Should You Change Your Baby's Formula Due to Frequent Bowel Movements?

If a newborn is having too many bowel movements, should we switch to a different formula or continue with the current one?

The child has been drinking formula milk (non-hydrolyzed) since birth and is currently 18 days old, staying at a postpartum care center.
Initially, I used Abbott Stage 1 formula in the hospital for 5 days without any issues.
However, after moving to the postpartum care center, the child was given their provided Abbott Stage 1 formula (which is the same as ours), and within 2 days, I noticed small rashes on the child's face, followed by mild diaper rash.
I took him to see a doctor for the diaper rash, which was improving, but in the last 2-3 days, the frequency of bowel movements increased significantly—10 times the day before yesterday, 12 times yesterday, and again over 10 times today.
Although the stool color and shape are normal, the pattern shows a large stool followed by small amounts each time.
As a result, his diaper rash has returned, and the facial rash has not improved, prompting me to take him to the doctor twice more.
The hospital doctor advised me to dilute the milk and give him probiotics along with intestinal powder after each meal, and if that doesn't work, to switch to hydrolyzed formula.
The clinic doctor suggested switching directly to hydrolyzed formula.
I am concerned that changing the formula might cause other gastrointestinal issues, but I also worry that not changing it could be harmful to his digestive system.
Therefore, I brought my own newly purchased large can of Abbott Stage 1 formula to the postpartum care center, hoping they would use the new formula for the child.

I would like to ask Dr.
Hsiao two questions: First, could the rashes on his face and the increased frequency of bowel movements be related to the formula? Should I switch to another brand of regular formula, or should I switch to hydrolyzed formula? Or should I continue with the Abbott formula that I purchased? Second, is the child's condition indicative of a gastrointestinal issue, or could it be a problem with the formula provided by the postpartum care center?

chubby, 30~39 year old female. Ask Date: 2015/08/30

Dr. Xiao Kaiwen reply Pediatrics

Rashes on a newborn's face are usually not related to formula milk.
An increase in bowel movements may or may not be related to formula milk; it can only be confirmed if the symptoms improve when the formula is discontinued and reappear when it is reintroduced.
If switching to your own infant formula improves the situation, it is certainly acceptable to use the one you purchased.
You may try other brands of infant formula, but the outcome may be similar.
The nutritional content of hydrolyzed infant formula is comparable to that of standard infant formula, so if the situation improves with hydrolyzed formula, it is advisable to continue using it.
If the formula provided at the postpartum care center is well-tolerated by other newborns, it should generally be safe.
If the situation does not improve with hydrolyzed infant formula, you might consider trying a lactose-free formula.

Reply Date: 2015/08/30

More Info

When it comes to infant nutrition, particularly regarding formula feeding, it’s essential to approach any changes with caution and a clear understanding of your baby's health and needs. Based on your description, your baby has been experiencing frequent bowel movements and some skin irritation, which has understandably raised concerns about the suitability of the formula being used.

Firstly, it’s important to note that changes in bowel habits can be influenced by various factors, including the type of formula, the baby's digestive system, and even environmental changes. In your case, the switch from one formula to another, even if they are similar brands, can sometimes lead to gastrointestinal disturbances. This is particularly true if the baby is sensitive to certain ingredients in the formula, such as lactose or specific proteins.

1. Skin Rashes and Increased Bowel Movements: The presence of rashes on the face and diaper area, along with an increase in the frequency of bowel movements, could indeed be related to the formula. Some babies may develop a sensitivity or mild allergic reaction to certain components in the formula, leading to skin irritations and gastrointestinal symptoms. The fact that your baby’s stool is normal in color and consistency is a positive sign, but the frequency of bowel movements (10-12 times a day) is on the higher side for an infant. This could indicate that the formula is not being well tolerated.

2. Should You Change the Formula?: Given the symptoms you’ve described, it may be prudent to consider changing the formula. The advice from your healthcare providers to dilute the formula or to introduce probiotics is a common approach to help manage mild gastrointestinal issues. However, if these measures do not yield improvement, switching to a hydrolyzed formula may be beneficial. Hydrolyzed formulas are designed for babies with sensitivities and can be easier on the digestive system. They contain proteins that are broken down into smaller pieces, which can reduce the likelihood of an allergic reaction.

3. Assessing the Source of the Problem: It’s also important to consider whether the issue lies with the formula provided by the maternity center or if it’s a broader sensitivity your baby has. Since you mentioned that your baby tolerated the initial formula well in the hospital, it’s possible that the specific batch or formulation provided at the maternity center is different in some way. If you decide to switch back to the formula you purchased, monitor your baby closely for any changes in symptoms.
4. Monitoring and Follow-Up: Regardless of the decision you make, keep a close eye on your baby’s symptoms. If the rashes persist or worsen, or if the bowel movements do not normalize after changing the formula, it would be wise to consult a pediatric gastroenterologist. They can provide more specialized insight into your baby’s digestive health and help determine if there are underlying issues that need to be addressed.

In summary, while it is common for infants to experience some gastrointestinal adjustments when changing formulas, persistent symptoms warrant a careful evaluation. Switching to a hydrolyzed formula could be a beneficial step if you suspect a sensitivity. Always consult with your pediatrician before making significant changes to your baby’s diet, and ensure that any new formula is introduced gradually to monitor for any adverse reactions. Your proactive approach in seeking advice and monitoring your baby’s health is commendable and essential for ensuring their well-being.

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