My son is a month old and has a yeast infection from constant diarrhea. The doctor prescribed nystatin cream for his butt. The rash started to clear up but has come back and getting worse. He has diarrhea after every feeding. I have him on enfamil newborn formula. Is the formula causing the yeast infection and diarrhea? what can i use for his bottom for the yeast infection, I am out of the nystatin. What formula can I use to slow his bowels from overworking?
Hi there: Really loose stools as long as they are not exceptionally runny can be normal in a young infant
By exceptionally runny I would say leaking out of the diaper and coming out with each one...
Most formula fed babies tend to have more firm stools however. Is he a fussy guy?
The yeast infection is common and not tremendously concerning. Yeast lives on all of our skin and babies don't have a great immune system for keeping it in check yet...in addition to providing a nice moist environment under the diaper where it is happy to grow. Does he have thrush in his mouth as well?
With such frequent stools I would also start using a tough barrier cream with each diaper change. My favorite is the purple desitin (original) cream that has the highest concentration of zinc oxide in it available OTC....and is nice and thick thus performing its function at making a barrier between skin and stool/urine very well.
When he pees you don't need to wipe off the cream...just apply more. When he poops remove the stool you see but don't scrape the cream off either.
If the rash really looks just like what he had when the doctor prescribed Nystatin you can use over the counter clotrimazole or miconazole 2x a day under the diaper cream for at least 1-2 weeks not dependent really on when the rash goes away....as sometimes it can look better and you stop then it comes back.
If he were exceptionally fussy/gassy or you have ever noticed blood in the stools I would take him in to have the stool tested for blood in the doctor's office just in case....sometimes babies with an allergy to milk protein can have very abnormally loose stools (as well as visible or hidden blood in them) and this corrects with changing to an elemental formula in which the protein source is already broken down like Alimentum (which happens to be extremely expensive) thus you want to be sure that he needs it before transistioning...you can also try it as you can buy it and if it magically clears up the loose stools you have your answer. The issues is your doctor can try to have it covered under your insurance for you as we use it up to 12 months. Milk allergy tends to go away by about a year in MOST kids with it and they can tolerate milk just fine when they are older.
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He has been more fussy lately then normal. He also has the thrush in his mouth along with the yeast on his butt.
Also i noticed the last diaper change little streaks of blood in with his loose stools.
Hello, Looks like Dr Navitsky is offline. The fussiness may be from a sore mouth / throat from the oral thrush. He should be on oral nystatin as prescribed by his pediatrician. He must be drinking enough to pee wet diapers at least 6-8 times a day. The streaks of blood may be from a tiny tear (fissure) or from a milk-protein allergy as the above Expert wrote to you. Recommend as she did that you discuss with your baby's treating pediatrician switching to a predigested or elemental formula such as nutramigen or alimentum. I am not posting this as an answer and will then Opt Out so that you can continue your communications with Dr Navits. Best,
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Hello,Apart from allergy, bacterial diarrhea can also present as you describe with soreness at anus - here the lab report will show mucus, white cells as well as red cells when seen under microscope.Oral antibiotics will be needed to be prescribed. Please visit the neonatologist to get stool sample tested. If the poop smells like acid, he may be having excessive acid secretion causing the skin rash (like burn) at anus. Here an antacid syrup (2-3 ml) with each feed, along with good protective cream will help.
Good morning: I do not think oral antibiotics are at all called for at this time as a 1 month old baby has little exposure to gastrointestinal bacteria that are harmful in the US (they drink only breastmilk and formula!). Same goes for using an antacid as symptoms for this would be more upper GI. However I strongly agree with Dr Sivak that you need to see his pediatrician to check for occult or hidden blood in the stool. The streaks you saw if you have saved the diaper you can bring in...but if he is bleeding internally from a milk protein allergy this will not "go away" and his stool will be positive for a quick hemmoccult test on a card in the office. However if his bottom is quite raw like "raw meat" the blood could also be from this....or from some sort of anal tear. Due to the very loose stools..and the blood you saw this is really enough for me as a pediatrician to try a formula like Alimentum or Neocate which you can go and buy today. If the symptoms are due to cow's milk allergy the loose stools clear up in a few days but the blood may take a week or so to go away. Generally babies with this gain better weight once they start on a predigested formula (Gentlease and its kind is not enough). If you are desparate today go buy a can of one of these and start using it until you can get in early this week to see your pedi. The mouth thrush needs to be treated with oral Nystatin solution...if you have already used this for a short time I'll give you my tips on making the next course more successful (as this is really what we would try for a number of weeks until switching to something more powerful). Make sure to boil his pacifiers and bottle nipples for about 3-5 minutes after use...just in case the yeast spores are living on them and you reintroduce them to his mouth each time. Use the Nystatin 1mL to each side of the mouth 4x a day as directed and squirt the solution over the cheeks/tongue/under tongue/lips on each side for maximum effectiveness rather than just aiming it to the back of the throat for swallowing. Use it many days after you see no thrush for a complete course of at least 10 days to 2 weeks. I would say the root of the yeast/rash problem is the overly loose stools! The clotrimazole 1% cream and miconazole 2% creams are found in the athletes foot section of any store and labeled "antifungal" they run about 3-5$ for a tube. Feel free to respond again when you get up! If you feel that I have answered your question please click on the accept button. Thanks!
US Pediatrician licensed in California living abroad
Hi, I've read your post and assume that you have had some good input from other experts, but I can't help offer you some information that may help. First of all loose stools with every feed is often common in infants, however, this "gastro colic" reflex is usually outgrown fairly soon. I think at a month particularly on formula, your baby should not be having this type of stool pattern. It may be due to formula. Lactose sensitivity of course always comes to mind, even though this is not as prevalent as some think. However, you might consider a trial of Enfamil Gentlease or Similac Sensitive formula. These are good for gas and fussiness as well. But remember you may need several days on a new formula to see results. Regarding the yeast, I have found that protecting the skin and creating an environment with the proper pH that does not promote yeast is the best defense and treatment in the long run. To do this I would recommend you purchase some Domeboro powder packets. Make up a solution according to directions and use this either in a spray bottle or on cotton pads to soothe the diaper area and let air dry. You may also apply the nystatin to any rash areas after this. Once you see improvement the domeboro can be used occasionally as a preventative. Also, A and D ointment is a nourishing diaper cream that works to protect the sensitive skin in the diaper area. Hope this helps, let me know if you need any other info or have any questions.