Frequent Bowel Movements in Infants: When to Seek Help

Frequent bowel movements?

Hello, Dr.
Hsiao.
Thank you very much for taking the time to read my question.
My daughter is currently 1 month and 21 days old and is exclusively on Meiji formula milk.
At one month old, due to gastroenteritis, we switched to lactose-free formula, which reduced her bowel movements from 10 times a day to 5 times a day, similar to her frequency before one month.
We gradually started transitioning back to Meiji formula (one scoop at a time over the course of a week), but during the transition, her bowel movements began to increase again.
Now, she has a bowel movement right after finishing her milk, and she cries while passing a small amount of stool, with intervals of about 5-10 minutes before she continues to have more bowel movements.
I have compared her stool color with a color chart, and it appears to be within the normal range.
I would like to ask if this stool pattern is normal and if any further examinations are needed.

Xi Pipi Xi Dao Xin Teng De Mama, 30~39 year old female. Ask Date: 2020/05/15

Dr. Xiao Kaiwen reply Pediatrics

If you switch back to regular formula and the stool frequency increases again with a watery consistency, it indicates that the gastroenteritis has not fully resolved.
You can revert to lactose-free anti-diarrheal formula; in fact, it is fine to use anti-diarrheal formula for one to two months or even longer, as its nutritional content is the same as regular formula and is suitable for infants.
The color of the stool primarily helps in assessing potential biliary obstruction in infants and is not related to diagnosing gastroenteritis.
However, if diarrhea persists for an extended period, it is advisable to consult a pediatrician in a hospital to rule out other possible gastrointestinal issues.

Reply Date: 2020/05/15

More Info

Frequent bowel movements in infants can be a source of concern for many parents, especially when there are changes in consistency, frequency, or accompanying symptoms like crying. In your case, your daughter, who is 1 month and 21 days old, has experienced a notable change in her bowel habits after switching from regular formula to lactose-free formula due to a bout of gastroenteritis.
Firstly, it is important to understand that infants have different bowel movement patterns compared to older children and adults. Newborns and young infants can have bowel movements ranging from several times a day to once every few days. The frequency can be influenced by several factors, including diet, hydration, and individual digestive health.

In your situation, transitioning from lactose-free formula back to regular formula can indeed affect bowel movements. Lactose intolerance, even if temporary due to gastroenteritis, can lead to increased bowel movements, especially if the infant's digestive system is still adjusting. The fact that your daughter is having bowel movements shortly after feeding and is experiencing discomfort (crying) suggests that she may be experiencing some digestive distress.

Here are some considerations regarding her bowel movements:
1. Normal Frequency: While 5-10 bowel movements a day can be normal for some infants, the key is whether the stools are soft and the infant is comfortable. If the stools are soft and she is not showing signs of dehydration (such as dry mouth, lack of tears, or decreased urine output), this may be a normal adjustment period.

2. Signs of Distress: If your daughter is crying during bowel movements, it could indicate discomfort, which may be due to gas, constipation, or the process of adjusting to the formula. It's essential to observe if she seems to be in pain or if there are any other concerning symptoms, such as vomiting, fever, or blood in the stool.

3. Dietary Adjustments: If you suspect that the formula is causing her discomfort, it may be worth consulting with a pediatrician about possibly trying a different formula or continuing with lactose-free options for a longer period. Sometimes, gradual transitions can help the digestive system adjust better.

4. Consulting a Pediatrician: Given her age and the changes in her bowel habits, it would be prudent to consult with a pediatrician. They can assess her overall health, review her feeding regimen, and determine if any further tests or dietary changes are necessary. They may also check for any underlying issues that could be contributing to her symptoms.

5. Monitoring: Keep a close eye on her bowel movements, noting the frequency, consistency, and any signs of discomfort. This information can be very helpful for the pediatrician in making an assessment.

In summary, while frequent bowel movements can be normal in infants, especially during dietary transitions, it is essential to monitor her comfort and overall health. Consulting with a pediatrician will provide you with tailored advice and peace of mind regarding your daughter's digestive health.

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