Your Baby's Diarrhea: Causes and Solutions

Q: Your Baby's Diarrhea: Causes and Solutions

Hello： Yes, lactose-free formula does not require a reduction in scoops, because diarrhea from regular formula is primarily due to the inability to absorb lactose. <br>Since lactose-free formula does not contain lactose, diluting it does not affect the severity of diarrhea. <br>Q

My baby's diarrhea issue!

Hello Doctor: My baby was born in May 2006 and is now almost nine months old.
Since December 11 of last year, due to a cold, I took him to see a doctor.
The medication included the antibiotic Ulex (Keflex), and we also switched his formula (from 4 teaspoons of Karlo + 1 tablespoon of S26 to 6 teaspoons of Karlo).
Since then, he has had watery stools, about one to three times a day, sometimes so watery that it stains his clothes.
We subsequently visited three different doctors, and each prescribed anti-diarrheal medications (KBT or Loperamide).
When he took the medication, he did not have diarrhea, but once we stopped the medication, the diarrhea returned! This cycle of diarrhea lasted intermittently for about a month (his activity level did not show significant changes, but his weight hardly increased).
By the third week of diarrhea, we switched to lactose-free formula, but there was still no significant improvement.
Eventually, we couldn't take it anymore and took him to a medical center for a stool examination (he had taken a packet of anti-diarrheal medication the day before).
The results showed intestinal inflammation but no ulcers or bacteria, so the doctor said it was a case of general gastroenteritis.
However, since the diarrhea had persisted for a while, recovery would be slower.
The doctor advised us to reduce the amount of lactose-free formula to half or two-thirds of the original amount and prescribed Cholestyramine, 1/4 packet three times a day.
He also advised me to continue giving him the Lactobacillus acidophilus and Bifidobacterium infantis capsules (with over 1 billion CFUs) that I had previously obtained from his pediatric clinic.
I have a few questions for the doctor: (1) I read online that lactose-free formula does not need to be diluted, but the doctor still advised me to reduce the amount.
I asked the doctor repeatedly, but the answers were vague, and I still do not understand.
Is it really necessary to reduce the amount? Will my baby be lacking in nutrition? I am currently hesitant to give him solid foods.
(2) Is Cholestyramine also a type of anti-diarrheal medication? The doctor initially prescribed it for four days and then for seven days.
I am worried that taking it for too long may cause adverse reactions.
After stopping the medication, will he start having diarrhea again like before when we stopped the anti-diarrheal medication? (3) Since starting Cholestyramine and the probiotics, he has been having four to five bowel movements daily, which are mushy.
My baby has rarely had that many bowel movements since birth, even during watery diarrhea, he never exceeded three times.
Is this normal? Thank you, doctor, for patiently reading and answering my questions! I appreciate your help!

Bu zhi suo cuo de mama, 30~39 year old female. Ask Date: 2007/01/25

Dr. Pei Rensheng reply Pediatrics

Hello: Yes, lactose-free formula does not require a reduction in scoops, because diarrhea from regular formula is primarily due to the inability to absorb lactose.
Since lactose-free formula does not contain lactose, diluting it does not affect the severity of diarrhea.
Questran is also a type of antidiarrheal medication, and prolonged use can negatively affect the absorption of fat-soluble vitamins.
However, using it for a month is generally acceptable, so there is no need to worry too much.
I recommend gradually tapering off the dosage rather than stopping suddenly.
After starting Questran along with Probiotics, if you experience four to five bowel movements daily that are mushy, you can consider reducing Questran when the stools become firmer or the frequency drops to less than twice a day.
Only after completely stopping Questran should you reduce Probiotics.
Wishing you health and happiness! Sincerely, Pei Ren-Sheng.

Reply Date: 2007/01/25

More Info

Understanding your baby's diarrhea can be a challenging experience, especially when it persists despite various treatments. Let's break down the concerns you've raised regarding your nine-month-old baby who has been experiencing diarrhea since December, particularly after a course of antibiotics and a change in formula.

1. Nutritional Needs and Formula Adjustments: You mentioned that your doctor advised you to reduce the amount of lactose-free formula. While lactose-free formulas are designed for babies who are lactose intolerant, the need to reduce the quantity may stem from your baby's current gastrointestinal condition. When a baby is experiencing diarrhea, their digestive system may be sensitive, and reducing the formula can help ease the burden on their intestines. However, it’s crucial to ensure that your baby is still receiving adequate nutrition. If you are concerned about nutritional deficiencies, consider discussing with your pediatrician the possibility of incorporating small amounts of easily digestible solid foods, such as pureed fruits or vegetables, to provide additional nutrients without overwhelming their system.

2. Cholestyramine and Its Role: Cholestyramine is not a typical anti-diarrheal medication; it is primarily used to lower cholesterol levels and can bind bile acids in the intestines. In cases of diarrhea, it may help by reducing the amount of bile acids that can irritate the intestines, thus potentially alleviating diarrhea. However, prolonged use of any medication, including Cholestyramine, should be monitored closely by a healthcare provider. It’s essential to follow your doctor’s guidance on the duration of treatment and to discuss any concerns about side effects or the potential for recurrence of diarrhea after stopping the medication.

3. Frequency and Consistency of Bowel Movements: The increase in the frequency of your baby's bowel movements to four or five times a day, even if they are mushy, can be concerning, especially if this is a significant change from their usual pattern. Diarrhea can be classified as watery stools occurring more frequently than normal, and in infants, it can be a sign of an underlying issue, such as a viral infection, food intolerance, or a reaction to medications. It’s important to monitor your baby for signs of dehydration, such as decreased urine output, dry mouth, or lethargy. If the diarrhea persists or worsens, or if you notice any other concerning symptoms, it would be prudent to follow up with your pediatrician for further evaluation.

In summary, managing your baby's diarrhea involves a careful balance of ensuring adequate nutrition while allowing their digestive system to recover. Communication with your healthcare provider is key to navigating these challenges effectively. They can provide tailored advice based on your baby's specific situation, including dietary recommendations and monitoring for any potential complications. Always trust your instincts as a parent; if something feels off, don’t hesitate to seek further medical advice.

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