Sunday, June 5, 2011

The Gut, Microbes and Poop.


There’s a topic I spend an inordinate amount of time thinking about. To the point that I think I may be obsessed. To put it into perspective, I live in Paris. Just wandering through the streets of the city in the Spring-time is a visceral experience worthy of song and poetry and of course, blog posts. The other day, I was with my 12 year old son walking the dog, thinking about the way the gut and brain ARE. Not the way they communicate, but the way they are. The way we are.

I caught myself as I hurried to catch up to Leo. I slipped my arm into his and set a pace to match him, as I finally took in the sun, the breeze and perfect beauty of the day. I pushed the other thought away. For awhile. Clearly, it has returned. It always returns because mommas and babies and families are not as well as we could be. Not by a long shot.

As a lactation consultant I used to think about breastfeeding. I thought about my own babies, my clients and their babies, about what I read and observed and learned. I loved nursing my babies and I love helping mommas nurse their babies. So, I am still a lactation consultant, but now I pretty much think about the gut. And all that is associated with the gut—like the brain, hormones, the nervous system, structure, personality, emotions and general well-being.  Because I think about the gut and the brain, I also think a lot about bacteria and inflammation. Not because bacteria cause inflammation, but because more often than not, lack of bacteria does.

In essence, bacteria are the way we are. Today, I took my son to the Muséum National d'Histoire Naturelle. The building is ancient, of course, but so are the displays. The cursive handwriting on the jars intrigued me as much as the specimens. There were thousands of skeletons and fossils and organs of species long extinct and of those still here. Including homo sapiens.Leo asked me what was here before any of them. “Microbes,” I said. 

Microbes have a 3.4 billion history on Earth and microbial mats are the oldest known ecosystem on Earth. Whatever form life on Earth takes, microbes share the journey with us. They are the way we are; they are the way that life is. NASA and other scientific sources use the term co-evolution to describe the fact that all life has evolved in relation to microbes. Microorganisms can form endosymbiotic relationships with other organisms. Examples are rampant, but the relationship that interests me is the one between the bacteria that live within the human digestive system and the human organism itself.  These microbes contribute to immunity, synthesize vitamins and ferment complex indigestible carbohydrates. They drive our relationship with the world around us.

So, how does this relate to babies, birth and infant feeding? In every possible way, it turns out. While the infant gestates in a sterile environment, the mother’s body is prepared at birth to immediately alter that scenario, exposing the newborn to her own microbes, inoculating him with the flora that will rapidly multiply and populate his gut. As the infant journeys through the birth canal, he is exposed to a medley of microbes, designed to optimize his potential for thriving in the world his mother inhabits. The inner terrain and the outer terrain find perfect balance in the transition from intra-uterine to extra-uterine life.

According to archaeologist and prebiotoc researcher Jeff Leach, “…this cycle links the co-evolution of intestinal "microflora" of the mother to child, and may represent a more significant bond for those who understand it exist(sic). This evolutionary bacterial right of passage has been and continues to be critical to the success of our species, and all mammals for that matter.” Once inoculated in the birth canal, the baby is further populated by the microbes in his mother’s milk, on her skin and in her mouth. In the normal physiologic process of birth and feeding, the infant is being prepared for life in the world the mother’s body has adapted to survive in.

This is where my head starts to whirl. I ask question after question trying to see all the connections. There is no doubt, given the physiology of this process that several things should and should not happen. First, babies clearly need to be born vaginally. At birth they need to be touched only by their mothers and they need to go to breast. And they need to be kissed by their mothers. This process of inoculation by microbes that initiates in the birth canal is given robust life at the breast. The human organism, which contains 10x more bacteria than human cells, has its blueprint for functional health and well-being laid down in utero (that’s another post) and is given form and structure in the birth canal and at breast.

Human milk contains carbohydrates known as oligosaccharides, which are virtually absent in cow milk. They are undigested in the stomach and small intestine and are able to reach the colon intact where they provide food for the bifidobacterium, enabling them to multiply rapidly. Now here are two pieces of interesting information that fit a lot of pieces together for me. First, again according to Jeff Leach, “As the bacteria thrive on this "food" from mother's milk, they grow in number and absorb water, resulting in more regular and soft bowel movements. It's important to know that the bulk of infant feces are made up of live and kicking bacteria.” Secondly, the insoluble fiber in human milk acts as a kind of irritant in the gut, causing the production of a lubricant that further speeds up the process of elimination.

Someday, I am going to write “Confessions of an IBCLC Heretic”, because for almost 20 years, I have been saying that it is absolutely not normal for babies of any age to have fewer than several significant bowel movements per day. Not per week! Per day. The more I learn about the gut and the gut-brain axis, the more I have to learn. But, I am confident that human milk is not “all used up” and that babies are not “efficient enough that there is no waste”.

Such comments do not even bear up under the scrutiny of common sense. If all those babies who stop pooping at 4-6 weeks are using up all the milk, what are the babies who are pooping 6-8 times per day doing? Making it? Babies need to poop.

There is so much that we impose on mothers and babies in our contemporary, invasive birth practices that damages intestinal flora. Frankly, I think disruption of this essential process of gut inoculation is reason enough to avoid cesarean unless there is clear and real medical necessity. And it is reason enough that babies not be touched by anyone who is not the mother before the baby nurses. Introduction of any substance other than mother’s milk damages the gut—this includes artificial milk, sugar water and drugs.

So, the infant gut, pristine in utero, becomes a hotbed of microbe activity at birth and the nature of those microbes will become how and who that baby is. Gut flora determine our relationship to the environment around us, as 75% of the immune system resides with the gut. They determine much about our emotional well-being as 80% of our serotonin is in the gut. The enteric nervous system—often referred to as the ”second brain”--is embedded within the gut. Gut microbes determine our vulnerability to disease and to stress and direct our potential to thrive emotionally, physically and intellectually. 

