happy, that is a good sign. Second of all, does he eat well, at least eight feeds a day? When he does have bowel movements, are they very soft and large?

The usual pattern is for babies to have frequent bowel movements for the first four to six weeks. After this time, some breastfed babies slow down on their bowel movements and do not have them daily or even weekly, but may have ""blowouts"" when they do occur, and they are still soft and easy to pass. Breastfed babies almost never get constipated, so when they do not have bowel movements in the first four weeks, it could be a sign that they are not drinking enough milk. Since your baby is 3 weeks old, it is a little soon for the bowel movements to be slowing down (although this could be a natural pattern for him). It might be a good idea to have a weight check and be sure that the baby is gaining. He should have been back to his birth weight by about 10 days, and then have gained 4 to 8 ounces a week since then. Also, be sure he is eating frequently and finishing the first breast first before offering the second side.

If you have any doubt at all that things may not be going well, don't hesitate to contact your health care provider and/or your lactation consultant for an evaluation. Sometimes a quick check can bring great peace of mind! I know because I do lots of quick checks for moms every week!

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