Another Loose stool question...five month old

[MommaMenk]

To keep it short. After I couldn't breastfeed we started DS on formula. He was on the Similac Advance and broke out with a rash and was super gassy. We started him on Alimentum and he did well. The Alimentum is so expensive and we are getting to the point we can't afford it anymore. We tried soy and he broke out with a terrible rash on his face and was spitting up every two minutes.He also was constipated.

I read a lot of good things about Good Start gentle and decided to try it.It has much better ingrediants then Alimentum and I really like that! We are doing half Good start and half Alimentum to ease him into it with the intent to increase it an ounce each week until the Good Start is all he gets. He has done great so far. He is spitting up much less and no rashes. The only issue is he has frequent loose stools and smelly more frequent gas. Today he has gone every time after every feeding. He doesn't seemed bothered by it and is happy as ever. Should I worry or could it just be him adjusting?

[lfpalmer]

Your gradual transition is wise. Babies will have different stools on different kinds of feeds. His current stooling sounds a little more like breastfed stools, actually. The gas IS a concern but as long as he’s happy, the rashes are gone, and weight gain stays close to his own natural course, he’s good to go with this new formula.

My first guess about the gas is that it’s from the lactose, which is present in his new formula but was not in the Alimentum. Lactose is the natural baby sugar found in nearly all mammal milks and is health-protective. True inability to digest lactose (lactase enzyme deficiency) is incredibly rare in babies, as children are designed to thrive on mommy milk. However, intestines that are irritated by food reactions or infections can temporarily lose good lactase production. This will lead to gas and some loosening of the stools, as natural flora do their best to digest (ferment) for baby what baby’s own enzymes failed to handle. Baby will absorb some of the lactose break-down products provided by the flora. Over time, recovering intestines will return to good lactase enzyme production and gas will diminish.

If this IS the right formula for your baby, the gas should gradually decrease, the spitting up and rashes should not return, and your baby should otherwise be mostly happy, and thriving. If only gas proves to be a continuing problem, I would have a slight concern that baby is not digesting and absorbing as much sugar as would be optimal. Sugar is important for brain development. At his age of 5 months, I would give a try at gradually introducing some low-allergen solid foods. These would provide alternative carbohydrate sources and reduce the lactose load from the formula. Early solid food introduction is not recommended for breastfed babies as it hurries the transition to the less-protective adult flora, however, a baby receiving any formula has already made this transition, so we don’t have this concern here.

Let me know how it goes and we can come up with other alternative plans, if needed.

[MommaMenk]

Thanks for the reply! So he seemed fine for the first week, but suddenly the past few days his spitting up  has returned and is much worse. It seems weird it took so long to come back. He also wakes up from naps and in the morning crying like he is in pain. I don't know if it is formula related or maybe he is starting to teeth and its the side effects from that. He has been chomping on everything for a couple months now but is doing it much harder now ( he pulls my finger into his mouth and it hurts lol)...

I am just starting him on some foods to see if it helps..but the spitting up is so frustrating..idk. Seems like reflux is worsening...

[lfpalmer]

Hmmm...  your instincts will help you sleuth out whether it's just teething or not, but my guess is that it can't all be blamed on teething. So, he was good with Alimentum but it was getting too expensive. I'm interested to see how the solid foods go; turkey or chicken might be a good early food to try. Maybe green beans, squash, rice, avocado... You'll know from his diapers whether he's ready to digest these, and then of course you'll be watching for other reactions.

I think my favorite scenario would be to return him to the Alimentum for another month or two, and see if he can do well with a more solid food diet. The Alimentum cost will go down of course the more nutrition he obtains from solids, and the solids may be tolerated better if he's not reacting to his formula.