Given the significance of gut function to the well-being of the infant, I want to see all babies have strong healthy guts. So, when I see a baby who is not on solids, not sick, getting enough food and still not pooping as often as I know healthy babies do, I want to know why.

I will rule out or refer for treatment any tongue-tie and other structural causes of vagus nerve suppression, such as birth trauma. I want to rule out oversupply or over-active milk ejection reflex. I want to know what baby’s poop looks like. Pasty poop is not normal, nor is mucus or poop that soaks into the diaper or is green, simply a skid mark or takes a lot of straining to achieve. And volumes of poop once per week does not indicate the milk has been “all used up”. It means it has been sitting in the colon, going nowhere. Pasty poop has not absorbed enough water. Poop that smells foul indicates an imbalance of intestinal flora.

Other indications of poor gut function include cradle cap, eczema, skin rashes, “baby acne”, a red ring around the anus, thrush, dark circles under the eyes, difficulty organizing states, cognitive delay, difficulty sleeping, poor appetite, poor growth, “colic”, “high-needs” behaviours, congestion, reflux, refusing the breast, arching at the breast, gassiness and infection.

Clinically, I know that gut function is a problem because when babies are treated, gut function is restored. Restoring gut function is a complex topic and is somewhat individualized. Treatment eliminates allergens and food sensitivities and might include use of probiotics, bentonite clay for detoxification, digestive enzymes, slippery elm bark powder and other healing herbs, castor oil compresses on the belly and most importantly healing the maternal gut through elimination of pro-inflammatory foods and the inclusion of healing foods, supplementation, and structural or bodywork or energywork for baby and mom. Remember, the intestinal flora in the mother’s gut ends up in her milk.

The process of microbe inoculation that is clearly a primal imperative is interrupted and incomplete at best in most babies. Within weeks of birth, many mothers are observing the kinds of symptoms I have described. Because common tends to be referred to as “normal”, often symptoms are dismissed by health care providers or labeled as "dairy allergy" (as if there is no other allergy), reflux, GERD or "colic" or worse: "breastmilk allergy" and many moms end up weaning prematurely because the gut damage tends to worsen with time or the "treatment" involves weaning to artificial infant milk. Sometimes, on the other hand, the symptoms seem to disappear and certainly the gut can heal, especially on a diet of exclusive momma milk. But, often, the symptoms have simply changed or are not recognized as such. Ear infections, frequent colds, bed wetting, asthma and “tummy aches” often replace the vomiting, colic and sleeplessness of infancy. The bottom line is that our babies need healthy guts both to survive and to thrive in the world. Passing off as “normal” common indications of poor gut function serves no one, least of all, the baby.

I will continue thinking about the gut and about microbes and about how we are as they are. And with any luck, as people become more attuned to the primary urgency of protecting the gut integrity of the infant, practices will change. In the meantime, I hope we will all begin to see babies and in a different way and be more inclined toward restoring full function than simply managing dysfunction. And that we remember that to heal the baby, we have to begin by healing the mother.

67 comments:

  1. Beautifully written, Jennifer!

    -Emily
    Seattle, WA USA

    ReplyDelete
  2. 1. I'd like to pre-order "Confessions of an IBCLC Heretic" RIGHT NOW, please. 10 copies.

    2. Absolutely fascinating perspective on the microbes. I can't wait to learn more at school - and at the same time, I worry that we WON'T learn more. Perhaps I'll have to get it in my Master's, with you . . .

    3. OH, the "normal" pooing every 5 or 6 days. Thank you for spelling this all out. I actually find myself saying "just because something is COMMON does not mean it is HEALTHY" all. the. time. on various breastfeeding boards.

    I'd actually love to know more about WHY the colon holds onto feces longer when the gut is not functioning properly - as in, what is the specific mechanism or set of mechanisms, if that makes any sense?

    In short, fabulous, bookmarking, sharing.

    ReplyDelete
  3. Anne--as to your #2--I am thinking the other students will be learning it from you.
    Jennifer

    ReplyDelete
  4. Sat in tears reading all that as it rings so true. I've recently "had" to put my youngest on hypoallergenic milk neocate after 5.5 months of breastfeeding.... my eldest was 8 weeks and went onto nutramigen. My eldest is now 3 and still has egg, dairy, potato, horse, dog, cat, kiwi allergies to only name a few... and has had severe eczema since birth. My youngest is now 6 months- followed same patterns- severe eczema, reflux, not sleeping at night, giant hiccups, windiness, terrible tummy pains, strains and takes forever to release a bowel movement, awful stools. Pediatrician "Allergic to breastmilk" it kills me inside and I so want a solution for them. If you can email me that would be great, any tips and ideas on how I can improve their lives would be greatly appreciated. xx

    ReplyDelete
  5. Hula--I am so sorry for this--I have seen many similar cases and they are traumatic for everyone. I can give you some basic suggestions here, but when I searched your blog I could not find out what foods you eliminated while nursing her or what steps you took to heal your own gut. Can you fill me in?

    Otherwise, I only do email and skype with my clients.

    Jennifer

    ReplyDelete
  6. An enlightening read. My daughter only passed poo every 5-10 days. She was exclusively breastfed from birth and still nurses at 2.5 years, but she was an emergency c-section as an upsetting medical emergency and had severe tongue tie that doctors refused to treat. Now I was told it was 'normal' for bf babies not to poo often but after a few days she would start showing distress. I am hoping for a natural delivery for my next child and will be very firm about his tongue tied should he have this happen as seems genetic in my family. Thank you for such insight

    ReplyDelete
  7. This comment has been removed by the author.

