Digestion FAQ Archive

• Is it normal for a 9 month old on Nutramigen to always have loose bowel movements?
• My son is five months old and has bad reflux. Can you please give advice on what other solids I should start him on and when?
• My 16 month old had diarrhea for almost 2 weeks. Can teething cause such loose stools for this amount of time or has she become lactose intolerant?
• My (exclusively breastfed) 3-month-old will flail, scratch, and wail while trying to poop. Is there anything at all we can do to help?
• Should I try to wean my baby off the prune juice if I plan to start oatmeal cereal soon because he is acting like he is ready for it. Will this constipate him more?
• What can I do to remedy my son's struggle with gas?
• My ten month old is spitting up on a daily basis.
• I'm concerned that my 8 month old needs more fiber in his diet since he occasionally becomes constipated. When can I start introducing whole grains?
• How do you know when it is time to seek further help regarding issues with gas in a baby?
• Can cereal cause my 4 month-old to be gassy and irritable?
• My baby is just turning 5 months old and while she's eating well, her bowel movements are infrequent. Is she constipated, or is this normal?
• How can I treat my baby's constipation naturally?

My 9 month old daughter is on Nutramigen (about 28 ounces a day), and we adding 4 tablespoons of oatmeal cereal to two bottles daily. Is it normal for her to always have loose bowel movements?

It is difficult to answer this question without seeing the stool myself. However, children on Nutramigen often have loose stools, but not watery. If a child is on Nutramigen for a milk-intolerance, it is important to address the stool issue with your pediatrician or pediatric gastroenterologist as there may be an on-going medical issue. In addition, healthy children 9 months of age usually have their cereal by spoon rather than in the bottle unless there is a medical reason that they are unable to take by spoon.
 

My son is five months old and has bad reflux. We currently have him on Prevacid. He has been getting rice cereal mixed with his formula in his bottle since he was 2.5 months old. I have tried Oatmeal and Barley successfully as well (starting last month). Can you please give advice on what other solids I should start him on and when? Is fruit Ok to introduce after vegetables or too acidic since he has reflux? What about juice? Can I introduce it at six months? I appreciate your advice.

The type of food does not usually have any inpact on reflux in an infant. What does make the reflux worse, is when parents over feed their infant or feed them too much at one time. He should be paced through his meals and solids and liquids should be given as separate times (if he has GE reflux).
 

My 16 month old had diarrhea for almost 2 weeks. Can teething cause such loose stools for this amount of time or has she become lactose intolerant? She never acted as anything was wrong, eats normally, and has not become dehydrated.

Most cases of acute diarrhea in infants are caused by a viral infection (a "stomach virus"). Stool cultures detect bacterial causes of diarrhea and are "negative" when the infection is due to a virus.

Teething does not cause diarrhea.

It is quite common for loose stools to persist for a few weeks or even months after an episode of infection with a stomach virus. Occasionally, there is a temporary inability to digest milk (lactose intolerant) while the intestinal cells repair themselves. This lasts only a week or so. A common cause for persisting diarrhea is too much fluids. When the child becomes sick, they are not very hungry and we are told to give plenty of fluids. As the illness passes, the child could now be in the habit of drinking a lot of milk, water, or juice. The amount of fluid may be more than the intestines can absorb, so the stools are watery. Juice in large amounts can also cause diarrhea due to excess amounts of sugars and fluid.

If your child is not acting ill and has a normal appetite, be patient. Eventually the diarrhea will go away. If you think she is drinking too much (more than about 20 oz/day), cut back.
 

My (exclusively breastfed) 3-month-old will flail, scratch, and wail while trying to poop. At times she can rile herself up into a long, high-pitched screech. The behavior goes on until she finally poops (very loudly), or we distract her somehow. Unfortunately, this often happens at night, and interferes with her ability to soothe herself back to sleep. It's making nighttime really hard. At her 2-month appointment, my doctor said this is typical for babies before their GI tract is mature. How much longer will this go on? Is there anything at all we can do to help?

