Nurse suggested diluting formula as measure against constipation in 7-week old - is this as bad of an idea as I think?

@gell
All this to say, your nurse may be right. But i would get a confirmation from a second professional in your area/ climate, that knows your baby.
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Second? OP needs to get word from a first. Nurses can be great, but they're not qualified to offhandedly suggest adding water to the diet of a newborn with undiagnosed stomach problems.

I'm actually surprised and a little worried that a nurse would do this – or rather, not know not to do that. It's quite an overstep.
 
@holy_venom95 Midwife, paediatric nurse and lactation consultant here. Congrats on a little cutie! Obviously I don’t know the medical history and context here so can’t give you a proper answer that you may be after. Some food for thought - you’ve mentioned constipation. Many, many parents say constipation when the baby is presenting as a typical 7 week well and term baby. So firstly what are you noticing about Bub? Next, how are you making up the formula (including sterilising equipment, levelling out powder, mixing powder into cool/Luke warm (but never hot!) water etc. what type of formula are you using (and otherwise tried) and how long has this been used for? We recommend not shifting formulas too often as this can muck up the gut briefly and doesn’t give us a true representation of how it’s being tolerated. Generally it takes around 2 weeks for a previous formula to exit the system and transition the gut to the new one). We usually recommend a low protein, basic (so not any specialty formulas), cow’s milk based formula to start off. Sometimes newborns have an immature gut that self regulates and begins to tolerate the formula well after a few weeks without needing to do anything at all. So is it potentially too early to tell? Alternatively we would be on the look out for things like CMPI and if that’s the case we’d look at some extensively hydrolysed formulas to trial (before moving to prescription which on a specialist can do if you’re in Australia). Your question around adding an extra bit of cooled boiled water to each feed is hard to answer. We really don’t want to muck around with the recipe because it would dilute the formula and hence nutritional content per feed. Having said that it’s not uncommon in some specific instances for this to be recommended. I’m sorry this is a vague answer but hopefully that gives you something to think about. Good luck! Sometimes doing nothing at all is the best answer in a well baby :)
 
@virkambhatt From a father of a constipated baby, thanks for this answer.

Question: why never mix formula with hot water? We opted for a newborn powdered goats milk formula, but since it’s powdered it was recommended that we use hot water to help sterilize the powder. Appreciate your support :)
 
@tiff7iney Congrats! You actually are changing the properties of the milk by using boiling water directly on powder. Eg if you have a probiotic formula, which is often more expensive, you’ve effectively killed off all the probiotics. Always in cool or at most luke warm water. Powder should be sterilised already. I’m not familiar with this recommendation to use boiled water and I could be wrong based on that powder manufacturer. I’m not sure which brand you’re using but I’d recommend moving away from goat milk (just a basic cow’s milk one). Any reason you were recommended or chose goat milk? Usually they have a higher protein content which we want to avoid if possible.
 
@holy_venom95 FWIW - my EFF son was constipated pretty much from birth because of the palm oil in the formula I chose (Enfamil). His stools were little round marbles with the consistency of clay. The first time I saw regular baby poo, I thought he had diarrhea. I just had no idea what infant stool should look like. I switched formulas (Similac in the light purple can - I can’t remember the name now), and like magic, he stopped straining and screaming and crying for hours on end. It was miraculous. If you’re using a formula with palm oil, consider switching.
 
@holy_venom95 Please do not do this. Formula is made with the balance of water and nutrients your baby needs. There are other things you can do to resolve conscription that don’t compromise the proper nourishment of your baby!
 
@holy_venom95 Mine suggested a teaspoon of gerber apple prune juice in the bottle at that age and it helped a ton….obviously I’m not a medical pro and don’t know your baby but may be worth asking your pediatrician about this fix
 
@holy_venom95 You got a lot of responses here but have you considered just changing formula? I’d personally feel way more comfortable changing a formula to gentle or sensitive instead of diluting.

Check out @theformulafairy on IG she’s a great science based resource.
 
@holy_venom95 Our pediatrician and midwife categorically forbade us to do any modification to the formula recommended amount.

Anecdotical, but my mixed fed baby had a huge constipation and reached 9 days without popping.
We were feeding her with the Nan supreme pro. The pediatrician suggested the switch to the Nan total confort. 4 days after the switch she started pooping and she became regular every 2/3 days.

I would talk with the pediatrician about the different formula options that are available
 
@holy_venom95 I wouldn’t go against the preparation instructions on the formula container. Adding extra water sounds like a bad idea. Maybe you need to switch formulas? Our baby had a bout of constipation and our pediatrician recommended adding in a bottle of Enfamil Reguline a day. It seems to help him stay regular.
 
@holy_venom95 I would not do that. It'll fill baby up faster while delivering less nutrients, which in extremes could be bad yes. I'd consult a pediatrician about it.

There are a lot of health articles citing the danger of it from various sources.
 
@holy_venom95 I'd switch formulas first before trying anything else.

And reach out to your doctor about solutions. There are lots of things to try that aren't medication or water.
 
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