Patient's question:
My baby has had issues since birth. After passing meconium, his stomach hasn't been doing well. Diarrhea has persisted for nearly a month. After taking Smecta and Bifidus for a while, his stool consistency improved—it no longer separated like before—but he still doesn't have formed stools, and they remain very loose. The frequency is extremely high (it's impossible to count how many times he goes), almost every time the diaper is opened, there's poop. Each time he defecates, it's just a little bit, and he uses nearly fifty diapers a day. Sometimes even when passing gas, there are poop particles. Every time he has a bowel movement, it looks very difficult. I wonder if my baby really has poor digestion? What medicine can help relieve his symptoms? Please kindly ask the experts for an answer!Doctor's answer:
For children with diarrhea, I have the following summaries and suggestions, hoping they will be helpful to you:Diarrhea: It is characterized by an increase in bowel movement frequency and changes in stool consistency (such as loose stools, watery stools, mucus stools, or blood-streaked stools, color changes, etc.). If a child’s original stools were ribbon-like but are now pasty, it is still considered diarrhea. The most common causes of infant diarrhea are indigestion and intestinal inflammation.
Generally, if a child’s stool contains bubbles, it often indicates indigestion. Only when a child’s digestion is poor and food residue increases, fermented by bacteria in the intestines, will the stool contain bubbles. Additionally, bubbles in the stool may also be related to a child crying for too long and swallowing excessive air.
If the child also has vomiting, and the vomit has an acid odor or contains undigested milk curds, or if there is abdominal distension (the child’s abdomen is higher than their chest when lying flat), and the stool contains bubbles but no mucus or blood, with stool frequency only increasing but the consistency remaining yellow or slightly greenish and pasty, or watery and mushy, it is likely indigestion. In this case, you can give the child some digestive water to help, or probiotics like Mammai Love to adjust the intestinal flora, or anti-diarrheal medications like Smecta.
If the child also has severe vomiting, even vomiting immediately after eating, or intermittent crying that can be relieved on its own, with significant changes in stool consistency, such as being like egg drop soup or watery, or containing mucus, it is more likely to be intestinal inflammation. This requires immediate medical attention, and a stool test can help diagnose it.
If the child has persistent crying during diarrhea and appears lethargic, and the stool is tomato-juice-like, it could be a sign of intussusception. If the stool also has a very foul odor, it could indicate necrotizing enterocolitis.
Some children may also develop diarrhea after drinking cold tea. If the child has indeed consumed cold tea before the diarrhea, the likelihood is higher. It is recommended not to give the child excessive amounts of cold tea in the future.
Additionally, improper introduction of solid foods can also cause diarrhea, such as adding them too quickly, too much, or too early.
In terms of care, it is important to note that when a child has intestinal inflammation, their digestive function may be affected. In this case, you can give them pepsin or compound starch enzyme solution to help.
If the child is formula-fed, it is recommended to use a diarrhea-specific formula. If it is not available temporarily, dilute the milk slightly. If the child is breastfed, consider whether the mother’s diet may be the issue. The mother’s diet should focus on being easy to digest, nutritious, and light. If the mother’s digestive function and stool are also poor, it is recommended that she take probiotics like Chang Le Kang or Peifeikang to restore the balance of intestinal flora, which will help the child recover.
I advocate treating a child’s diarrhea with a "mother-child approach."
Additionally, because frequent bowel movements will certainly cause discomfort to the child’s bottom, it is recommended to avoid wrapping the bottom too tightly while ensuring the child does not get cold. When cleaning the bottom, it is best to use water rather than a cloth. If using a cloth, avoid rubbing and instead gently press, as the child’s delicate skin is prone to breaking, which can cause severe crying. If the child is crying uncontrollably, check to see if the skin is red, as this indicates discomfort.
To prevent this type of diaper rash, you can apply a layer of ointment, such as tetracycline ointment or eye ointment, after each cleaning. Also, change the diaper promptly and let it air out to prevent the ammonia released during decomposition from irritating the delicate skin.