Addressing Dietary and Bowel Concerns in Infants: A Pediatric Guide

Dietary and bowel issues

Hello Doctor, my daughter is currently over seven months old, weighing 6.7 kg and measuring 67 cm (measured on June 12).
She is breastfed, consuming about 100-150 cc per feeding, 4-5 times a day.
She eats vegetable porridge (carrots, cabbage, spinach, broccoli, sweet potato) about 1/4 to 1/3 bowl per feeding, twice a day.
I would like to ask you a few questions:
1.
Her bowel movements were originally 2-3 times a day, soft in consistency, medium in amount, and yellow or green in color.
Starting from June 13, she has been having 6-7 bowel movements a day, soft and mushy, sometimes with mucus in it, and the amount is small to medium, mostly green.
Is this diarrhea? How should I handle this? I have currently stopped giving her sweet potatoes and other high-fiber vegetables (she has been eating each type of vegetable for 2-3 weeks, so it shouldn't be food allergy-related diarrhea, right?).
2.
Her weight has slightly decreased from 6.9 kg last month to 6.7 kg this month, and her height remains the same as last month.
Her activity level, energy, and appetite (she has always been a bit reluctant to drink milk) have not changed significantly.
What should I do about this?
3.
I have been quite troubled about how to adjust the timing of solid foods and breastfeeding.
Currently, she breastfeeds in the morning, has porridge at noon (sometimes she asks for about 90 cc of breast milk afterward), breastfeeds again around 2 PM after waking up, sometimes has porridge again around 4 PM (about 1/4 bowl), breastfeeds around 5 PM, has porridge around 7 PM, and breastfeeds once more before bed.
This is her general daily dietary routine, but the amounts of breast milk and porridge vary (recently around 110 cc).
I feel like she is always eating and worry that she is not getting enough, so I keep feeding her, but her weight has not increased (if she were gaining weight consistently, I wouldn't be as concerned).
Doctor, do you have any dietary adjustments or recommendations?
Thank you for taking the time to clarify my concerns.

tina, 30~39 year old female. Ask Date: 2010/06/15

Dr. Xiao Kaiwen reply Pediatrics

1.
An increase in the frequency and water content of stools is defined as diarrhea.
In infants, diarrhea can vary in severity, and it is advisable to consult a pediatrician.
Diarrhea caused by inappropriate complementary foods (such as allergies) typically occurs within three days of consumption.
2.
The increase in height and weight of infants does not follow a smooth, linear progression; there may be periods of stagnation before growth resumes.
As long as the infant is not ill and exhibits normal activity and energy levels, temporary periods of decreased appetite are acceptable (especially since 7 months is a peak period for decreased appetite).
3.
Similarly, the growth in height and weight of infants does not follow a smooth, linear trajectory, and parental body types should also be considered.
In general, breastfeeding should continue for the first six months, after which complementary foods should be introduced to prevent iron deficiency.
The introduction of complementary foods should follow this sequence: diluted fruit juice, rice or wheat cereal, porridge --> vegetable and fruit purees --> soft meats, progressing from liquids to purees to finely chopped and thinly sliced pieces.
Foods should be introduced one at a time, allowing three days for the infant to adapt before introducing another type.
There are also various parenting books available for reference.

Reply Date: 2010/06/15

More Info

Addressing dietary and bowel concerns in infants is crucial for their overall health and development. Based on the information provided, your daughter is currently seven months old, weighs 6.7 kg, and has a height of 67 cm. She is primarily breastfed and has started consuming vegetable porridge. Let's address your concerns one by one.

1. Bowel Movements: You mentioned that your daughter’s bowel movements have increased to 6-7 times a day, with soft, mushy stools that sometimes contain mucus. While it is common for infants to have varying bowel movement patterns, an increase in frequency, especially if accompanied by a change in consistency and the presence of mucus, can indicate a mild gastrointestinal upset. This could be due to several factors, including dietary changes or a response to new foods. Since you have already eliminated high-fiber vegetables like sweet potatoes, it may be beneficial to monitor her for any signs of food intolerance or allergies. If her stools remain frequent and watery, or if she shows signs of dehydration (such as decreased urine output, lethargy, or dry mouth), it would be wise to consult your pediatrician for further evaluation.

