We have been discussing infrequency of stooling.  I had a call today from a
mom with the other end of the spectrum.
Baby is 6 weeks old.  A couple of weeks ago the baby had a bout of "diarrhea"
(mom's definition).  Baby had stools 8-10 times per day.  She took the babe to
his pediatrician who said the baby had a virus and told mom to give Pedialyte
every other feed *instead* of breastfeeding.  I know...I know...
Baby seemed to get a little better, then had another round of "diarrhea" and
gassiness.  She called the LC that time.  The LC asked her about foods mom was
eating, so she kept a food journal, but couldn't seem to see any correlation
between her diet and stooling and gassiness.
The LC called me a few days ago for other ideas.  I asked if she had seen the
stool or asked about smell or color and she said no, so I was suspicious about
whether this even was diarrhea or just an increase in stooling for some reason
(growth spurt perhaps?).
The mom called me today.  She does eat a lot of dairy products, and nurses the
baby on both sides, so I thought cow's milk protein allergy or maybe too much
foremilk/lactose.
But then I asked her to describe the stools to me.  She said normally it is
mustard yellow and grainy.  When he has these episodes of diarrhea it is
*brown* and seems to have "separated" with "water" on top of it.  The mom
reports that during these times he will nurse for a moment then pull off and
cry and be gassy.
He has had nothing but breast milk and the Pedialyte.  No history or symptoms
of thrush.  No vitamins or fluoride.  He is gaining well.
So far he has had two rounds of this diarrhea and gassiness in the last two
weeks.  Mom is not aware of his having been exposed to anybody with diarrhea.
He is the first child and neither parent has been sick.  He's not in daycare.
She has only been nursing him every three hours.  I suggested bf more
frequently, keeping him on just one side til he's done, eliminating the daily
bottle of expressed breast milk that dad has been giving him, and just put him
to breast.  I suggested cutting out dairy since mom states she drinks a lot of
milk.
She is taking him back to the pedi tomorrow.  I discussed it with my husband
(an adult gastroenterologist) and he suggested a stool culture for bacteria,
parasites or malabsorption problems, which I relayed to the mom.  I really
don't want to escalate this to the pediatric gastroenterologist and invasive
tests if we don't have to.  Am I missing something?
Cynthia D. Payne
LLL of Berkshire County Mass.