Sleeping FAQ: 0-8 weeks – Other

My 6 week old son is having problems pooing and weeing and it is disturbing his sleep

My son of 6 weeks was quite happily following the routine until about 1 week ago, when he started waking during sleeps, getting sleepy during feeds and then being impossible to wake for awake time, therefore the routine times went all haywire! I am pretty sure the problem is down to him having difficulty going to the toilet. He has always been a straining baby even when solely on breast milk and has always seemed to have trouble going for a poo but it seems to be causing him a lot of trouble this past week. I am unsure as to whether it is the formula. He has been on Aptamil for about 2 weeks now and the first week he was very content – much more so than when he was just on breast milk. I am now giving him a combination of formula and expressed breast milk feeds. He is now straining so much that he wakes during his sleep times and cries so much that he won’t go back to sleep (I leave him for 10-15 minutes). He poos about once a day and it is soft; he sometimes strains to wee; he strains so much he gets sweaty, clammy and quite often vomits if he’s just fed. I have taken his temperature and it is fine (36.2) It seems like a cycle I will never break as I cant seem to help him poo (tried the cycling legs, massaging tummy, Infacol etc) and his sleep and feeding are now haphazard! I also find it so upsetting when he cries all the time and am finding it hard to cope with as I often find myself in tears too! I just don’t know how I can solve this problem and help him. I have just started giving a couple of fluid ounces of cooled boiled water but there has been no change as yet.

At present he weighs 11lbs.6oz and is taking feeds at 7.30am 4-5 oz formula, 10.30am 5-6 oz breast milk, 2.30pm 5oz formula, 5.30pm 3ozs breast milk, 6.40pm 3ozs breast milk, 10.30pm 5oz formula, 4.30am 5oz formula.

He naps from 9-9.45am, 11.30am-1.30pm, 3.45-4.45pm and settles at 7pm.

Some babies can find it a struggle to poo even though the end result is fairly soft. Many do grunt and groan and strain which can be distressing for you both. Some experts believe the reason behind this fussing when trying to poo is that the stools of a young baby are so soft they do not put enough pressure on the anus, making elimination more difficult. Also, as they spend a great part of their day lying flat it is harder to eliminate than when being upright and letting gravity take over. It may help your son if you elevate the head end of his cot by placing the legs on two substantial books such as telephone directories.

There is a medical condition which may match your son’s problem. The fact that he is producing soft stools but visibly straining and uncomfortable when doing so could indicate a tight anal sphincter. Not all GP’s may be familiar with this condition so it would need a referral to a paediatrician. Treatment is very simple: it involves gently dilating the sphincter muscle but is not something you should attempt to do yourself.

Having a mixture of breast and formula will mean he may only poo once a day; some breast fed babies can go two or three days without a poo and are absolutely fine. But as he also strains whilst trying to wee I feel you should seek advice from your doctor. A lot of newborns will flush red, go still and quiet when having a pee, but should be able to pass water with no difficulty. Have you seen him pee without a nappy on? Can you see if he is really having trouble eliminating it? Visit your Dr and explain fully your concerns over the problems he appears to be having.

If you find his poos are getting harder and more pellet like, then he is getting a little constipated. There are things you can do for this, other than those you have already tried but until he has been checked over it would be best to continue to try to help him in the ways you are and offering cool boiled water.

He appears pretty on track with his timings. Being sleepy in feeds is normal for a baby of this age. Breast milk contains a hormone: Oxytocin which does have a “sleeping pill” effect on some babies. Even in formula feeds a newborn can get tired and sleepy with sucking. Make sure he is not too warm whilst feeding; the warmth and closeness of your body will make him sleepy so you may have to remove one layer of his clothing when feeding. If you notice he is beginning to fall asleep then remove his bottle and lay him flat on the floor, on a sheet or blanket, and let him come round again before attempting to feed him some more. You may have to do this several times in a really sleepy feed but it will mean he will feed better. The amount he is taking in at present is fine for his weight.

Once your son has been thoroughly examined and the cause of his distress found, then comfort and hold him during these episodes as much as you can. Once the problem with pooing has been looked at you will be able let him learn how to settle himself back to sleep when he wakes.