C.G. asks from Kansas City, MO on November 30, 2010
Blood in Vegan Infant's Stool
I apologize for the long post, but I have been doing a lot of research and it doesn't seem like the other posts quite cover our situation so I am going into great detail. My son is 15 weeks old and has had traces of blood in his stool for about 6 weeks now. The doctor's first suggestion was that it could be due to a fissure, but we haven't been able to find one by visual inspection and the blood has not gone away after using a prescription cream to prevent/heal fissures. He has been exclusively breastfed since birth. I have been vegan for 10 years, so I'm pretty sure that the bleeding is not due to a milk protein allergy/intolerance. I don't eat dairy, eggs, or meat, and I have tried cutting out soy and wheat for over a month and the remaining top allergens (corn, nuts, tomatoes, citrus fruits) for almost two weeks now and I haven't noticed any consistent improvement. This whole six weeks the blood has been erratic. He'll have it one diaper and then not the next. Sometimes it is two or three diapers in a row and then not for a few diapers. When it shows up, sometimes it's just the slightest of specks, sometimes it's streaks and sometimes it's mixed throughout the stool. His stools alternate between bright green and yellow/brown/orange and he has one about every diaper (this has not changed since birth). He is an extremely happy baby and only cries when he is hungry. He strains sometimes when having a bowel movement, but shows no signs of pain and the stools are always loose like breastfed stools are supposed to be. He was just under 8 pounds at birth and is now up to 17 pounds at just shy of 4 months, so he has had no problem gaining weight. I haven't seen any other symptoms of allergies/intolerance; he isn't' gassy, he's not in pain, has no rashes, his skin is not excessively dry, nothing special seems to happen right after he eats. He spits up occasionally, but he is a baby, and it is nothing like the bouts of vomiting we had in his first few months (he has some issues with reflux). He has been a bit congested lately but he did pick up a cold from me a few weeks ago and I think it's just the tail end of that. I do not want to put him on formula or undergo invasive tests unless we have absolutely no choice. Can anyone help with what this might be or what experience they might have had with this kind of issue, please?
More info in response to some of the early answers/concerns: He has been to the doctor about this issue several times, starting two days after we first noticed it. We have been back a few times and are trying the elimination diet with the blessing of our pediatrician. We will be testing for e.coli and salmonella next. As much as I value the wisdom of other mothers out there, rest assured that I would not attempt to deal with this without medical supervision. I'm just trying to do my own research as well. He is not on any supplements of any kind. The blood is bright red but little enough that the doctor is not all that worried. I have not been able to find any cracks in my nipples and I never see any blood in my milk when I pump occasionally. He is not circumcised. The blood is not "currant jelly" like they warn about for intussusception and the doctor says his bowel sounds are great every time they check him. We cloth diaper and had a small problem with a diaper rash from ammonia, but got that worked out within a few days and he has not had any diaper rash for weeks.
So What Happened?™
Thanks so much for all of the responses and your kind thoughts. I will continue to update this as things progress, but for now I have cut out basically everything that was left and am pretty much on the total elimination diet (minus the turkey, of course, so that leaves rice, squash, and pears to which I have added figs and potatoes). It's too early to tell if it's working and my pediatrician's office is being difficult about a referral to a GI specialist at Children's Mercy hospital without first having done a formula trial. We'll keep at it and hopefully soon I will have something more concrete to update.
Update 05/2011: We saw a GI specialist who also suggested an allergy and switching to formula. We put it off and put it off and the bleeding just went away on its own at about 4 months old. (We never did get them to test for any infection.) I'm back to my normal diet and we haven't seen any signs of it since.
More Answers
H.S. answers from Cincinnati on November 30, 2010
Umm forgive me for being rude...He's 15 weeks old and has had blood in his stool for 6 WEEKS???? It could be a number of things and you've ignored it? Well you do have absolutely no choice but to seek medical help. Good grief!
3 moms found this helpful
M.K. answers from Kansas City on November 30, 2010
ANY BLEEDING IN A 15 WEEK OLD INFANT IS DANGEROUS IF YOU DON'T KNOW THE CAUSE OR SOURCE!!!
I don't have a good answer, just some suggestions. The Dr has seemed to rule out fissures and I agree it doesn't sound like allergies. Is the Dr not worried? Did you have an occult blood test done just to be 100 % sure it's blood and not something else? Color matters! Bright red or black? Each indicates different issues. I personally believe you are down to possible invasive procedures, there is really no getting around it. First, I would ask the Dr to order stool cultures for bacteria and parasites. You don't eat eggs, but it is possible baby could have been exposed to salmonella or something else. This would be the least invasive. Next comes scopes, ect...I say persist with the Dr to figure this out!!!!
