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Pediatrics/Reducing substance +ve in 5 month old

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QUESTION: Dear Doctor,

My 5 month old baby has been tested positive for mucus, acidic reaction and reducing substance. Everything else came back negative. This test was instigated because we have been green stool for about a week. It was mucusy and pasty.

I dont know what this report indicates. I had the report checked by one of the local doctors and told me that he is not being able to break the suger in the breast milk. I wasnt very satisfied with the answer.

Anyway, please kindly help me in understanding what the report result means and whether a baby can be lactose intolerant. Also I would really appreciate if you could tell me if this is a temporary issue or a chronic one.

Thanks and eagerly waiting for your advise.

Thank You.

ANSWER: Hi, Intekhab,

A lot of this depends on the formula or breastmilk fed.  If a baby is nursing and gets predominately the lactose rich, fat poor foremilk, then green stools can happen.  This is called a foremilk/hindmilk imbalance.  

Babies aren't completely lactose intolerant, for that is the sugar in breast milk.  They can be relatively intolerant, and this is why a overload of lactose can cause stool changes.  The green stools for a week just could be due to a temporary viral illness.  Give me some more information and I can help.

Good luck, Dr. Olson

---------- FOLLOW-UP ----------

QUESTION: Thanks for your response Dr. Olson.

My baby is exclusively breastfed and we have NEVER tried formula. We are quite adamant about NOT giving formula to our baby which is why he has not been trained with the bottle even.

My baby only pooped green stool in the early days of breastfeeding when he was only receiving foremilk as the baby was not being able to latch on properly, hence my wife was only able to feed for short periods due to cracked nipple. Until about couple of weeks ago, my baby pooped YELLOW stool. So, for a good 3-4 months he pooped YELLOW stool.

Both me and my wife check the baby's temperate and it is normal. He does not have cough or blocked nose, so cold is perhaps not the reason for green stool.

Very recently he start sucking on his fingers and toes which he did not do before.

My wife has lactose free milk every morning with oat meal. Can this be a reason? However she has been having this for a while now.

Few weeks back my baby had inconsistent bowel movement. He used to poop for 4-5 times a day and then suddenly it went down to once every 3-4 days where the stool was thick and pasty. And then after few days of low frequency, thick and pasty bowel movement he went back to once a day with GREEN and MUCUS filled stool which is a little less pasty.

I cant think of anything else at the moment. Please kindly ask me if any further information is required.

Answer
Hi,

Thanks for the additional information.  I find that in other parts of the world, the stool test for reducing substances is done often, but generally, at least with the pediatricians in my practice, we seldom use it.  Gives you some pretty non-specific information.

If he is thriving, growing and developing well, then whether the stools are green or other colors probably doesn't make a difference.  If the green stools are persisting in an otherwise healthy infant, I really don't do anything about it.  

Mother eating or drinking whatever wouldn't cause this.  

I tend not to do too much looking re stool colors in healthy infants.  Reading your two reports, it sounds like he is healthy.  If not, please tell me.

Good luck, Dr,. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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