    ReplyDelete
  8. Thank you, Kitty. Was his TT ever treated?
    Jennifer

    ReplyDelete
  9. Wow, that was very in depth. I was also thinking while reading and for a while now breastfeeding has become more and more less common. Only recently have women started realizing the benefits again. So, since a lot of women were fed formula and cow's milk as babies and c-sections are more common their bodies are most likely not as healthy so it affects their milk. Also, people nowadays are eating more foods with chemicals and preservatives than not, so I'm sure that doesn't help our gut function. I breast fed both of my daughters, however, I breast fed my youngest, Destiny, much longer than my oldest, Celeste. I only breastfed Celeste for 2 months and breastfed Destiny for 8 months, yet Celeste has never had any infections. The most she's ever had was a stomach virus. Destiny, however, has had problems since in the womb. She was born with her intestines twisted up so they were obstructing themselves. She also had problems with the valve going from her kidneys to her bladder. So, for the first month while the hospital was trying to figure out why she wasn't ingesting anything and it was all coming back up she pretty much had nothing but IV fluids. When she was a little over one she had ITP. I'm wondering if there was anything I could have done to prevent any of this or if it's just the way her body formed. I took my prenatals and fish oils, stayed away from caffeine, too much fish, pretty much everything that I wasn't supposed to consume. Would you happen to have any insight?

    ReplyDelete
    Replies
    1. What years were your daughters born? The only thing I can think of is genetically modified food - those are some significant differences between your two daughters. I believe 1992 was when the first GMO foods were introduced, but it was later that they became more prevalent.

      I don't think that there was anything you could have done at the time - I know that as a mother myself, if there was something I could do I would have done it, and therefore I know you would have too. GMOs are not labelled, and are only recently even beginning to enter the public eye.

      Delete
  10. This was very interesting to read. My first son was born at home and nursed constantly... he also pooped constantly (about 5-6 times a day) My second son was induced (by breaking my water) in the hospital. He only pooped about once every 5 days... sometimes even a whole week. This continued until he was fully potty trained at just before 3 years old. He still only poops every few days though. He was diagnosed with Autism (aspergers) at the age of 6. He is 9 now. I wonder if his inability to rid himself of these toxins has contributed to his condition. I would love to hear your thoughts on this.
    Thanks.

    ReplyDelete
  11. Rasa, I'm sure that gut damage IS contributing to your son's condition. My son, 10, was born by c/s. He also is diagnosed with Aspergers. Elimination of gluten, casein and corn from his diet have made a HUGE difference. He also has a detoxification disruption (which I wonder now after reading this post isn't more connected to his gut flora and fauna as opposed to a genetic predisposition). My second son, born at home a few months ago, has a couple poops a day and he reacts mildly to things I eat, but I'm starting to think it has more to do with my own horrible gut leaking proteins than his, still not sure. I strongly recommend an elimination diet for your son, it's allowed my 10yo to function very very well and if I were to have him re-evaluated, he would likely lose his diagnosis.

    ReplyDelete
  12. I've removed dairy, eggs, and peanut butter from my diet for my baby. I had a c-section due to her being breach my doctor wouldn't allow me to try on my own. I also did not get to hold my daughter for 48 hours until after she was born due to her being transfered to a different hospital. I did pump and she received that but, was also given formula. I was able to nurse within 72 hours. She constantly has gas also has regular poops and has never gone days without pooping... I think that only has happened for one day. I would like to know how to help her any myself. I don't want her to have food allergies. You told someone else that you don't email those who aren't your clients....Can I be your client even though I don't live near you?

    ReplyDelete
  13. Jennifer, my colleague and friend, thank you for taking the time to post on such a vital subject. Like you, gut health fascinates me, even the process of the gut forming in embryonic development is absolutely astonishing. Keep spreading awareness and preaching the truth!!!

    ReplyDelete
  14. Thanks Dani. I did do an elimination "cleanse" with my son during the diagnosing process (it took almost a year) and it did seem to make a difference. I am careful about it and watch for behaviors associated with his diet, but haven't completely removed them as we are a family of 6 (5 being picky eaters!) I will try again though. Thanks.

    ReplyDelete
  15. i've always been... interested in & fascinated by POOP and health. considered myself quite knowledgeable. then my 3rd child was born - at home, but under threat of order to come be induced by doctor (i am rh- and "sensitized"), we broke my water at home. besides being a significantly rougher birth, despite being in water and at home, all was well. my son passed his meconium and had his first few breastmilk poops, but not as many as i was used to a baby having. we instinctively practice Elimination Communication from birth on with our babies, so i felt acutely aware of this non-expression of bowel activity of his. he developed a fever at 5 days and i knew if he'd just poop the fever would be gone. i resorted to a glycerin suppository and he did poop and his fever immediately went away. My amazing midwife did bodywork to compensate for birth trauma (broken water brought labor on fas & heavy and he happened to have cord wrap around neck & arm and a very short umbilical cord - she ended up having to pull on him a bit we turned and unwrapped him quickly and did resuscitation) she taught me techniques. still he only was pooping maybe once a week, but otherwise thriving and breastfeeding properly. we went to chiropractor. we did acupressure. Reiki. Nutritional changes. Nothing got him pooping better than just growing out of it. for all the fretting i did, he is my healthiest, most robust child, and they all are extremely healthy, so that is saying a lot. He rarely gets sick even when the rest of the family does. he has never spit up, thrown up, or had diarrhea. he never has a stomach ache. nothing. my husband says he inherited his iron gut. which i think i find funny because there are a few foods my husband cannot eat without coming up with *gut trouble*. I do believe our thought patterns are he key to healing our bodies. i love to think of a baby being so powerful. we all are.

    ReplyDelete
  16. Such a great post. My kids have a wheat allergy, and are sensitive to almost every grain out there as well, dairy, etc. Both my children had this experience and it was very difficult to go through; thank goodness they have an extremely stubborn mother who was determined to BF! We got to 1.5 and 2 years, but I wish I would have had you :) It would have saved me ALOT of heartache.

