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Pediatrics/Re: Infection & baby food

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Question
Dear Doctor,

My daughter is 7 mths old and weighs 6.7 kgs. Her was born on 09-08-12 prematurely at 34 weeks with wt. of 1.48 kgs. She is very active and has achieved all milestones till now. Her wt at 5 ½ mths was 6.4 kgs
About 20 days back she suffered from stomach infection (routine stool examination done) as a result of which her bottom would turn red and painful upon her passing the poop. She had no problem at the time of passing her stool, but would cry when she was being cleaned and also when the skin would come in contact with her urine. Her infection was treated by giving oral medicines and applying ointment – nizral & sofradex-F for a course of 5 days. Her doctor said that it is food or water infection.
Based on her doctor’s consultation, apart from breastmilk we starting giving her wheat cerelac (consistency between semi-solid & liquid form) 1 spoon a day, gradually increasing to twice a day soon after she turned 5 months as I had to resume office shortly and she was not happily taking milk (NAN 1). She was digesting the same. When she turned 6 mths, we gradually started giving her other foods, introducing one item after a gap of 4-5 days and now her schedule is as under:
Morning- Formula milk (switched from Nan 2 to Simalac Advance 2 as advised by her doctor)

Mid morning- 2 spoons of Ragi Malt or Sattva cooked in water and then mixed with milk (buffalo or formula) – semi-solid consistency

Afternoon – Rice and Moong dal khichdi – with little ghee and jaggery – semi solid to liquid consistency

Mid-evening – Banana milkshake

Late evening – Breast milk

Night - Wheat cerelac 2 spoons

Milk for rest of the time whenever she is hungry.

We also have tried giving her little mashed potatoes, melon juice or mix vegetable juice with dal water.

She does not like anything that is in liquid form, be it milk or plain water. Her milk consumption is also very less around 125 – 150 ml a day  

Recently, last 2 days back, her bottom again become red & painful and we applied sofradex F cream for 2 days and it has healed.
1.   Is her weight OK. Her weight in the last 1 ½ months has not increased much. What could be the reason?
2.   What could be reason that her bottom turns red – is the infection not gone or is it because of hot weather or her taking less water?
3.   Is her food intake ok or what additional things can be given to her
4.   Can we clean her tongue because it becomes white as she takes food. Her doctor has advised not to clean the tongue as it can cause meningitis

Thanking you in advance for the reply.

Answer
here are answers

1. Is her weight OK. Her weight in the last 1 ½ months has not increased much. What could be the reason?
==at present weight is fine.. and not gaining is no good. you may need to stress on milk free feeds.as milk kills appetite and is less nutritious after age 6 months.

2. What could be reason that her bottom turns red – is the infection not gone or is it because of hot weather or her taking less water?
===at times it can be fungal infection due to moisture but if it is just red and no rash it may be due to straining at stools. if it is painful .. stop using diapers likely to be sensitive skin or allergy.

3. Is her food intake ok or what additional things can be given to her
== i feel she may not be able to digest wheat and milk. try a lactose free formula for 2 weeks and observe weight gain.

4. Can we clean her tongue because it becomes white as she takes food. Her doctor has advised not to clean the tongue as it can cause meningitis
==== usually not needed to clean unless you find some evidence of infection or white fungus.

welcome

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