2. Weight Concerns: It is concerning that your daughter’s weight has decreased slightly from 6.9 kg to 6.7 kg over the past month, especially if her height has remained the same. While fluctuations in weight can occur, consistent weight loss or stagnation in growth can be a sign of inadequate caloric intake or other underlying issues. Since you mentioned that her activity level, energy, and appetite have not significantly changed, it may be worthwhile to assess her feeding patterns. If she is showing signs of "milk aversion" or "nursing strike," it may be beneficial to explore different feeding strategies or consult with a pediatric nutritionist for tailored advice.

3. Feeding Schedule: Your current feeding schedule includes multiple breastfeedings and two meals of porridge. It’s essential to ensure that your daughter is receiving a balanced diet that meets her nutritional needs. At this age, infants should be gradually introduced to a variety of solid foods, including fruits, grains, and proteins, while continuing to receive breast milk or formula. The general recommendation is to offer solid foods after breastfeeding sessions, as this can help ensure she is still getting enough calories from breast milk while also exploring new flavors and textures. You might consider adjusting the timing of her meals to allow for more solid food intake before breastfeeding, which may help her consume more calories from solids.

In summary, it is crucial to monitor your daughter’s bowel movements and weight closely. If her stools do not normalize or if you have concerns about her weight gain, it is advisable to consult with your pediatrician. They can provide guidance on appropriate dietary adjustments and assess whether any further investigations are necessary. Additionally, consider working with a pediatric nutritionist to develop a feeding plan that ensures she receives adequate nutrition while exploring a variety of foods. Remember, every child is different, and it’s essential to find a routine that works best for her individual needs.

Similar Q&A

Addressing Dietary Concerns for a 3-Year-Old: Tips for Healthy Eating Habits

Hello Doctor: My daughter is 3 years and 4 months old and has not yet started preschool. She is currently being cared for by a nanny, but her appetite has not increased; in fact, it has decreased. She used to eat a full bowl of rice, but now she only eats half a bowl, and sometim...

Dr. Zhang Yingwen reply Pediatrics
To help young children develop good eating habits, there are two basic principles: 1. Avoid snacking, and 2. Maintain regular bowel habits. According to the description, the sister's irregular bowel movements affect her appetite. In addition to the intake of dietary fiber fr...

Guidance for Parents: Addressing Pediatric Weight Concerns

Hello, Dr. Chang. My baby boy was born at 37 weeks with a weight of only 1885 grams. When I asked the doctor why he was so underweight, the doctor said it was due to a tight and tangled umbilical cord, which resulted in him not receiving adequate nutrients in the womb. After birt...

Dr. Zhang Yingwen reply Pediatrics
The baby is one year and six months old and weighs only eight kilograms, which is indeed underweight and indicates poor growth. It is necessary to consult specialists in four areas for evaluation: pediatric neurology, pediatric endocrinology, pediatric gastroenterology, and pedia...

Understanding Digestive Issues in Infants: A Guide for Concerned Parents

Hello Doctor: I would like to ask you about my younger sister, who is currently over six months old. Her milk intake is 165cc every four hours, and she has rice cereal once or twice a day. If she eats rice cereal, the interval for milk is extended to five or six hours. Since she ...

Dr. Zhao Yongkang reply Pediatrics
1. Generally, the digestive medications used for children are primarily probiotics for the gastrointestinal tract, which pose no harm to their bodies. 2. Long-term use does not lead to dependency. 3. Sometimes, children may have poor appetite due to slower development of their di...

Understanding Pediatric Digestive Issues: Tips for Concerned Parents

Dr. Pei: Hello, my daughter is over three years old. When she was five months old, due to her mother's health issues, she stopped breastfeeding and started drinking Abbott formula. About two to three months later, I noticed that before bedtime, my daughter would become very ...

Dr. Pei Rensheng reply Pediatrics
Hello: 1. Your daughter has exhibited signs of teeth grinding and muscle spasms before sleep, which raises concerns about possible electrolyte imbalances or abnormal brain discharges. It would be advisable to consult a pediatric neurologist for an evaluation, which may include ...