Gut
QUESTION:
My 5 week old has just started on Aptamil Gold formula after complications with breastfeeding. She seems so unsettled now. She has a lot of wind, constantly cries (high pitched cry) bringing her legs up so I’m assuming colic?
Any suggestions would be great. We really hate seeing her in so much pain.
It’s been a couple of days since that message and I’m considering on changing formula like you said might help 🙂 I’m just so lost doctor. She constantly cries and seems so unsettled and in pain. Apart from changing formula to a colic formula is there anything else I can do to help her?
ANSWER:
Dear V,
Thanks for your question and for visiting Kids Consult.
You could certainly try colic drops (of which there are many, and none better than any other) to see if that helps relieve wind. They are very hit and miss.
Secondly, if you wanted to try changing formulas, you could move to S26 Delicateeze or Nan Comfort - both are lower in lactose which can help alleviate lactose overload issues causing excessive wind.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop
My baby is 14 months old. She always had a problem with colic, wind etc. We always had to keep her up, massage her stomach, bicycle legs etc. She also had silent reflux for which she was medicated. Now, especially during the night, she can’t go back after breastfeeding to sleep until she can get rid of the wind. But she is tired and she wants to lay down but will cry because of the pain. We haven’t been eating dairy, eggs or meat as she was told to put that away.
She got kind of better but now this is back again. Not sure what to do or how to help her - she wakes up a few times during the night as well and wants to eat which of course creates more wind. Any advice how to help her? Thanks in advance
ANSWER:
Dear S,
Thanks for your question and for visiting Kids Consult.
I wonder if the fact that she is feeding overnight is the whole cause of her symptoms? I would strongly advise not feeding her overnight, and using sleep settling techniques to re-settle her instead.
In terms of intolerances, you are doing the right thing with avoiding dairy. I'm not sure you need to avoid eggs and meat.
It would be worth considering other intolerances such as Coeliac Disease, which might be causing recurrent gut symptoms - your GP should certainly review her and can arrange blood tests accordingly.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop,
I have a formula fed baby but he only has a dirty nappy once every 5-6 days. It's the consistency of peanut butter. His GP has checked him over and asked if he had bowel movements in the first 24 hours of life etc. She has concluded that he just has a slow bowel.
Will a HA formula help him become more regular?
He is 4 months old. Thank you.
ANSWER:
Dear B,
Thanks for your question and for visiting Kids Consult.
The stools you describe are completely fine from my perspective. If he has significant pain when stooling, or they are becoming dry and hard, then that's constipation and I would treat it, but I wouldn't do anything with your son.
There is nothing about a HA formula that will guarantee the stool change you want. Changing to any different formula will likely change the stools, but if he is feeding well, don't risk mucking around with the feeds to try to achieve a stool that is more regular - it's not necessary.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop,
I have a 12yo boy. He was diagnosed at the age of 6 with ADHD. For about 6 years he was taking Ritalin and has now been on Concerta for the last 18 months. During all this time he has also been taking Clonidine to help him sleep. For the last 12 months he has suffered from bad constipation to the point where he was compacted. He was started on Movicol daily. That was 2 months ago and he is now compacted again. He has been put on Movicol, Parachoc and Metamucil to try and help him move his bowels.
I’m worried as he is so young that he needs these to help him to pass a stool. I’m worried there could be something else wrong that has been missed. In the last 6 months he has also been diagnosed with scoliosis. Any information would be great.
ANSWER:
Dear M,
I saw a teenage girl in my office today who was exactly the same.
The bottom line is that his constipation needs to be treated, and unless you give him laxative, it's not going to get better. So the treatment combination is a good one. I would normally treat him for 6-12 months of daily laxative to ensure complete resolution, given he has had symptoms for so long.
In terms of potential underlying issues - it would be important to ensure his lower spine looks normal, and that Coeliac Disease and an underactive thyroid have been excluded on bloods.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop,
I have a question about breastfed babies and stools. My 10 week old daughter is exclusively breastfed and hasn’t passed a stool in over 2 weeks now. She went 8 days at around 8 weeks before stooling, then stooled for a couple of days but has stopped again. I have been told/read it can be quite common for EBF babies to go 10-12 days without stooling and that it is really uncommon for them to get constipated but I am now starting to get concerned that there may be something wrong as it has been close to 14 days now without a motion.
My first daughter only ever went a week without a stool then went back to every 2-3 days so should I be concerned or just wait it out? Thank you, K
ANSWER:
Dear K,
Thanks for your question and for visiting Kids Consult.
It's certainly true that breastfed babies can stool infrequently, and if they are not showing any signs of discomfort or irritability, and the stool when it comes is nice and soft/loose, then there's not much to worry about. They tend to become more regular over time.
If you wanted to hurry things up a little, I would recommend 20ml cooled boiled water with 1/2 tspn brown sugar a couple of times a day until you get a result. Alternatively, I think it would be fine to continue watching for a few more days if she looks well otherwise.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop,
I have a 10 month old daughter who is currently taking Amoxyl for a chest infection.
Should I be giving her probiotics as well? My GP wasn't sure. Thanks so much for your time J
ANSWER:
Dear J,
Thanks for your question and for again visiting Kids Consult. Your question is a very good one!
Two recent studies have looked at probiotics in a randomised way. Both found that in some cases probiotics can be helpful, in others they do nothing, and in others can cause adverse reactions.
The bottom line is we don't know! So, until we do know that something is of benefit, and does not cause harm, I'm reluctant to recommend them.
Regards,
Dr Scott Dunlop
Consultant Paediatrician
QUESTION:
Dear Dr Dunlop
My 2yo daughter has recently had a few ear infections and tonsillitis requiring antibiotics.
Should I also give her a probiotic for her gut health? Many thanks, S
ANSWER:
Dear S,
Thanks for your question and for visiting Kids Consult.
The jury is definitely still out when it comes to the benefits of probiotics. I generally don't recommend them due to the lack of good evidence.
A recent study looked at gut samples of adults taking probiotics and found that in many patients the probiotic simply passed straight through, and in others impaired the return of normal gut flora. This was looking at samples of colon on endoscopy as opposed to most other studies that look at stool content.
Long story short - in my opinion, save your money until the evidence is much better.
Regards,
Dr Scott Dunlop
Consultant Paediatrician