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6 months child constipated with small amounts of blood in stool. Feeding nan pro2, juices and semi-solids. Advise ?

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My son is a little over 6 months now. Due to my wife's problems with breastfeeding ( low milk volumes), we started with nan pro 1 from birth and things went on smoothly till about a few days ago. We switched over to nan pro 2 ( a gradual transition as advised by the ped doc, over a period of 1 week. At the same time we started of with juices ( pomegranate, apple) and semi- solids as well - banana with nan milk, banana with nan curd ( made of nan milk), dal khichadi mashed.

The issue is that a couple of days ago he started getting constipated with small amounts of blood in the hard stool.

Is the bleeding and constipation a problem of nan pro 2, did we transition to pro 2 faster or is it some issue with the semi solids. Please Advise

What do you suggest we do with the formula milk and solids. What types of semi solids are preferable?
Posted Fri, 22 Jun 2012 in Child Health
Answered by Dr. Santosh Kondekar 1 hour later

I understand your concern. here is my explanation for the issues mentioned above.

having less volume breast milk is 99% times just a "felt" problem , if the baby is gaining 500 gm weight a month, then having less milk is not true. Often as baby weight rises in first 2-5 months to near double the birth weight, he empties breast very fast and that makes mom feel that she may be having less milk but it is not true.

infants need breast milk at least till 1 year age , it has some protective and psychological benefits.

When kids are given formula milk, most such formulas especially the "2" (even "1") are usually XXXXXXX in phosphates; that does result in hard stools.
Hard stools make child uncomfortable and when stressed against rectum, do cause some pain and bleeding. Pomegranate is known to cause constipation, so may XXXXXXX Banana chikoo pineapple may not.

Is the bleeding and constipation a problem of nan pro 2,
===== related to some extent.

did we transition to pro 2 faster or is it some issue with the semi solids.
=== not exactly. transition should be from 2 weeks to 2 months depending on child's acceptability

If possible, try to understand the concept of introducing natural solids.start with fruit juices, thick soups/porridge etc with home based preparations with rice flour, ragi flour with salt/sweet and liberal ghee/curds. Initially introduced as small amount like medicines and then gradually increased over weeks in quantity and thickness.

After another two months child may accept mashed feeds with banana, boiled potato/egg etc. (read details at feeding advice , (also download free feeding booklets from the links at that website)

Those who want an easy way out go after changing formulas from nan to lactogen to enfamil to cerelac/nestum rice or to soya based etc some babies do get suited with one of them, often with nestum rice.

Once constipated , treatment is not easy. it involves
1. diet modifications as above with less proteins (toor daal, top milk causes hard stools) and avoiding XXXXXXX pomegrante etc for short phase
2. add liberal curds/ghee
3. may need stool softners like lactulose syrups
4. frequent enemas or suppositories under medical advice
5.anal relaxant/pain killers like xylocaine jelly or glycerine

All these may be titrated with individual seriousness of the problem as felt by the treating doctor. treatment and response can be intermittent over a month. you may read some details about childhood constipation at my article at a site

I hope this clears your concerns. feel free to revert back. thank you .
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