Frequent Stool Passing of my baby

My baby is 1.5 year old. Weight 12 kg. Birth weight was 3 kg. He took exclusive breast milk up to 6 months and then up to 1 year he breast fed occasionally. Now he is on formula milk(NAN3), corn flakes, khichuri, rice and lentils. He passes stool 6-8 times a day for 2/3 days. Next day it stops and reappear after 2/3 days. This is happening from January 2016. There is no blood mixed with stool but some undigested food particle present with foul smell. Semi solid in 60% cases and watery for 40% cases. No vomiting tendency and abdominal pain observed. Stool R/M/E was done two times. Here is the latest reports. Rota virus vaccine has been taken.

Can you please advise me about his treatment.

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Author Info

APOLLO BISWAS

Comments ( 2 )

  • Dr. Kamrunnaher shultana

    You have provided almost all essential information nicely. When a child gets diarrhoea of short or long duration, physician firstly search for infection. So stool R/M/E and a culture is usually done. If infection is proved, antibiotic or antiprotozoal drugs are given. Stool R/M/E report of your baby does not suggests infection. Stool culture was not done which could provide more specific information about infection. It can be toddler’s diarrhoea. It usually happens in children of six months to five years of age, usually presents with – chronic diarrhoea (loose stool for more than 14 days with non diarrhoeal episode for more than 48 hours), growth is never hampered, stool is loose without any visible blood, containing undigested food particles, having foul smell, no vomiting or abdominal distension, stool c/s proves no infection. So I will suggest an stool culture from a reliable lab(Mohakhali Cholera Hospital, ICDDRB). Toddler’s diarrhoea is caused by intake of less amount of fat( less than 3gm/kg/day). It resolves by 5 years of age. Needs only dietary support like plenty of fluid, fibers intake with adequate amount of fat and to take less fruit juice. Probiotics can also be used. Another diagnosis that came to my mind is chronic diarrhea due to food intolerance (milk/cereals) or infection ( Rota viral infection should be ruled out). In case of food intolerance dietary avoidance of the offending food is enough. Rota viral infection is treated with adequate fluid therapy. Supplementation of essential nutrients is important in both cases. Your baby is vaccinated against Rota. At this stage dietary intervention is most important. Continue breast feeding. Stop giving formula milk, corn flakes. If it is mandatory to give formula then you can use soy protein based formula like ‘Pregestimil’ (never use feeding bottle, use cup and spoon) or yoghurt. Among fruits, give only banana, apple and coconut water. Freshly prepared homemade food like khichuri(rice, lentils, chicken/ egg/fish, green banana /potato, adequate soy been oil) is well tolerated during diarrhoea. Try to find out which particular food is creating the problem. So use one (either egg or chicken or fish/ banana or potato or papaya) in a day and observe the stool. This will help you finding the offending food. One issue you did not mention whether your child is gaining weight or not? If weight gain is satisfactory, no matter how long the diarrhoea persists. Vitamin or micronutrient deficiency should be treated as well. If your baby does not improve after all these, you better consult paediatric gastroenterologist.

  • Dr. Kamrunnaher shultana

    Your doctor has given you a very good advice. Complete the treatment prescribed by him. Don’t forget my suggestions also.

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