Infant Digestive Health: Breast Milk and Formula Choices

Breast milk + standard infant formula or hydrolyzed formula?

Doctor, my baby is currently a little over one month old (1 month and 11 days).
Initially, I was feeding him 70cc of breast milk and 60cc of Abbott standard infant formula, along with additional probiotics, every three hours, eight times a day.
I noticed he was experiencing gas, but he had a bowel movement after almost every feeding, with the stool being a slightly thick, yellow, and mushy consistency that didn't have much odor.

However, in the past few days, I switched to 70cc of breast milk and 60cc of Abbott hydrolyzed formula, along with additional probiotics.
Since then, his bowel movements have decreased to once a day, occasionally twice a day, but the first bowel movement of the day is very large, completely saturating the diaper with watery yellow stool that has a strong odor (I can smell it even before picking him up) and sometimes even soiling his clothes.

As for the gas, it seems to have improved, as he passes gas at least eight times a day.
I'm concerned about the bowel movement frequency— is it normal for him to have one to two bowel movements a day? And regarding the stool volume, does this indicate diarrhea? Is the Abbott hydrolyzed formula unsuitable for my baby? Thank you, doctor.

Zhen, 30~39 year old female. Ask Date: 2022/07/21

Dr. Xiao Kaiwen reply Pediatrics

It is normal for infants to have bowel movements ranging from once or twice a day to once every two to three days.
Abnormal stools in infants include hard, pellet-like stools, watery diarrhea, stools containing blood, and grayish-white stools.
The odor of the stool is not considered abnormal.
In cases of infant diarrhea, in addition to watery stools, there is typically an increased frequency of bowel movements.
Clinically, it is rare to find cases where a standard formula is suitable but a hydrolyzed formula is not appropriate for diarrhea, as hydrolyzed protein formulas simply break down milk protein into smaller molecules while retaining other components.
Therefore, it is recommended to continue feeding with hydrolyzed protein formula and monitor the situation.

Reply Date: 2022/07/21

More Info

When it comes to infant digestive health, particularly regarding the choice between breast milk and formula, there are several important factors to consider. Your baby, who is currently just over a month old, is experiencing some digestive issues, including gas and changes in bowel movements, which can be common in infants as their digestive systems are still maturing.

Firstly, it's important to note that breast milk is generally considered the best source of nutrition for infants, especially in the first six months of life. It contains the right balance of nutrients, antibodies, and enzymes that help in digestion and promote overall health. If breastfeeding is an option for you, it is highly recommended to continue as much as possible. However, if you are supplementing with formula, it is crucial to choose one that is appropriate for your baby's needs.

In your case, you initially mixed breast milk with a standard infant formula (Abbott Similac) and added probiotics. The gas and bloating your baby experienced could be attributed to the formula, as some infants may have difficulty digesting certain ingredients in standard formulas, particularly lactose or the protein content. The fact that you switched to a hydrolyzed formula (which is easier to digest) and noticed an improvement in gas is a positive sign. Hydrolyzed formulas break down proteins into smaller pieces, making them less likely to cause digestive discomfort.

Regarding your baby's bowel movements, it is normal for infants to have varying patterns. The typical range for bowel movements in infants can be anywhere from several times a day to once every few days. The consistency of your baby's stool is also important; it should be soft and not hard or pellet-like. The fact that your baby is having a large, watery stool with a strong odor could indicate a few things. While it may not necessarily mean diarrhea, it is essential to monitor the frequency and consistency of the stools. If the stool is consistently watery and frequent, it could be a sign of diarrhea, which may require medical attention.

The change in stool frequency from multiple times a day to once a day or occasionally twice a day is not uncommon when switching formulas. However, if the stools are excessively watery or if your baby shows signs of dehydration (such as fewer wet diapers, lethargy, or dry mouth), it would be wise to consult your pediatrician.

As for whether your baby is suitable for the hydrolyzed formula, it can be beneficial for infants with digestive issues or suspected allergies. However, every baby is different, and what works for one may not work for another. If you notice continued digestive issues or if you have concerns about your baby's nutrition and growth, it is always best to consult with a pediatrician or a pediatric nutritionist. They can provide tailored advice based on your baby's specific health needs and help you determine the best feeding strategy moving forward.

In summary, while breast milk is ideal, if formula is necessary, choosing the right type is crucial. Monitor your baby's digestive health closely, and don't hesitate to reach out to healthcare professionals for guidance. Your baby's comfort and health are the top priorities, and with the right support, you can navigate these early feeding challenges effectively.

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