Pediatric Bowel Issues: From Constipation to Diarrhea

Bowel movement issues

Hello, doctor.
My baby had difficulty passing stools and appeared to be in pain after being fed with Enfamil and Meiji formula since birth.
It would take several days for a bowel movement, and we had to take him to the pediatrician, who recommended using petroleum jelly to help him pass stool, but it was still soft.
Later, due to severe colic, we switched to a hydrolyzed formula, and his bowel movements became normal, resembling the color of sweet potato puree, occurring every 1-2 days.
However, as he gets older (currently four months), his stools have become increasingly watery, still occurring every 1-2 days.
Could this be related to the hydrolyzed formula? Or is there a possibility he could be developing lactose intolerance? We have just switched to a new hydrolyzed formula, Nutrilon, to see if it helps with constipation, as the pediatrician suggested it could be a good option.

Lala, 20~29 year old female. Ask Date: 2016/01/14

Dr. Xiao Kaiwen reply Pediatrics

The infant has been consuming fermented milk for a while without any issues with bowel movements, so it is likely not the cause of the diarrhea.
There are many potential reasons for prolonged diarrhea in infants, such as gastroenteritis, lactose intolerance, and cow's milk protein allergy, among others.
If the infant's diarrhea persists, it is advisable to take the child to a pediatric gastroenterologist for an evaluation.
If necessary, the physician will provide the mother with professional advice and may conduct further examinations.

Reply Date: 2016/01/14

More Info

When it comes to pediatric bowel issues, such as constipation and diarrhea, it is essential to understand the various factors that can influence a child's bowel movements. In your case, it appears that your baby has experienced a range of bowel issues since birth, including difficulty with bowel movements and changes in stool consistency.
Initially, your baby had trouble passing stools, which is not uncommon for infants, especially those who are formula-fed. The use of petroleum jelly to facilitate bowel movements is a common practice, but it is essential to ensure that it is done under the guidance of a healthcare professional. The fact that your baby was able to pass soft stools after switching to a different formula indicates that the formula can significantly impact bowel health.

As your baby has grown, you have noticed a change in stool consistency, with stools becoming increasingly watery. This change could be attributed to several factors, including the type of formula being used. The "酸化配方" (acidified formula) you mentioned may have different effects on digestion and stool consistency compared to other formulas. It's important to note that some formulas can lead to looser stools, especially if they contain certain ingredients that are easier to digest or if they alter the gut microbiome.

Regarding your concern about lactose intolerance, it is indeed possible for infants to develop lactose intolerance, although it is relatively rare in very young children. Symptoms of lactose intolerance typically include diarrhea, bloating, and discomfort after consuming lactose-containing products. If your baby is experiencing watery stools consistently after consuming a formula that contains lactose, it may be worth discussing this with your pediatrician.

Switching to a hydrolyzed formula, such as the "新安琪兒水解" (New Angel Hydrolyzed Formula), can be a good option if there are concerns about allergies or intolerances. Hydrolyzed formulas are designed to be easier to digest and may help reduce gastrointestinal discomfort. However, it is essential to monitor your baby's response to the new formula closely.
In terms of bowel movement frequency, it is normal for infants to have varying patterns. Some may have bowel movements multiple times a day, while others may go every few days. As long as your baby is comfortable, feeding well, and gaining weight appropriately, variations in stool frequency can be typical.
If you notice any concerning symptoms, such as blood in the stool, persistent diarrhea, or signs of dehydration (such as decreased urine output, dry mouth, or lethargy), it is crucial to seek medical attention promptly.
In summary, the changes in your baby's bowel movements could be influenced by the type of formula being used, and it is essential to monitor their response to dietary changes. Consulting with your pediatrician about any ongoing concerns is always a good practice, as they can provide tailored advice based on your baby's specific needs and health status.

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