Can cow milk cause abdominal pain for a child after giving rotarix vaccine?
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my daughter is 4 months old. for last 15 days she was given additional cow milk also with saffron mix (little) apart from breast feed.A week back she was given Rotarix vaccine. After 5 days she got severe abdominal pain, with bloody stool. we rushed to the hospital and they informed that it is intussception and was given X ray air blow enema treatment after that she got normal. after sixty hours today she is passing green mucus stool in little quantity in 3 times a day,but without blood but not with severe crying but sometimes scream for a minute and then gets normal and happy,the symptoms are 20% less than that of what earlier. my first question is these symptoms are reoccurrence and second is the reason for this bcoz that reaction of rotarix vaccine or infection from cow milk with saffron mix (little)
Posted Wed, 15 Jan 2014 in Abdominal Pain
Answered by Dr. Deepak Kishore Kaltari 5 hours later
Brief Answer: Do get Ultrasound abdomen to rule out recurrence Detailed Answer: Namasthe Welcome to Healthcare-Magic Greetings of the day Dear Mr XXXX From the description given by you its unlikely to be recurrence. Color of stools of infants vary depending on the feeds given. I would suggest you the following which I normally follow for my patients. One should always reconsider the p possibility of intussusception in crying child, especially if it has recently undergone reduction of the same 1. Get Ultrasound of abdomen : It will definitely rule out intussusception. It's non invasive, no radiation risk, no discomfort to the baby. It's the recommended option in any child to confirm the diagnosis. 2. Examination of Peri Anal area : Sometimes presence of small fissure following Enema may be the cause of crying while passing stools. It's a Standard protocol to follow these in order to avoid missing recurrence. The good thing is child is happy. Intussusception in infants is usually Idiopathic that is there is no definitive reason. Sometimes it occurs after upper respiratory tract infection or rota virus vaccination. It leads to hypertrophy of peyer's patches that is lymphoid tissue present below the mucous membrane of last part of small bowel (ileum) leading to abnormal peristaltic movements . This predisposis to telescoping of one segment of the intestine into another which is intussusception. Also it is strongly advisable only to give exclusive breastfeeding till 6 months of age. No water, no cow milk. If it's possible to keep the baby on breastfeeding it will be very good. I hope it helped. In case you require any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Pediatric Surgeon
Follow-up: Can cow milk cause abdominal pain for a child after giving rotarix vaccine? 3 hours later
thanks doctor for your valuable advice. yesterday whole night she didnt sleep till morning 7 a.m (normally she will wake till 3 a.m), but now since morning she is sleeping. At night some times she will cry than she will play,I felt that she developed a gas in her stomach since she is not passing the usual quantity of motion.after i did little message to her stomach in the morning she is comfortable and sleeping but still SHE HAS NOT PASSED THE MOTION SINCE LAST 8 HOURS, otherwise things are ok. My doubt is that is it needs an urgent attention, since our appointment with doctor is after three days for review, is it ok to wait till that date. Another thing that they said that in case of reoccurrence if any complications arise than they have to do a major surgery, If by chance if anything like that happen than will that affect my child in future and how much risky is this surgery. Further they said that the intenstine is still thick in our case hence we have to be careful since chances are more for reoccurance in our case,is that so ?
Answered by Dr. Deepak Kishore Kaltari 17 minutes later
Brief Answer: Give her activated charcoal in feeds Detailed Answer: Greetings Dear Mr XXXX From the description given its unlikely to be recurrence. It is sometimes normal for children to be irritable after intussusception reduction because of some amount of bowel oedema which is normally present in all cases and subside over a week time. In case she is irritable, there is distension of abdomen or vomiting would suggest you to go ahead with Ultrasound scan. Even if the recurrence occurs non operative management like air or barium enema reduction can be re attempted provided certain criteria are fulfilled. 1. There should not be gross distension of abdomen 2. No fever 3. No tachycardia Further management of recurrence depends on individual case. I would suggest you one important thing to be done. It will definitely be very reassuring to you. Take a tablet of Flatuna( activated charcoal) , grind into powder . Mix a table spoon of this into the feeds, and feed the baby . If she passes black colour stools that is due to excretion of activated charcoal, it rules out any obstruction or recurrence of intussusception. This is my standard practice after every successful non operative reduction. Reassuring for me and for the parents. Would suggest you to do it. In case she does not pass stools , distension of abdomen or vomiting then consult your Physician at earliest for assessment by ultrasound. Rest be assured everything looks fine. Do consider giving her mixture of Flatuna tablet in feeds( powdered and added in feeds). Wishing her a speedy recovery. If you have any doubt or concern, get back to me anytime. Will be glad to assist you. Take care Best Regards Dr Deepak Kishore