Infrequent stools in exclusively breastfed infants

Few data are available on the number of stools in exclusively breastfed infants. Two studies aimed to assess the stool pattern in exclusively breastfed infants and to evaluate the reactions of mothers in the case of infrequent stools and the decisions of healthcare providers.

Infrequent stools were defined as an interval of >24 hours between bowel movements. Study 1 concerned 198 infants. Mothers responded to a questionnaire where they described their knowledge and attitude toward infrequent stools. Study 2 was performed using the Internet with 85 French-speaking mothers worldwide responding to a questionnaire on bowel movements and reactions of mothers and healthcare providers. Using the scale provided, mothers evaluated their anxiety and the discomfort of their infants.

In Study 1, 37% of exclusively breastfed infants experienced at least one episode of infrequent stools that occurred at <1 month of age in 19% of cases. Mothers who were aware of infrequent stools intervened less frequently (17%) than mothers who were unaware of this condition (79%) (p<0.0001). In Study 2, the median duration of all combined episodes of infrequent stools was 10 weeks (range, 1-34 weeks) with a maximal duration of 28 days. The most frequent action for infants was abdominal massage (79%), whereas in mothers it was consumption of fruit juice/mineral water rich in magnesium/vegetables (73%). There was a correlation between the maternal anxiety score and the infant's discomfort score (p=0.0001).

Parents/health professionals should be informed of the prevalence of infrequent stools in exclusively breastfed infants and adopt a wait-and-see attitude.