Feeding FAQ: 3-4 months – Other

Should I be concerned about my 3 month daughter’s infrequent pooing?

My 3-month-old daughter is only having a bowel movement every 3-4 days, which is a fairly dark yellow/green/brown colour, and the consistency of yoghurt (although it can be more solid). This bowel movement is huge, and completely fills the whole nappy area. She never seems distressed when passing it, and is never fussy or irritable at other times. She is the quintessential CLB, and has slept through from her 10.30pm feed to her 7am feed since she was 9 weeks old. I fed her on only breast milk until she was about 6 weeks, then introduced a bottle of formula at 10.30, which she accepted readily, since then I have been following the weaning plan to get her onto formula exclusively. Currently only her 7am and part of her 6.15pm feeds are breast milk, both of which I express. She always feeds happily, seemingly not bothered by the transition to the bottle. I do give her one drink of cooled boiled water between her 2.30 and 6.15 feeds. The nurse at the paediatrician’s office suggested giving her 1oz of prune juice diluted in 1oz of water, which I haven’t tried yet. She also suggested tummy massage and inserting a thermometer into her rectum to stimulate bowel movement. (We are currently living in the USA). I’m sure the problem has something to do with the transition to formula (the one I use is fortified with iron, and made specifically for newborns to 6-month-olds), but as she seems happy with it I thought it was going well, but I am worried about the infrequent bowel movements.

As the consistency of your daughters bowel movement is fairly soft and she appears in no distress either before or when passing it, it would be better to accept that this is her natural rhythm. Some formula-fed babies do go more than one day without a bowel movement and it is not uncommon with breast-fed babies. As you are still in the process of changing her over completely to formula this may be the reason for the infrequency.
Massaging her tummy after her bath may stimulate her colon a little, which could result in more frequent but smaller stools, but if her rhythm is every 3-4 days then it is best to accept that and remember which day it is likely to happen.
Once she is fully on formula and you notice she does appear to be having more problems passing her stools, or is seen to be straining in between them, then giving her prune juice in water would be a good way to help her. Formula-fed babies can become constipated, but this would mean small hard pellets being passed. You would be aware of your babies discomfort and possible pain on passing them. If this should happen it would be best to ask your paediatrician for advice on how to deal with it.