This can be normal as often babies will appear to be straining/uncomfortable when passing stool, but when the stool is passed it is normal in consistency. This is an immaturity of the GI tract and will be "out grown". Typically, however, it does not disturb a child's sleep and should not go on for a long time. Look for signs of constipation. If there is constipation (hard stool), treat that. If there is no constipation, you may want to discuss the possibility of a food allergy (allergic to something in your diet) with your pediatrician.
 

My 3 moth old son had problems with constipation as a newborn and his doctor had us add kayro syrup to his bottles. I just recently (1 wk ago) started him on one ounce of 50:50 diluted prune juice, once a day. He now has an easier time with his BMs and they are not as formed as they were. Should I try to wean him off the prune juice also? I plan to start oatmeal cereal soon because he is acting like he is ready for it. Will this constipate him more?

I prefer using prune juice rather than kayro syrup. An infant's stool should be soft - if not, they may need prune juice (or other high fiber foods) on a daily basis. If your child is ready for cereal and is prone to constipation, you should avoid rice cereal as it is binding. Oatmeal should be OK especially if served with a high fiber fruit. Baby cereal should be a part of an infants diet after 4-6 months of age as it provides the iron they need. If it leads to constipation, we don't stop the cereal, but rather we treat the constipation.
 

My 3 1/2 month old son has had quite a lot of gas day and night since he was born. He was fed milk based formula for a couple of weeks and then we switched to soy. He is still on soy. Is there nothing I can do to remedy his struggle with gas? We have tried the drops, feeding him upright, holding him upright after feeding, etc. It is just to hard to watch and wish there was something else to do.

It is important to use a nipple that is "slow flow" - when you turn the bottle over, the formula should come out one drop per second. Second, make sure he is upright when he is fed. Third, take frequent breaks through the feed. For example, after each ounce, pull out the bottle, put the bottle down on the
ground and stand with him- hold him up on your shoulder and straighten out his
legs. Walk around the room and wait some time for the formula to exit from his stomach. Walking around will take eating off his mind - staying in the seated position, he will expect to eat. After you wait some time, then go back and give some more formula. A given "meal" should take approx 40 min to complete. After the meal, hold him upright to help digestion. Avoid putting him down on a full stomach. If he is still fussy, he may need to see his doctor.
 

My healthy ten month old is crawling and pulling up and standing alone for short periods. He is breastfed and eats cereals and fruits/veggies well. However, he is still spitting up a little on a daily basis. I thought that this would pass when he was able to sit up. Anything that would seem to increase his diaphramatic pressure will cause him to spit up including, playing, being picked up less than gingerly and while straining to have a BM. Is this within the bounds of normalcy? Does this mean that he is being overfed?

Yes it is still very normal. Infants can spit up at his age. I cannot tell if he is being overfed from your question, but he may be having too much at once. For example, a child with reflux should not have milk and solid food at the same time. The milk and the solid food should be separated in time, for example:
* wake up - milk/nurse
* 1.5 hours later - solid break fast
* later in the morning - snack
* lunch - solid food
* afternoon - nurse/milk
* later in afternoon - snack
* evening - dinner
* bed time - milk/nurse

As a child gets closer to 1 year of age, he should take more solids and less milk. Of course, the solid food should contain protein, carbs and fat - not just veggies and fruit (veggies and fruit are good additions to yogurt, baby cereal, meats, poultry - but on their own are not enough for a meal at this age). Ultimately, the child's weight gain will determine if he is getting the proper amount of calories.
Also, you may want to bring some activities to the high chair so that he is not down / crawling / increasing his intra-abdominal pressure immediately after eating. This can be difficult if he is an active child, but it is worth a try.
 

My son is 8 months old. I am concerned that he needs more fiber in his diet since he occasionally becomes constipated. I currently feed him a variety of vegetables and fruits and baby oatmeal and barley. When is it appropriate to start giving him whole grains, such as wheat bread. Also, can I transition to regular oatmeal as opposed to baby oatmeal. Thank you.

