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Toddler has tachypnea, respiratory distress and laryngomalacia. Breathing rapidly while passing stool

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My son is 4 months and 3 weeks old. At birth he suffered from Tachypnea, respiratory distress and laryngomalacia. He spent his first 12 days in the ICU. After he was became stable and was able to breast-feed successfully, he was discharged.

As he entered 5th month, the local doctor suggested introducing Cerelac in small quantities. As we did that, probably the mom gave little extra, and he did not pass motion for 4 days. When he did finally pass the motion, he was breathing rapidly with a shrill noise coming from his nose/throat. His chest and stomach were shrinking and expanding as it was happening with him at birth. This happened for 4-5 minutes while he passed motion and it stopped as soon as he finished passing motion. There was no signs of indigestion as the quality of poop was not hugely different, accept that it was big quantity.

The local doctor asked us to stop the Cerelac for now and continue exclusively on breastfeeding. His birth weight was 3.1KG and he is slightly less than 6KG now. He continued to be hungry, he demanded more food and looked on hungrily as we eat infront of him. So we decided to supplement him with Formula(Lactogen 1) instead.

He continued his usual poop routine of once a day or once in 2 days. After 4 days of supplementing lactogen, he suffered the same breathing problem while passing motion today. Is he constipating? How to know?

What is the problem with him and what should we do now?
Posted Tue, 2 Apr 2013 in Child Health
 
 
Answered by Dr. Y V Siva Sankara Murty 50 minutes later
Hi,

Thanks for writing to health care magic.

Does he have the respiratory problem when he is not passing his stool?
What is the respiratory rate of your baby? This you can count by observing his chest going up and down. Request you to count for one minute and give the respiratory rate.

How is the stool now. Is it hard or semisolid?
Are there any blood streaks on the stool?
Does he cry while passing stool?
How is his activity?
Just examine his perianal region. (Area around the anus) Do you find any thing abnormal.

Please reply in detail so that I can answer you better. If you do not understand any part of my questions please leave that and answer the rest of the questions.

A baby should be exclusively breast fed till 6 months and my sincere advise is to continue breast feeding and not to start any thing else. This is good for the baby's brain and prevents against infections.

Waiting for your reply.

Above answer was peer-reviewed by
 
Follow-up: Toddler has tachypnea, respiratory distress and laryngomalacia. Breathing rapidly while passing stool 30 minutes later
Does he have the respiratory problem when he is not passing his stool?
No. He was suffering at birth, but this did not recur till we started experimenting with external food. The respiratory problem coincides exactly with the duration he is passing stool. It gets over as soon as he is finished.

What is the respiratory rate of your baby? This you can count by observing his chest going up and down. Request you to count for one minute and give the respiratory rate.
The local doctor checked his respiratory rate and pulse etc today, he confirmed everything is normal.

How is the stool now. Is it hard or semisolid?
The stool was initially a little hard, semi-solid afterwards.

Are there any blood streaks on the stool?
None, no blood streaks seen.

Does he cry while passing stool?
He did not cry the first time it happened. Today, he was crying while passing stool.
How is his activity?
He is fairly active most of the days. Very rarely he is dull.

Just examine his perianal region. (Area around the anus) Do you find any thing abnormal.
No abnormality seen.

Please reply in detail so that I can answer you better. If you do not understand any part of my questions please leave that and answer the rest of the questions.

A baby should be exclusively breast fed till 6 months and my sincere advise is to continue breast feeding and not to start any thing else. This is good for the baby's brain and prevents against infections.
I understand the importance of breast feeding, but what to do when the baby is visibly hungry and demanding while feeding and the breastfeeding does not look sufficient? Is it a problem to supplement with Formula? Is it OK to supplement after each feed or we should skip feeding and give. Kindly suggest what to do.

What is the connection between the external food and his respiratory distress? What should be given to him if we can not give formula?
 
 
Answered by Dr. Y V Siva Sankara Murty 13 minutes later
Hi,

Thanks for your reply.

Just monitor your baby and do not worry.

The physiology of breast feeding is that more the baby suckles at the breast more milk is produced. If the baby is given some other feed this sucking decreases and the milk production decreases. If the mother is free from any other worry and takes the baby into her lap with love and affection enough milk will be produced. The worry if the milk is sufficient or not is good enough to decrease milk production.

The main problem with formula is infection. Still if formula has to be used use a glass and spoon and never use a bottle.

Supplementation after a feed is a better alternative out of the two. This is because the breast feeding is not affected.

I feel a harder stool is formed after the formula was started resulting in difficulty in passing it. Do not worry.

Developmentally did you baby achieve neck holding?
Did she achieve social smile?

Please reply.
Above answer was peer-reviewed by
 
Follow-up: Toddler has tachypnea, respiratory distress and laryngomalacia. Breathing rapidly while passing stool 21 minutes later
He is able to hold neck but it is still not 100%. Some times the head looks a little unstable.
He is a great smiler, he has a ready smile for everybody in the family.

The local doctor also said about the difficulty of passing the stool. What I am still not convinced about is the following.

1. What is the relation between his breathing distress with the passing the stool?
2. He does not look like he is unable to digest formula or he is constipated. If he was constipated, he would grunt or strain(Forgive me for this, I read about constipation over internet). The noise that we see instead is a shrill noise from his nose/throat along with XXXXXXX and rapid breathing. I did not find any information on internet, that relates infant constipation with breathing problems.

Kindly clarify this point.

Regards,
 
 
Answered by Dr. Y V Siva Sankara Murty 1 hour later
Hi,

Thanks for your reply.

Do not worry. The oxygen requirement is marginally increased during bowel movement. This could be responsible for increased breathing. The laryngomalacia could be responsible for breathing difficulty because of partial obstruction of the air way and could be responsible for the shrill noise.

For any further queries regarding your kid at any time you may use this URL to contact me directly
WWW.WWWW.WW
In such a scenario the questions are directed directly to me and I would be more than happy to answer your queries.

Hope this helps.
Take care.
Above answer was peer-reviewed by
 
Follow-up: Toddler has tachypnea, respiratory distress and laryngomalacia. Breathing rapidly while passing stool 10 hours later
Thank you doctor. The local doctor has prescribed a bunch of medicines. As we know the kid has a condition, it is not an illness, I dont think medicines are necessary. Please let me know if I am wrong.

Here are the medicines:
Mecolin
Clavam
Sinarest
Dexia
Atrovin

Please let me know if we need to administer any of these.

Thanks
 
 
Answered by Dr. Y V Siva Sankara Murty 1 hour later
Hi,

Thanks for your reply.

If it is my baby I prefer to not to use any medicines.

And why should I suggest some thing else for your baby.

Just monitor your baby and let me know the progress if possible.

Unnecessary medicines will cause more harm then good.
Breast fed babies some times pass up to ten stools a day and some times do not pass stool for 3 or 4 days. Both are normal if the baby is other wise active.

I suggest you to give more of fore milk (milk that comes in the start of breast milk) Then change over to the other breast. This fore milk has got laxative effect and will increase the frequency of stool.

Monitor you baby's activity, feeding, respiratory rate etc. A baby who is feeding normally and active and passes urine around 6 times a day should be most probably a normal baby.

Hope this helps.
Take care
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