    ReplyDelete
  17. Jenny--For most of the kids who come through this scenario, it is bc their moms were just as stubborn as you. For the most part, the only advice they get otherwise it to wean to a predigested formula to take meds or both. The advice to eliminate cow milk is often given with no direction (for example, many moms think 1 week is adequate and have no idea that they must do a thorough elimination). And for some reason, many health care providers seem to be under the impression that cow milk is the only allergen out there, yet I see just as many kids who need to be off gluten, corn and other risky foods.

    ReplyDelete
  18. Glorya,
    It is impossible to know if you could have done anything to prevent your daughter's situation. What comes to mind is that if you had not been as attentive as you were, perhaps she would have had a far worse situation to contend with.

    My oldest was diagnosed with a congenital condition when he was 5. I asked myself the same questions and I will admit that I do think if I had been gluten-free at the time, my body would have been much healthier. But, I would also have been healthier if my mother had not fed me Karo syrup and condensed milk as an infant. If I had not been vaccinated. If I had not been on so many medications on my twenties. You can only do what you can from where you are, so while education can inform our present decisions, it cannot change the past ones. All I could do with my son was heal him and that is where my energy has gone.

    On the other hand, if you asked if I think our children are canaries in the mine, warning us of the damage we are doing to our bodies and our planet, I would say "yes". I would also say, though, that most of what moms do while pregnant to keep themselves healthy is woefully inadequate and many even be harmful. We cannot be healthy by taking synthetic prenatal vitamins and following a mainstream prenatal protocol. We need a complete overhaul of the way women prepare for pregnancy and birth.

    ReplyDelete
  19. Rasa--I imagine that you have done gut healing with your son since his diagnosis? I have seen children "lose their diagnosis", especially when it is less severe by doing gut healing.

    ReplyDelete
  20. Dani--Just read your post--you made my point better than I did!

    ReplyDelete
  21. Rasa--"Picky eaters' are usually kids with food allergies! Maybe now is a good time to take a serious look at your whole family's diet.

    ReplyDelete
  22. Minty--you wrote: "I do believe our thought patterns are he key to healing our bodies. i love to think of a baby being so powerful. we all are." Very well said!

    ReplyDelete
  23. Taryn-I do work with folks via phone and skype, but I use email to sort out of it is the best fit, as I practice holistically and healing takes time. I am not a doctor and do not make any pretense to be one. I can usually help a mom solve almost any breastfeeding problem, but these other issues tend to require a process that takes time and folks have to be committed to the process.

    In other words--I am more than delighted to work with moms--I love watching families heal and learn to thrive--but I do try to make sure it's a good match.

    ReplyDelete
  24. Melissa--WE have a lot of work to do--so grateful for my amazing IBCLC collaborators!

    ReplyDelete
  25. What a beautiful blog - very well said! I am a naturopathic physician and I see lots of babies and do lots of breastfeeding support. Finding the cause of allergies and gut realted problems are a big part of what I do. Thank you for writing this.
    Arika Dortero ND
    Whole Family Naturopathic Medicine
    Seattle WA

    ReplyDelete
  26. I always enjoy your posts on Lactnet! Wish you were in the States....
    Am wondering if you would be willing to share which probiotic you recommend for newborns? Have read about L. reuteri in my textbooks. Thanks!
    Peggy Hinkle
    peggyhinkle@yahoo.com
    2011 IBCLC candidate

    ReplyDelete
  27. I'm a homebirth midwife and keenly aware of the baby's inoculation with beneficial flora at birth. I make a point of wearing sterile gloves so as not to expose the baby to anything other than family germs if I need to touch the baby. I encourage newborn self attachment, and the breastfeeding rates in my practice are 99%. I still see numerous cases where the baby's poops are less frequent than twice a week. The way this has been explained to me is that there is a feedback between the mother's body and the baby's body--that the baby's saliva gets into the mother's system and communicates the baby's precise needs. Thus a sick baby's mother will produce breastmilk with more antibodies. And the composition of the mother's milk changes as all the baby's needs change. It makes sense to me that the perfect system is one where the mother produces milk that is so beautifully processed by the baby's gut bacteria that there is little waste.
    Could you please cite research that it is unhealthy for a breastfed baby of six weeks to poop less than twice a week.
    Thank you.
    Ronnie Falcao, LM MS CPM
    Mountain View, CA
    USA

    ReplyDelete
  28. I was curious about how you said babies must only be touched by their mom's initially. As I understand the proper formation of a babies gut flora and total body flora, it begins in the birth canal and then is uniquely shaped by each soul who touches them. This is a good argument for homebirth, as the baby won't be passed around to 10 nurses 3 docs, etc. A babies flora doesn't become complete until anout the age of 3, and in btw birth and 3 it is important for baby to come into contact with dust, animals, anyrhing that might carry bacteria on it helps build Baby's total bio-flora. Could you explain your reasoning?

    ReplyDelete
  29. Lucy--The mother's world is the baby's world. When her microbes are first to inoculate the baby, they are the ones that will form the foundation of his inner terrain. Since the baby will inhabit the mother's world, the baby needs to be microbially adapted to her world, not those of others at the birth, even a homebirth.

    I certainly do not argue that babies should live in sterile environments. Far from it, just as you do, I think babies should live in a world of people, animals and plain old dirt. I simply argue that the FIRST contact needs to be the mother and yes, I believe that all babies born outside of their homes are microbially compromised. How extreme that compromise is depends on how much the infant's gut flora is influenced by other people and the hospital germs themselves. This is where breastfeeding is essential, since artificially-babies have gut flora that more closely resembles that of the hospital environment.

    ReplyDelete
  30. Love this!! I hope you write a book about this. Fascinating!

    Anything I can do to improve the guts of my school aged children?