2 moms found this helpful
E.Z. answers from New York on November 30, 2010
I would definitely take him to a Pediatric GI. They can begin with a stool test (so bring some to your first appointment) and I would also suggest having an ultrasound to see if he has any abrasions internally. I don't think it is anything you are eating and I would continue breastfeeding, it does sound like there may be something internally in one of his intestines.
Good Luck! Let us know what happens.
2 moms found this helpful
S.P. answers from Los Angeles on November 30, 2010
What did the lab tests find?
Is this fresh blood? RBCs, etc.?
or simply reddish staining without major blood components?
If child is pooping many times a day,
have you done any charting/journaling
regarding what you have just previously eaten
versus what's showing up in his stool?
Since he's generally happy and not showing signs of pain,
is gaining weight appropriately, I totally agree with you
regarding not wanting any invasive procedures.
And of course you shouldn't stop breast feeding.
Yikes!
Have you checked in with La Leche League?
Y'never know what situations
they may already have encountered over the years.
FWIW, if they decide it's necessary to do any scoping exams,
your baby will be sedated and the people who do this kind of exam
will not be LEARNING on your child.
They will be experienced and competent.
They got into this field because of their love and caring for children.
Remember to B-R-E-A-T-H-E.
Also, enjoy how happy and apparently pain-free your baby is.
1 mom found this helpful
D.P. answers from Pittsburgh on November 30, 2010
C.,
No expert here...that sounds extremely scary to me.
Please find a pediatric gastroenterologist in your area. Call a nearby Childrens Hospital for a list of them, if you haven't already.
Here is one article with some common causes: Cracked, bleeding nipple in mom, circumcision healing, small crack in his rectum....
http://www.babycenter.com/404_is-it-normal-that-theres-a-...
Is your baby pale? It could be Meckels' diverticulum.
1 mom found this helpful
D.B. answers from Charlotte on November 30, 2010
C., you need a pediatric gastroenterologist. Is there a children's hospital in your area? How about a teaching hospital?
I hope that you get him checked out here. It might not have anything to do with your breastmilk. It could have something to do with his structure. There are tests they can do to figure this out.
All my best,
D.
1 mom found this helpful
R.S. answers from New York on November 30, 2010
Hmmm...what a challenge. First, are you sure it is blood, and not just colored stools from something you ate (like beets)? Was it tested with a hemoccult test to confirm it is actually blood? Second, are you certain that you have totally eliminated soy and cow's milk out of your diet? Cow's milk is fairly easy, but remember that many foods contain some soy (and don't need to be labelled as such on the packaging or may be a modified version of soy) or are manufactured in places where soy was/is also processed. If your baby is taking large quantities of breast milk (a virtual oversupply), it is possible to have the stools contain a small amount of blood due to an accumulative amount of soy or cows' milk protein contained in your milk.
At four months old, it is hard to tell what it is -- or, more importantly, if is even a problem at all for your little guy. My guess is that since he is, by all other aspects, happy, healthy, and growing well, he is likely fine, and this issue can again be addressed when be begins to take a significant portion of solids on top of your milk at 6 months or more. You cannot test him for food allergies anyway, and there is no clear evidence that food elimination really gets to the root of the problem -- since so many foods today are really not "pure," so to speak, but really combos of multiple food types (may contain modified soy for thickener or flavor, dyes to color, and what not).
I commend you for maintaining a vegan lifestyle AND breastfeeding your infant in what tends to be a meat- and formula-oriented society. My hunch would be that if you were to seek help from a medical specialist like a gastroenterologist, the first thing he/she would do is make you feel like a crazy, inadequate mother for your choices. There are few breast milk friendly and even fewer vegan friendly docs out there - and very likely, without hesitation they would slap you with a diagnosis of milk protein allergy and push you toward a protein hydrolysate or amino acid formla. My suggestion, therefore, would be to let this go -- for now. Ensure that he is gaining good weight. At 17 lbs at nearly 4 months, he's just right. He's happy, and I presume he does not have eczema? Likely this is mild food allergy that is NOT affecting his growth, and if it does not affect his growth, there are no long term consequences and he can be permitted to naturally outgrow it (which most infants will do by a year of age.)
Good luck! And remember to take your nutritional yeast for B12 support, for both you and baby. Please update and let us know what happened.
K.M. answers from Kansas City on December 01, 2010
No advice, but just wanted to let you know we see several specialists at Children's Mercy in KC and love that place!! I would check into a specialist there.
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