Friday, May 30, 2008

What is That Doing in Your Diaper?

by Wendy Haldeman, MN, RN, IBCLC, Co-Founder of The Pump Station

Occasionally I will receive a frantic phone call from a mom who feels compelled to describe in graphic, agonizing detail the contents of her baby's diaper. This of course, invariably happens as I am trying to have a quick lunch at my desk while trying to catch up on paper work. Oh well. Bon appetite.

What was concerning this mother, understandably, was the apparent presence of mucous and blood. (I hope you are not trying to eat while reading this blog). I instructed her to call her pediatrician. Having done that, she begged me to take her through the possible causes and treatments.

The presence of mucous in the stool may indicate that the infant's gut is inflamed due to an allergic reaction to something that the mother is eating. The most common culprit is dairy, with soy as a close second. Other possibilities include eggs, fish, shell fish, corn, wheat, citrus, chocolate, and/or tree nuts. Blood in the stool can be due to breastfeeding on a nipple that is cracked, an allergic reaction to something in the mother’s diet, or the infant could have a small anal fissure.

When blood in the stool is thought to be due to an allergic reaction, the treatment plan varies. Some pediatricians will advise the mom to place herself on a restrictive diet and see if the problem resolves. Other doctors have instructed the mother to stop breastfeeding altogether and place the infant on a hypoallergenic formula. Another plan of action is to refer the baby to a pediatric gastroenterologist.

My experience has been that the problem often resolves itself when the mother is able to eliminate problematic foods from her diet. Occasionally, we have had thriving, healthy infants continue to pass small amounts of blood in their stools. The pediatric gastroenterologist has encouraged the mother to continue to breastfeed. Interesting to note is that despite the small amount of bleeding, these babies have not developed anemia.

Discovering foreign “stuff” in your baby's diaper can be anxiety provoking. Please try to remember that the causes are often correctable and mothers are able to continue to breastfeed without any negative consequences to the baby. Finally, please try not to call me when I am eating!