    ReplyDelete
  31. Ronnie--I have scoured for such research. As I am sure you know, it has been a pattern in bf research for partially bf babies to be labeled as bf, which would certainly skew a query such as this. I also don't think enough folks doing research are asking these questions.

    What I have are pieces--like we know that oligosaccharides change over time, but I am still not sure what triggers this and if it happens too soon in some babies. I know that most mothers have compromised intestinal flora, so the baby will as well. I know that there are anti-inflammatory cytokines in human milk, but do not know at what point the balance tips when pro-inflammatory production is accelerated. I am the first to admit I have innumerable questions.

    But, like you, I am a clinician. And I am very observant. I am not arguing that pooping less than twice per week is unhealthy--I am arguing that less than several times per day is indicative of compromise somewhere in the brain-gut axis.

    I see a frequent correlation between babies with structural problems, TT and food sensitivities and infrequent stooling and/or straining and pasty poop. And I find that when those problems are resolved in almost all cases, babies poop far more frequently. I also find that "happy babies" who poop infrequently poop more often when bodywork is done or allergens are eliminated.

    If normalizing structural or functional problems normalizes bowel movements, then I can at least conjecture reasonably well that not pooping was a consequences of the problem. That is indeed what I see.

    And as you saw in the post--baby poop includes a lot of microbial life--along with the undigested insoluble fiber from the milk, fiber which cannot be "used up"--it is indigestible by the baby or the bacteria. It must be eliminated.

    Homebirth or not, maternal gut health is key to infant gut health. That's where I think we need to concentrate if we want the healthiest babies possible.

    ReplyDelete
  32. Thank you! Very insightful.

    I am a new momma to a wonderful baby boy. Sylus was born at home almost 8 months ago. Exclusively BF until 6ish months. He pooped very regularly when he was a newborn and continued to into infancy. Around 5 months he went 4 days without pooping I was told it was "normal" and not to be worried. He had a few bouts of irregularity from there on out. With the introduction of solid food at about 6 months he continually goes 4-8 days without pooping. I have been instructed by his pediatrician to give him a glycerin suppository when he seems to become uncomfortable. Once again being reassured that it is "normal". I have always questioned his irregular BM's and have never felt ok with the lack of. It has become a constant worry and wonder as to why he isn't pooping. He is still bf a lot, only eating solid food twice a day. I give him baby probiotics once daily and i too take them. If there is any advice you have or recommendations it would be greatly appreciated. Thank you for your post it has been reassuring my instincts as a mother.

    ReplyDelete
  33. Sarah--If something is "normal", it does not require a glycerine suppository to fix it! I am writing a new post on gut healing, but the reality is that it is an individualized process. Even so, you can certainly begin with some basics--as you have with probiotics. But, I wonder why you have not eliminated any foods?

    ReplyDelete
  34. Jennifer, I loved your article and I am struggling with gut issues of my own. I have a 19 month old and we both tend toward constipation. We have food sensitivites and my daughter has eczema. We are on GAPS and have been on and off the intro. I would like to see if you would be able to help us in our situation. How do I get in touch with you to see if we would be a good match?

    ReplyDelete
  35. Jennifer...Thank you for your response. I have felt uneasy about giving my baby suppositories, as it seems to just be alleviating the symptom not solving the problem. I am willing to eliminate foods from my/our diet if that can help. I am a vegetarian the eats dairy and eggs. I feel like I am healthy, rarely sick, very regular, and a conscious eater. I don't have any allergies to foods that I am aware of. Where would I start as far as the food elimination goes? Should I bring Sylus back to strictly breast milk? I can't thank you enough. Up until reading your blog I felt like everyone around me was at a loss for answers as to why. Most people reassuring me that he will "grow out" of this stage of constipation. This has been very frustrating to me. Your blog post has shed a huge light on the issue and has reassured me to follow my intuition as a mother.

    ReplyDelete
  36. I am currently working with my 5 month old baby on healing his little gut. When dairy elimination wasn't enough, I eliminated soy, wheat, corn, eggs, and nuts too. I've seen improvement - from diarrhea back to normal consistency breast milk poop - but he is gaining weight slowly and fell doWn another growth chart curve in the past month. I'm actually very ok with the elimination diet because it feels so healthy and I can tell that my gut is very healthy too. I'm wondering how long you think a nursing mother should stick with an elimination diet before deciding that avoiding food sensitivities isn't going to solve the problem? (ps I am working with my doctor on this, and am also giving my baby probiotics...I've been on the full elimination diet for about three weeks)

    ReplyDelete
  37. This comment has been removed by the author.

    ReplyDelete
  38. K Maeve,
    Avoiding food sensitivities is always part of solving the problem. And when you say that it is making you healthier--then, why would there be any reason to revert to old eating habits?

    Babies always need probiotics, but may need other interventions while mom needs to consciously heal her gut as well, so just eliminating foods is not sufficient. Gut healing herbs and foods, probiotics, digestive enzymes and supplements as well as other modalities (such as acupuncture, homeopathy and chiropractic) might play a role. Healing the gut usually takes time.

