Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
185 Doctors are Online

Infant on formula feed. Developed loose stools and bloated stomach. Had projectile vomiting

User rating for this question
Very Good
Answered by
Practicing since : 1998
Answered : 1846 Questions
Question
Doctor,

You have the details about my baby and feeding issues already. you can search under my user name XXXXXXX. Please reply in detail for below and guide me through what is the best approach i need to take for my baby.

My baby is execlusively on formula feed from day 1 unfortunately. He is 2 months 1 week old now. After three weeks of age he developed loose stools, extended stomach (Bloating) and Excessive cry and was put on zerolac (Soy formula for 2 weeks.) He settled well on soy formula. We tried one feed of milk based formula and again the symptoms resumed this time more severely. He had projectile vomiting after and hour and a half and all other above mention symptoms including fever. We immedietely put him back to zerolac and there were no vomits. He never refuses feeds. His stool for reducing substances was positive. Heard it was 1+.

1) So is he lactose intolerant for sure or it can be cow milk allergy too?
2) Continuing on soy milk is not good for baby boy so what is the best option for me. Will opting for a hypoallergenic formula be better then soy one. Or since he is not allergic to soy, are there any lactose free formulas that i can use?
3)I am trying my level best taking medications, proper diet and pumping every 3 hrs to revert to breast feeding. I had to pump only this week and can't latch him on as I am going on a dairy free diet and want to test trial on my baby to see if he can toleretae breast milk after a week. However in case if he develops the same above symptoms even with breast milk, then i have to go for lactose free milk alone and thus depend on formula with no other choice. So please suggest whats best formula to put him on under such situation. Right now on Zerolac he is settled well, feeds regulary and smily. But since its soy based, I am worried he won;t get enough nutrition. Please understand i can get the formulas from US so please help me to choose the the best one.
Posted Tue, 18 Jun 2013 in Child Health
 
 
Answered by Dr. Y V Siva Sankara Murty 12 hours later
Hi Sucharitha,

Thanks for writing to me personally.
I understand your problem and appreciate your concern for your baby.

1) So is he lactose intolerant for sure or it can be cow milk allergy too?

The history and stool for reducing substances are suggestive of lactose intolerance. But a stool pH would have helped in confirming the diagnosis. There is no real harm in trying breast milk once since a confirmation of diagnosis is not made and also primary lactose intolerance is very rare. Your doctor correctly suggested to wait for one week (this will give time for secondary lactose intolerance to subside) and try and restart breast feeding (which I repeatedly suggested is ideal for your baby). So wait these few days and may be by Wednesday or Thursday restart breast feeding. A stool pH if the symptoms recur along with stool for reducing substances will confirm the diagnosis. (Hope he will be happy with breast feeding and it was only a secondary lactose intolerance because of some infective loose motions he had).

2) Continuing on soy milk is not good for baby boy so what is the best option for me. Will opting for a hypoallergenic formula be better then soy one. Or since he is not allergic to soy, are there any lactose free formulas that i can use?

Yes you can try Simyl MCT Milk powder or Pregestemil milk powder. But hope he will stabilize with your breast milk which is ideal.

3)I am trying my level best taking medications, proper diet and pumping every 3 hrs to revert to breast feeding. I had to pump only this week and can't latch him on as I am going on a dairy free diet and want to test trial on my baby to see if he can toleretae breast milk after a week. However in case if he develops the same above symptoms even with breast milk, then i have to go for lactose free milk alone and thus depend on formula with no other choice. So please suggest whats best formula to put him on under such situation. Right now on Zerolac he is settled well, feeds regularly and smily. But since its soy based, I am worried he won;t get enough nutrition. Please understand i can get the formulas from US so please help me to choose the the best one.

Yes I can understand the effort you are putting in. In a world where all the mothers are trying to avoid breast feeding (by giving all the wrong explanations despite our best efforts to promote breast feeding) I really appreciate your effort to try and breast feed your baby. I hope you will be successful in your attempts. (Please spread the message of breast feeding around you. You will be doing a lot good to the society)
Try and be as sterile as possible during preparation of feeds these few days. (Another episode of infection will result in lactose intolerance and we will have to delay breast feeding as we can get confused if this is primary or secondary)
Do not use a bottle to feed your baby now. (This will cause nipple confusion and he will not latch on to breast later). Use a spoon and glass. As of those formulas from United states I may not be of much use because I do not have personal experience using them (to be XXXXXXX to you). So I may not be really useful in helping you in that aspect. But why should we think that he will not be comfortable with your breast milk. Hope for the best.

