2 month old baby and diarrhoea… A&E?

[Fluffydino21]

Hoping to get some advice on what would be the logical next step.

My 10 week old baby has now been unwell for 3 weeks with vomiting (including with blood), diarrhoea and no appetite. She only has one of those issues at any one point over the 3 weeks but the current bout of diarrhoea has lasted 9 days and has gotten worse rather than shown any signs of improvement. She’s now having 8 dirty nappies a day.

I know dehydration is a real concern. It’s very hard to measure if she’s having 6 ‘heavy’ wet nappies a day because I’m having to change her so much. There’s often urine in the nappies and it probably adds up to the equivalent of 6+ heavy nappies.

We went to the GP twice last week and got nowhere. Stool sample result also hasn’t come back. They basically just said ‘I’m sure she’ll be better by Friday.’ She wasn’t. She was worse. Then they just said we could try taking her to A&E to see if they had any thoughts. Health visitor also said to call nhs 111 for advice but didn’t know who we should go to. it was all very vague.

No one seems particularly concerned but I’m worried how long this is going on for. When she was weighed 10 days ago she had already lost some weight.

Am I justified in taking her to A&E? What would your next step be? Thank you.

I’d cal 111 now, or go to A&E.

Is your baby putting on or losing weight?

I’d be taking her in. Are you near a hospital with a dedicated paediatric a&e? I hope you get some answers for her soon poor little thing.

Vomiting blood sounds very scary. Keep pushing for support/treatment OP. Do you have a children’s A&E?

Has she got any signs of CMPA. My girl was like this....

Sounds like an allergy

A 10 week old baby losing weight with blood in stools that are loose and the GP just says she'll be alright by Friday?

Got to love our NHS.

Is there blood in her poo?

I'd be taking her to A&E, either way.

Is she formula fed? Could this be gastroenteritis? Or cows milk protein allergy?

I’d call 111 and see if they think you should take her to urgent care, dehydration and weight loss are real concerns and I’d be unhappy if my GP and HV didn’t seem to be taking this seriously

Take her. Dehydration can happen quickly in babies.

A&E

Thank you all for your replies. I decided soon after posting to go to A&E again. We’d been previously 10 days ago for the blood in the vomit and that stopped but the diarrhoea started the next day. I’m glad we went and it’s reassuring to know you would all do the same as I do feel I’ve taken up a lot of nhs time over the 3 weeks!

She’s formula fed and there’s never been any blood in the poo.

We saw a consultant paediatrician who thinks it’s a temporary lactose allergy triggered by a bug. Could go on a few more weeks 😩 He also talked about the different signs of dehydration and I feel a bit more confident now to spot that if it happens. It’s just a shame you can’t see someone with this level of knowledge of babies at the GPs so you have to resort to children’s A&E.

Get to A&E now

saw the update so glad you’ve been seen

@Fluffydino21 did they prescribe allergy formula for you to use in the meantime? If not I’d try the GP today and insist you’re given some. I had two CMPA babies and taking the dairy out really does make such a difference. It does take about 3-4 weeks for it to work through their systems. Hope your little one is feeling better really soon

Thank you. With her being so young it feels like it’s gone on for such a big chunk of her life.

No, I did ask about other formula, but he thought it was best to see if it passed within a few weeks or not to determine if it was a temporary reaction from the bug or a longer standing issue. I’m probably not explaining it as well as he did but it made sense!

"It’s just a shame you can’t see someone with this level of knowledge of babies at the GPs so you have to resort to children’s A&E."

This is because GPs are merely a gateway into the system. Some of them will have specialist knowledge and backgrounds and they will appear occasionally, but it's patchy. This is what happens when healthcare is rationed.

I'm so pleased your baby is well and will recover fully xx

If it’s temporary lactose intolerance then lactase drops will help ease the symptoms until her gut has healed.

The next question is why did this develop, secondary lactose intolerance is generally caused by either a tummy bug or from a food allergy/intolerance. If it’s a tummy bug you need to check your hygiene, make sure bottles etc are sterile, and that you are making formula up safely, one bottle at a time with the powder going in to water of at least 70°c to kill the bacteria present, then being cooled quickly and fed immediately. Don’t make bottles up in batches, or boil the water and fill the bottles for the day and store it in the fridge before adding the powder. The other option is to use ready made formula for a while, because it’s pasteurised and sterile, where as the powder isn’t.

If it’s an allergy/intolerance it’s most likely cows milk protein, and the long term solution to this is a dairy free diet. If relactation and breastmilk isn’t an option then you’d need special formula.

https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/bottle-feeding/making-up-baby-formula/

lactase drops
https://www.tesco.com/groceries/en-GB/products/256004039?srsltid=AfmBOooTcwXrvZVVurzYFiQlZJGFpniYLKPHEMTajBnux6pFMLlA1OtV

Thank you. The doctors don’t seem to think it’s anything to do with the bottles. Mixed opinions between who we’ve spoken to but they think either the vaccinations or she coincidently caught a virus at the same time. It all started when we got the vaccinations and never had any issues beforehand.

I think we’re doing all we can with the bottles. We’re making up them up and sterilising as recommended. Not for the day or using a prep machine or anything like that.

If you are prepping bottles properly, then it’s unlikely to be bacteria, even though it’s not 100% sterile unless you use ready made. If the symptoms happened immediately after the vaccinations then it’s possibly a side effect, but it shouldn’t last 3 weeks and she shouldn’t be so poorly she’s losing weight. One of the problems with formula (even sterile ready made) is it lacks the immune factors babies get from breastmilk and means they are more vulnerable to infections and don’t fight them off very well. That said, I think it’s worth trying readymade formula for a week and add lactase drops, to see if that helps.

If you definitely can’t relactate but you have any mum friends who are breastfeeding I’d also consider asking them if they could donate some milk to help heal her gut. If the symptoms persist she definitely needs assessing by a paediatric team.

Ah fair enough. I would probably pursue the allergy formula if it were me, I don’t see why it would be a bad thing to get her some temporary relief from lactose if that is the problem and then reintroduce it. But I haven’t had the same conversations with the Dr’s that you have!

You could also try probiotics for her to put some good bacteria back into her gut and help it heal. There are some good baby ones around. When mine were small we used Optibac or BioGaia. I still give them to my two when they’re run down or if they need any medication to help even it all out in there!