    ReplyDelete
  39. Dear Jennifer,
    This blog has given me some different angles to consider things from. My son is 4 months old and we are fighting with eczema. (BTW he was born drug free, natural birth, immediate skin to skin for 1 1/2 hours, co-sleeping, exclusive breastfeeding...) He did a 9 day stretch of no pooping (which as with all of us I was told was normal at 7 weeks), but now reading your posts, I realize that it took place at the same time as his eczema started to spread and flare up. I have removed dairy, wheat, eggs, peanuts, soy and fish from my diet for the last 14 days. The eczema is still there so far, but I think its reducing... heres hoping. But again, its come to my attention after reading this another related change, he has started pooping 2 or 3 times a day for the last 3 days. hmmm - could be a link? Anyway, I'm doing this elimination diet of my own initiative and not with any guidance. Can you direct me to any websites where I could learn how to do this well and how to determine exactly which food is the culprit, and also if/what supplements or additional foods I should be taking (I'm worried about calcium).
    Thanks

    ReplyDelete
  40. I found this post very interesting and a noticed a possible connection between when my baby went 9 days between pooping and some eczema started flaring up. I've also noticed that now, 2 weeks into an elimination diet, he is pooping 2 or 3 times each day. Interesting. I'm very disappointed about the eczema as I've been doing the best that I can. He was born naturally with no drugs, was skin to skin immediately for more than 1 1/2 hours. Exclusively breastfed, sleeps with me, I eat (what I thought was) well, and it goes on. Anyway, it appears that my eating was affecting him as now the eczema has significantly reduced. (He is now 4 months old) However, I am doing the elimination diet entirely by myself without much guidance except what I can find on the internet. Can you recommend to me any websites where I can get more detailed advice on how to use this diet to find balance for my baby? Thank you and I wish you the best as you investigate these issues for the sake of our children.

    ReplyDelete
  41. Very interesting post. My 3-month-old was close to being born in the sac. He was still in the sac when he crowned, and the doc broke the bag as he was born. He was placed skin to skin and nursed almost immediately. But, due to his size they tested his blood sugar and found it dangerously low. NICU doc said formula was necessary. He ended up being admitted to the NICU shortly thereafter, and he was on a sugar drip to keep his blood sugar up so he wouldn't need formula and I breast fed and pumped until my milk came in and he was able to get enough sugar from that to come off the IV.

    He now has lots of GI issues. Colic, reflux, dairy sensitivity. And was only pooping once a week. I found an herbal remedy called "Colic calm" and as soon as he started taking it, he went from the once a week mega poop to 1-2 daily poops. Overnight! We've also started giving him probiotics. And he's been a much happier baby ever since.

    I've often wondered if being in the sac as he came through the birth canal prevented him from being exposed to the bacteria in there to kick start his gut flora. And if the formula he was given due to low blood sugar affected things as well. Other than the formula he was given in the hospital, he's been exclusively breast fed. And I would like to think that his nursing right away kept his blood sugar from dropping even lower, and provided at least some balance to the formula he was given.

    ReplyDelete
  42. Just a comment on eliminating symptoms by altering diet. There was one study done with about 100 children who needed ear tubes due to chronic ear infections. Nearly every child tested positive for a food allergy, and with continued medical treatment and removal of the offending food(s), several children took up to 15 and 16 weeks for the ear symptoms to resolve. Two weeks is just the beginning of a withdrawal diet for dairy, and symptoms of such long standing may not resolve overnight. Anny improvement means you're heading in the right direction. Hang in there. And without the other treatments mention in the blog, specifically probiotics, you may not get the thorough results you want. My experience with elimination diets has been that perserverance is needed, and the benefits can be long-lasting and global.

    ReplyDelete
  43. This is fascinating and makes complete sense to me. I've been concerned for some time that I might be passing my unhealthy gut flora to my daughter (I'm very prone to thrush) but so far nobody has been able to give me any information about it. Can you recommend any further reading? Many thanks.

    ReplyDelete
  44. Hi. Great article. Thank you. Could you please elaborate on what must be done to heal the baby's and the mother's flora? You briefly touched upon it but i would love more information. Could you point me in the right direction or perhaps write another post with more details? Especially for what mommas can do if they have had a csection. I had a genuine one, then antibiotics 2 months later and despite having a pretty good diet, lots of probiotics (for the baby too) and looking after myself I still have trouble with candida. I really want to send my little one into the world with a more resilient gut. What are your ideas on how to do this? Thank you :-)

    ReplyDelete
  45. My baby was born all natural with a midwife, no vaccines, i breastfed her immediately after she was born and she was never taken from me. She had colic, eczema, cradle cap, baby acne...She is now 2.5 and still has sleep trouble and problems pooping. We still breastfeed and co-sleep. I cut dairy when she was EBF and have cut gluten out of both of our diets in the past half year. We try to follow WAPF diet. I KNOW my gut was messed up (had terrible yeast infections, bladder infections, IBS, and a stomach virus during pregnancy) and I've done a lot to repair it (cutting dairy/gluten, eating fermented foods, green smoothies, coconut oil, nettles infusions, bone broth). I think hers still needs more work because like I said she still doesn't poop consistently, I try to get her to eat all the things I do to help but she won't always. She does love green smoothies and they had her pooping daily until we went on a vacation and she had lots of grains (not gluten, but corn chips, etc.) and now she seems all stopped up again. The one thing about her I can say is she is very rarely sick, never had to bring her to the dr. and she's never had any meds. I am pregnant again and want to know what else I should be doing to try to prevent the new baby from all these troubles?

    ReplyDelete
  46. So, once a baby is born via c-section, what can a mom do to correct the bioflora imbalance that has then occurred? If the baby is exposed to bacteria by going through the birth canal, and missed out on that bacteria... SIMPLISTIC logic would say, to try to remedy that, one should expose the baby to vaginal flora on purpose. Mucus swab or something. Since I've never seen anyone suggest that -- what is the correct way to help the baby?

    My 4-month old was born via csection after being induced due to pre-eclampsia. I fought as long as I could to not be induced, but in the end the dr scared my husband into agreeing. Our baby is fairly healthy, poops a couple times a day, but has a lot of gas and reflux.

    ReplyDelete
  47. Thank you so much for this article. I feel like it was directly sent to me by God. My 6 month old son has really bad reactions to dairy. I too was told "he'll just outgrow all this GI trouble." but it breaks my heart to see him struggling so much. People have not been able to give me any real answers or suggestions. I look forward to your next post, and thanks again.

    ReplyDelete
  48. What an amazing article! I'm wondering if you've considered elimination communication (or lack there of) as a source of babies with holding poop? It has been my experience that in babes born at home and exclusively breastfed who are pooping only every few days once mom starts to offer the baby a potty to go in rather than the diaper, the baby begins to poop more frequently.

    ReplyDelete
  49. Thank you for this article. My daughter was born at home and nursed right away, however she did nothing but scream for the first 2 months of her life. Our pediatrician diagnosed my daughter with Reflux, possible GERD and colic and wanted us to give her medication for it. She also suggested we may want to consider formula. I did an elimination diet starting when she was almost 2 months old and over the following months have added back in most things which do not seem to affect her, but continue to eliminate all milk and soy proteins. She has gotten better over time, but I would love to learn more about how the maternal gut may be connected to the nursing baby's health. When do you hold your workshops and how do I get in touch with you?

    ReplyDelete
  50. I do trust all the ideas you've offered for your post. They're really convincing and will certainly work. Still, the posts are very brief for novices. Could you please lengthen them a little from next time? Thank you for the post.
    GORDINI Girls' Gore-Tex II Mitt

    ReplyDelete
  51. Wow. I just found this post via The Natural Parent Magazine on Facebook, and it has me almost in tears.
    My daughter (now almost 9 months) was born via c-section, after we transferred from a home birth...
    We were both given heavy antibiotics, and she was given formula because of "low blood sugar" (which I researched afterward, and it was NOT low compared to what is normal for newborns - it was still within a safe range)...I wasn't allowed to see her until I could get up into a wheelchair, which was 8 hours later.
    They also didn't let me have her in my room until the 4th day, which was the day we went home.
    I pumped in the hospital, but only got a few drops of colostrum.
    I tried getting her to BF, and had 2 different lactation consultants, but because of the bottle, she wouldn't latch.
    I kept pumping once we got home, in the hopes that my milk would still come in, and it finally did after about 4 more days.
    By 3-4 weeks I had enough milk to give her just BM, no formula, though it took us until she was almost 3 months old, an amazing lactation consultant, an SNS a nipple shield and tons of tears until she finally figured out breastfeeding.
    But, due to the antibiotics and formula, gut health was not good, in either of us.
    We've been struggling with severe eczema (especially on her face) since about 3 1/2-4 months, with these last 2 months being the worst.
    I got to a point where I just didn't know what to do anymore.
    We had tried everything...I'd eliminated dairy, gluten, eggs and nuts since she first started getting eczema, and then nuts and soy.
    Humidifiers, air purifiers, natural salves (I won't use chemicals), pure coconut oil, olive oil, never any soaps or detergents, I eat organically as much as possible...
    Finally, I found a probiotic that was strong enough, as well as a DHA/EFA blend.
    I am on a modified GAPS diet, and we are buying only grass fed/finished meats, so that there is no chance of soy.
    Organic Evening Primrose oil has done wonders for her skin topically.
    She is exclusively breastfed still, although she has had a few bites here and there of organic avocado, cooked carrot or apple (no processed or baby foods), but I'll be holding off on even bites until her skin clears, and she's a year or so, that way her gut can work on just healing, not working on solids as well.

    Anyways...thank you for the excellent information!!

    ReplyDelete
  52. Jennifer, it is always so refreshing to hear logical and well thought out answers to problems which the medical community continue to tell us mothers are normal despite the fact that our "guts"(a perfect pun don't you think :) instinctively tell us differently. Thank you for being vocal about this.

    I have a 2 month old that I am suspecting has a slight Tongue Tie AND he has recently not pooped for 8 days, has a ton of gas which effects his sleeping, has cradle cap, and baby acne. I struggle with food sensitivities and have tightened up my diet since realizing diet was effecting us both. I just recently cut out meat from my diet because I just felt like it was causing a problem, even chicken. All of his symptoms seem to be getting better however, I'm interested in how Tongue Tie effects gut flora and pooping. Can you give me any information on this?

    ReplyDelete
  53. I love this. It makes so much sense. I'm in the last few days to weeks of my first pregnancy. I KNOW I have things wrong with my gut, and I've been doing some things to work on it. But it's takes time after years of having issues. Something that I've started doing that is amazing is NAET treatments. I swear by them! Anyone dealing with allergies should seriously consider finding someone reputable and getting started. We've been slowly working through my many issues and recently he addressed my digestive system. I was gaining weight, not because of the pregnancy, but from malabsorption and an allergy to acids/stomach acid. After correcting these issues through acupressure I've had a HUGE difference in my bowl. That same day I was treated I went poo every time I peed. Which, lets face it, is alot. I'm 38 weeks. :) It used to be that I would poop 2-3 times a day but I wouldn't see the food I had eaten until two days later come through. Things moved through, but very slowly. I'm now seeing the things I eat come through the same day. I think that is a pretty awesome thing. And I'm so excited cause my NAET guy can work on my baby in utero and after being born to correct any issues. I feel so blessed to have found this type of healing for our family! Hope it can help many of you too!

    ReplyDelete
  54. thank you so much for writing this article. my 13 month old son has struggled with constipation since the introduction of solids. we are now starting the gaps diet as a family & are going to work on healing all our guts. We all have gut problems. My son's constipation is getting better but it will take time. Where can I get more info on this? like a book & research on it? Thank you.

    ReplyDelete
  55. We have this problem described above. 5mos old, EBF, just started pooping once a week. Still the right color, but slightly pasty and slightly smelly.....We need help.

    ReplyDelete
  56. What a great article Jennifer. Someone in a natural parenting group shared this today. Of course I completely agree with you. I was very excited when I opened the article to read it and found you were the author. Well done!!

    ReplyDelete
  57. My gut reaction: loved this blog piece.