Continue to ask queries as and when required.
Take care.

Dr Y V Siva Sankara Murty
M.D.(Pediatrics)
Associate Professor of Pediatrics


Above answer was peer-reviewed by
 
Follow-up: Infant on formula feed. Developed loose stools and bloated stomach. Had projectile vomiting 3 hours later
Thanks heaps for your reply.

Is simyl MCT powder available now?. I donot find it when i googled it out. Is it from Similac brand. I only see similac sensitive formula which is lactose free.

Since its not sure at this time if baby is allergic to lactose or cow milk protien allergy, can i straight away try Nutramigen which is a hydrolysed formula which is lactose free and where milk protiens are broken down..??. since Baby never had blood in stools or skin rash/exzema except for a rash during the course of loose stools, i donot see it as a milk allergy but more probabiliy sec lactose intolerance. so looking at pregestimil or simyl MCT is a gooid choice. However donot want to put my baby under one more trial. so is trying hypoalleric formula like Nutramigin worth at this time or should i give it a go with pregestimil. Please suggest.

I wish my baby does well with Breast feeding when i try this wendnesday. However concern is I am not seeing any good milk flow at this stage. So baby any how has to to be supplemented with formula because my baby is very regula with feeds and follows a strict cycle each feed with 120 ml every 3-3.5 hours.so i a day 7- 8 feeds. I am now only making anywhere 4 teaspoons of Breast milk. So cannot imagine if i would be able to solely breast feed my baby at this stage.
 
 
Answered by Dr. Y V Siva Sankara Murty 4 hours later
Hi XXXXXXX,

Yes Simyl MCT powder is available now.

Be confident of breast feeding your baby. You can do it. You are not getting enough milk now just because your baby is not sucking at your breast. Once he sucks at the breast enough milk will be produced because of the basic harmone prolactin that is produced. You may also take Tab Metoclopramide during the initial period to enhance milk production.

I suggest you should not try any change over of the formula now. You should first try and breast feed after 3 or 4 days and give the add on of formula after every breast feeding initially. If he develops a reaction then change over to simyl MCT. If there is no such intolerance then you can entirely stop the formula after the initial transitional period.

Hope this helps.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Infant on formula feed. Developed loose stools and bloated stomach. Had projectile vomiting 2 hours later
Doctor - Two things to check.

I would prefer formula with DHA/ARA which is good for brain and vision like pregistimal rather than simyl MCH if baby develops symptoms due to lactose in breast milk. I am not sure if simyl MCH has DHA/ARA . Is that ok?

Secondly i see that usage of Tab Metoclopramide can cause depression and siezures in mother though safe for baby. So what would be the safe dosage to avoid any sideeffects.

I Apologise for my repeated queries.
Thanks,
XXXXXXX
 
 
Answered by Dr. Y V Siva Sankara Murty 20 hours later
Hi XXXXXXX

Please ask as many queries as required. I will be more than happy to answer them.

Yes formulas containing DHA are always better than with out them.

But with breast feeding you need not worry about all these. It is the BEST.

Do not worry about using Tab Metoclopramide. We use it routinely. Those complications are rare. (I am not supposed to prescribe any thing using this medium. So please use it as prescribed by your doctor)

Hope this helps.
Continue to ask further queries as required.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Infant on formula feed. Developed loose stools and bloated stomach. Had projectile vomiting 2 days later
Hello Doctor,

I ended up with unfortunate situation today. While extracting breast milk using electric pump, I could see even blood being pumped out along with milk. I am stuck. Please advice what next for me.

Thanks,
XXXXXXX



 
 
Answered by Dr. Y V Siva Sankara Murty 8 hours later
Hi XXXXXXX

Do not worry about that.

Did you start breast feeding your baby?
Are there any problems associated?

Now regarding your blood in the milk that is pumped out...

That could be because of vigorous pumping. It could also be because of improper latch (If you started breast feeding already). Is there any pain in the nipple. A soar nipple can also result in such a problem.

If you started breast feeding please continue the same. You need not worry about that blood. It will subside slowly. If the bleeding continues for a long time you may have to consult your doctor.

If you have sore nipple please write to me. (pain and tenderness at nipple)

Correct the latch if you already started breast feeding.

Continue to ask further queries as required.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication
Medical Topics

The user accepted the expert's answer

Ask a Pediatrician

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor