Dear Donna Corrieri,

It is hart to tell what is happening to your patient.
Keep in mind that at 33 weeks the gut is still not fully developped and
it is very possible that this baby has difficulties absorbing large
amounts of lactose.  It would help to know how much this baby is taking
at any one time.  The baby may also be allergic.  But you would think he
would do better on breastmilk and the worst on similac.

About the test looking for sugar in the stool, it is very helpful and
frequently used.

You mix some stool with water and put a clinitest tablet in the solution
(same tablet used by diabetics to check for sugar in urine).  If tablet
shows sugar it has to be lactose.  If more than 1% usually significant
and indicates lactose malabsorption.

It is very possible that this may happen in this baby and that the feeds
need to be advanced slowly.  However the blood in the stools worries me
and in a premature one should always think of necrotizing enterocolitis
especially if baby also very distended.

Hope this helps

Maryelle,MD
Little Rock