A baby's fiber requirement is approximately 4-5 gms per day. This can be accomplished with grains, fruits and veggies. If you look at the label on the jar, you will notice the amount of fiber per serving. Whole wheat breads don't always have as much fiber as you would think. Most of the whole wheat breads that are high in fiber are often "grainy and nutty" which is probably too much for an 8 month old to eat safely. Of course if you find a high fiber bread that he can handle, that would be fine.

It is very important that baby's receive "baby cereal" as it is fortified with iron. Many infants around 4-6 months become iron deficient as they loose the iron stores that their mother gave them during pregnancy. In order to combat that problem, we highly recommend infant cereal only.
 

How do you know when it is time to seek further help regarding issues with gas in a baby? Also, is it normal for a baby's gas to smell very foul (like eggs)? I have not received very clear instructions from my doctor (she is newer in the field of family medicine) and wonder if you could shed a little light on this issue.

The passage of gas is normal in babies as it is in children and adults. It is important to evaluate the gas if it is excessive and/or resulting in discomfort. As far as the odor, it depends on the age of the baby. If gas is excessive or causing discomfort, it can be due to malabsorption or a food allergy vs. a normal process.
 

My son is 4 months old and we have recently started giving him baby cereal (sometimes rice, sometimes oatmeal). He seems to be gassy and irritable. Can cereal cause these reactions? [He is also allergic to milk and soy, but we made sure the cereal had no soybean additives].

In children who have food allergies or food intolerance, it is possible that they have more than on intolerance. Therefore, it is important to discuss this issue with your pediatrician or pediatric gastroenterologist as further evaluation may be needed.

In addition, the symptoms of fussiness and gas may be due to a separate medical problem other than a food intolerance. This should be discussed with your doctor.
 

My baby is just turning 5 months old. She is a tall baby and her weight right now is between 16 to 17 lbs. Diring the past 2 weeks she has gotten more hungry and I have been trying to keep up with feeding her. She is being breastfed. What worries me is that her bowel movements have become infrequent. Some days there is only one and other days--for example yesterday--there were none. She is urinating a lot as usual, however. I have started to give her cereal. Rice and Oatmeal as well as applesauce but after these new foods she became irritable and become constipated. Now I am not sure what I should do? Give her cereal or continue with breast milk. Because I pump I calculated that she drinks about 900 to 1000 ml of breast milk per 24 hours. Do you have any advice about feeding her?

It is common for babies who are fed only breast milk to have infrequent stools. Going every 3 or 4 days (or even once a week) is normal as long as the stools are soft or medium and not hard balls. In other words, we define constipation as hard stools and the frequency doesn't count. Sometimes, when solids are introduced, the stool consistency changes. According to tradition rice cereal, apple sauce, and bananas are most likely to cause constipation.

If your child is having infrequent stools that are not hard, do nothing. If the stools are hard, avoid the foods just mentioned. There are many remedies for constipation. My two favorites are 1: prune juice (undiluted, about 4 oz a day, then titrate) or 2:granulated brown sugar. Add one to two teaspoons to a bottle of expressed milk (4 oz); sprinkle some brown sugar on the cereal.
 

My son is 15 months old.  My doctor told us to give my son 1/2 teaspoon of Senokot every day to treat his constipation.  Will he be ok in the future?  Will organic food help him?  He does not eat fresh vegetables.  Please help me. Thank-you.

Sennekot is generally very safe to use. Eventually your child will no longer be constipated. Avoid binding foods (bananas, rice products, apples and apple sauce). Use only whole grain breads. Increase fiber (bran cereal, bran cookies, bran muffins, etc.; frosted mini-wheats). Also there is juice product called Nutrabalance which has added fiber. Granulated brown sugar and prune juice are also natural laxatives. You can add a teaspoon or two of the sugar to cereal, beverages, etc. throughout the day.

Few kids this age like their vegetables. Avoid giving foods he doesn't like and avoid all struggles over foods.