Adapted from "What parents should know about cow's milk allergy, lactose intolerance, diarrhoea" booklet supported by the Singapore Paediatric Society.
As baby grows, her tummy also develops, gradually getting used to various types of food. Very young infants can sometimes experience difficulty digesting, even if they are only receiving breast milk or infant formula.
Common feeding problems may cause your baby to be uncomfortable, fussy or have excessive gas during and/or after feeding. If your baby shows any of these symptoms, she may not be able to digest milk–based infant formulas. It is important that you consult a paediatrician to help you manage baby's feeding problem.
Some common feeding problems include:
Regurgitation is very common in infants. Ingested formula or breast milk often rolls out of the mouth following a burp. More than half of all infants experience some degree of regurgitation. This condition usually improves over time and is usually resolved after the first year or even sooner.
Managing regurgitation
At least once a day, usually around the same time, your baby may fuss for no apparent reason. This fussy cry helps your baby release energy and tension so she can return to a more relaxed state. However, if your baby cries for more than three hours a day, she may have colic. Colicky infants often scream loudly, lift their legs to the abdomen and have a gassy, bloated stomach.
Colic usually develops between the second and fourth weeks after birth and can last more than three months. Paediatricians are still unsure of the exact cause of colic. The good news is that colic is not known to be dangerous and your baby will outgrow it.
Managing Colic
If you see a spot of blood in your newborn's diaper, try to stay calm. There are many possible causes. For example, your baby may have swallowed blood from a cracked nipple during breastfeeding. This will not hurt the baby. It may also be possible that the blood originated from a scratch or crack in the skin of your baby's rectum. A female infant may have a little bloody vaginal discharge due to the withdrawal of maternal hormones after delivery. This usually stops as the hormones return to normal levels. A male infant may be bleeding a little from a healing circumcision. Diaper rash can also lead to some bleeding if it gets severe enough.
Another common cause of the presence of blood in the infant's stools is allergy to cow's milk. The problem is usually associated with the bovine protein that may pass from the maternal diet to the baby through breastfeeding. It is therefore important to eliminate cow's milk and anything that may contain cow's milk from your diet. During this time it is useful to read labels of food products and be aware of the presence of casein and whey which are proteins from cow's milk. You can begin to reintroduce these foods slowly once the stools of your infants become blood–free.
If your infant is taking cow's milk formula, you should consider alternative formulas that are free from cow's milk protein (e.g. soy formula). Ideally, you should abstain from any formula that is animal based.
Blood in the diaper is a problem only if the bleeding becomes heavy or persistent, or if your baby appears ill, has a high fever, or bruises easily. If you do notice any blood in your baby's diaper, make sure you mention it to your paediatrician to be on the safe side. It is important for you to consult your doctor for a more thorough investigation and proper diagnosis.
Two common feeding problems in young babies are sensitivity to cow's milk–protein and lactose intolerance.
Cow's milk protein allergy (or intolerance) is often confused as lactose intolerance as foods such as dairy products contain both cow's milk and lactose. The symptoms of lactose intolerance will be alleviated when the presence of cow's milk is removed. This involves abstaining from preparations that contain cow's milk for the mother (if she is breastfeeding) and for the baby (if she is formula fed).
Breastfeeding remains the best form of nutrition for babies who are allergic to cow's milk protein. If the child is not breastfed, a good alternative can be found in soy formulas. Soy formula is a safe and effective nutritional solution that supports growth as well as cow's milk formulas.
Lactose is the sugar found in all mammalian milks and requires the enzyme lactase to digest it. Lactose intolerance arises when a person does not produce this enzyme (or not enough of it) and is therefore unable to digest lactose.
The symptoms of lactose intolerance are liquid, frothy stools and an irritable baby who may pass wind often.
Primary (or true) lactose intolerance is an extremely rare genetic condition and is incompatible with normal life without medical intervention. On the other hand, secondary lactose intolerance is more common. Anything that damages the gut lining (e.g. gastroenteritis, food intolerance or allergy) causes secondary lactose intolerance by reducing the production of lactase, impairing lactose digestion. Secondary lactose intolerance is generally not harmful to your baby as long as she is otherwise well and growing normally.
Secondary lactose intolerance is temporary and usually resolves when the cause of the damage to the gut has been removed, for example when the food baby is allergic to is taken out of the diet.
Soy formula does not contain lactose. Breastfeeding remains the best form of nutrition even if the baby cannot tolerate lactose.
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