    ReplyDelete
  58. What a great blog! So glad to have stumbled on this- and I know it was no accident. Need your help with my five month old, and more directly that means me as she is breastfed. There is a sea of information: No dairy, no grains, eat it raw, cook it, etc. I am lost in the conflicting theories. I need help! So much of what you have said goes with my intuition. Her acne wasn't normal, to have colic wasn't normal, and now at 5 months, her perfuse spitting up what looks like curds and whey (and smells fetid) is not normal! Could I e-mail? A blessing to have found you. Thank you for writing!!

    ReplyDelete
  59. Thank You!! I loved this post tremendously while reading it and even read bits of it out loud to my husband because when I'm excited about something I can't help but share!

    ReplyDelete
  60. I'm so happy that I just read your article in Pathways magazine and found this blog - fantastic! I am struggling with many of these issues with my 3 month old daughter. We planned a homebirth and got to fully dilated until the midwife noticed that she had flipped to frank breech and wasn't comfortable delivering. We ended up with an emergency c-section under general anesthesia, followed by morphine for pain relief (and of course antibiotics). Then, to make matters worse, when she was about 6 weeks, she got a high fever, and after 3 days I was told to take her to the ER. They would not let me leave without doing either a lumbar puncture or IV antibiotics (in case of meningitis). I chose the antibiotics, and of course you can imagine what we are dealing with. She is nursing fine and gaining weight perfectly (thank goodness). But, she is only pooping every 4-5 days and when she does, there is no substance to it - it just sinks into the diaper. I've had digestive issues and a dairy allergy for as long as I can remember, so I know that I am in bad shape too. If I would like your advice on how to proceed to heal myself and Sevina's gut - is it best to pay for the 2hr breasfeeding intake appt? Or what is the best way forward? Thanks you!

    ReplyDelete
  61. Hi Jennifer,
    I would love to be able to contact you. what you have written rings home to me.. my baby is 2 weeks old and the bowels are sporadic, every 2 days. i have an appointment with cranial to rule out vagus nerve.
    I do have gut flora issues and am 14moths into gaps protocol.. i cant help but think this is the problem.. although i don't think it is healthy to have a negative view such as this, and everyone keeps telling me it is normal that breastfeeding babies dont poo every day.. im not sure.
    i eat plenty of fermented foods, but im wondering is there more i can do to build up my baby's good flora?
    Thanks
    jo

    ReplyDelete
  62. YES! Oh my gosh Jennifer, I'm so happy to have found you and your post. I'm a holistic nutritionist and went through a process of intensive healing to overcome my Celiac diagnosis and heal my gut to the point where I have NO food allergies, sensitivities or intolerances for the FIRST time in my life and it's been 3 years of thriving now. I'm really passionate about preconception health and took this time to heal my gut before becoming pregnant and I'm so glad I did!

    It has never made sense to me intuitively or education-wise that it's "normal" for breastfed babies to go 1-2 weeks without pooping. Common, maybe, but normal, I don't think so. I couldn't find any information out there talking about what you've covered in this post. I'm glad I can refer people to it.

    We should chat. I'd love to learn more about your services and if you offer distance consultations. I have so many moms and pregnant women in my life. Thank you!

    ReplyDelete
  63. Great post! thanks. I have struggled with my own digestion for years & made the biggest progress after one of my children (at 4yo) got so backed up it became encopresis and I had to learn in order to help him heal. I realized so many of my own issues through observing his. I've since had another baby and am so much more in tune with her digestion than I had been with my previous kids. She was going several days without pooping and it was obviously unhealthy/uncomfortable for her. I eliminated Cheese (a HUGE challenge for me) and she improved. I still have a long way to go to healing my own gut and my childrens' we all have very sensitive guts here. Looking forward to learning (and healing) more!

    ReplyDelete
  64. This is amazing. My boy was an emergency cesarean, it was very traumatic for me and I still have nightmares. Breastfeeding was such a challenge. I pumped for him for 3 months because he just wouldn't latch. But I knew, I KNEW in my mind and my heart that putting him to the breast was the way I was going to get him everything he needs. My body needed to take cues from the things going on in his body, so that I could produce the perfect milk for him. We fought tooth and nail to get back on the breast, but he's now 6 months, and completely on the breast. No bottles whatsoever. I can see the difference in every way.

    Anyway, I have a friend whose 11 month old is on a feeding tube. When he was about 6 months, he stopped eating, stopped acting hungry at all, and refused to drink anything. He is formula fed, and throws up a lot. I know she wishes she could breastfeed, it's all been very heartbreaking for her as a single mother of a special needs, and high needs child. I recently offered to pump milk for him after reading an article about breastmilk increasing white matter in the brain (which is why he doesn't act hungry, apparently the message doesn't get to his brain that he needs to eat. Hence the g-tube). Do you think this will help his gut situation as well? He is developmentally behind, he stopped growing at 30 weeks due to her bicorneate uterus (she was told she was infertile for years, but that's a whole other conversation). So he is closer developmentally and physically to my 6 month old, than an 11 month old. Would my milk still be beneficial to him, even just with 3 or 4 feedings of milk instead of formula a week?
    After reading this, I'm just wondering if his gut situation could be having any effect on his developmental situation, since they're obviously very closely tied.

    ReplyDelete
  65. Just discovered this and thank you! It definitely resonates. My 3 & a half month old doesn't poop every day and is often gassy. I have rheumatoid arthritis so I knew my gut was already in bad shape and suspecting that might impact her. I had a natural birth (except for some pitocin at 8cm), but they did take her before they gave her to me because of meconium. I don't think they washed her but I'm not sure. Once I got her (wasn't long, I was yelling at them to give her to me) I put her on the breast immediately and she's been EBF ever since.

    I've been low dairy and already no pork (pork causes flares for me) but even when it was just me I had trouble doing/maintaining an elimination diet. I am concerned about what changes are realistic for me given that meal planning has been a challenge since baby got here. However, I think if I move slowly I can at least make some kind of progress.

    ReplyDelete