Dear Jan,

More info, please.  Is this baby thriving?  Is this baby on solids yet?  Ingesting any formula?  Bottom has been red since birth or more recently?

Breastmilk stools are naturally slightly acidic.  Too much lactose relative to the amount of lactase available in the small intestine can lead to even more acidity due to fermentation of lactose in the large intestine.  This can be the result of the overwhelming of available lactase due to oversupply, decrease in lactase due to damage to the brush border which can happen after gastroenteritis or irritation from allergies (most often dairy), or a primary lactase insufficiency (very rare in babies). The solutions are varied, according to the cause:  treatment of oversupply leading to the ingestion of breastmilk with an increased percentage of fat, recovery from gastroenteritis and/or manipulation of the moms/babys diets to eliminate possible allergens.  Some people have had luck with giving bottled breastmilk to which Lactaid drops have been added as a bridge until damage has been repaired or other factors brought under control (instead of the usual soy formula, which is lactose-free).

Is the red bottom the only symptom?  Is it possible this baby has a yeast or other skin infection?

I would imagine that there are probably some metabolic disorders that could also lead to a change in intestinal/stool pH, but there would be other symptoms as well.

Hope this helps in the absence of other information.

Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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