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Pediatrics/Bacteria++ & Related 8 months

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Respected Sir, I have been through all your blogs, reviews, website recently. Gives me the feeling, I am at the right place. I hv had 1 MC b4 my son ws born at 37weeks with 2.9kgs, hence I am a super worried mom, as you can understand.

He has been healthy and hyperactive since 7 months. He is 8months 2 weeks now. There has been 2 episodes of diarrhea recently. The first one was diagnosed with lactose intolerance,on his stool routine.He was given Toxim-O and enterogermina. I breastfeed him with the semi solid that he ate without any formula feeds for the time been. Later his ped, suggested me with Isomil.

He is more of a breast feeder, he can stretch for hours, with only breast feed, his weight is 8.16kgs and seems to increase now. In the 2nd episode, he passed green stools, with explosion and lot of pressure, though it was watery and it happened only with every breast feed that I offered. Hence, ped, asked me to quit breast feeding and put him on Isomil with other foods. As he denied to favour this situation, his anxiety and crying, forced me to restrict breast feed to 4 hours for 10-20mins. His stools were so bad, that he developed burns on his rear.

His stool routine showed RS-present, with no blood, pus and bacteria - ++ Thus ped gave him DIOF for 5 days*2tyms, zinc,zymosaf, eterogermina with other regular vitamins. She said that RS should hv nt been there so far. His condition didnt change, hence she switched to Toxim-O after 3days, and she asked me to quit after a single dose of Toxim-O, sending his stool for culture, routine.

2nd report - no bacteria found after culture.
Routine - alkaline, soft, vegetable cells-+,bacteria-++, pus cells-1-2hfp,occasional rbc's, blood present

He was also passing blood in his stools, she prescribed anvate, and its gone. Now, he didn't pass stool for a day and he strains to pass soft stools.

My queries:His wi8- 8.16 b4 diarrhea, abt 8.5kgs now
1) Even though no bacteria cultured, what does bacteria-++ mean?
2)Do we have to repeat the test, as he had just quit antibiotics? Did this modify his culture? If yes, after how many days?
3)What is it? Secondary lactose Intolerance? or Milk protein allergy? As ped, eliminated diary from my diet and his Isomil as well.Last one, we quit enfamil.
4)His stools stopped for Isomil discontinuation or Toxim-O?
5)How often to breast feed him, for he looks constipated and denies much of water? Ped says give ample, I am sacred this mi8 take him to a 3rd episode.Is it constipation? cz I have read abt stuck colon?
6)WHY DID this repeat? Is this something very serious without cure rather prevention?
7) Discontinued antibiotics?
8) what to look for in the near future? symptoms.

I am sure, I am looking forward towards a ped, who will understand my worries. Apologies for the long one.

Thanks & Regards
Sonam
India

Answer
Dear Sonam
Sorry for late.
here are exact replies:

1) Even though no bacteria cultured, what does bacteria-++ mean?
it just means they saw some bacteria I(may eb normal) but they did not grow.. means no serious bacterial load.


2)Do we have to repeat the test, as he had just quit antibiotics?
-- no unless symptoms or course not completed.
Did this modify his culture? less likely as it was just ++.
If yes, after how many days? if yes.. nothing certain.. but usually in 2 days.

3)What is it? mixed. infection > plus intolerance > feed related
isomil may be seen causing blasty loose stools and greenish, and often infectiosn cause bacteria and blood.

Secondary lactose Intolerance?
yes.. because RS test positive, but it can be due to any undigested sugar in feed/formula or milk.
or Milk protein allergy? unlikely


4)His stools stopped for Isomil discontinuation or Toxim-O?
as it were infection with bacteria , primary response was due to antibiotic diof/taxim o in this case.

5)How often to breast feed him, for he looks constipated and denies much of water?
=== start on feeds complementary cereals as he is 8 month old. 6 feeds total in a day should be enough at this age and weight. each feed of say apppx 150 calorie and ml

Ped says give ample, I am sacred this mi8 take him to a 3rd episode.?
apple? pref avoid. ample feeds.. yeah u can.

Is it constipation? cz I have read abt stuck colon?
most formula babies develop constipation and often have some sugar indigestion.

6)WHY DID this repeat?
second was more associated with formula. common have disturbances with formula.

Is this something very serious without cure rather prevention? no serious. but can repeat any time later too due to feed contamination, putting fingers in mouth etc

7) Discontinued antibiotics? do nothing for this ate present. may eb it was a good decision and might have proved light infection or no infection.

8) what to look for in the near future? symptoms.
regular stools per day and regular good urine at least 2 times in 12 hours.

read more at kondekar.com on loose stools

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