malabsorption in breastfed babies

[annonymous]

A couple of questions for you mommas out there...

First of all, the description of "blow-outs" in the CF world is pretty similar to the very common blow-outs in an exclusively breastfed baby.

Normal breastfed diapers can be loose, runny, shiny, etc...they can be frequent, infrequent, etc...so this subject has me confused. A CF nurse told me that I would definitely know by the smell. So please tell me, does a poopy diaper have to be "foul-smelling" in order to be considered malabsorbed?


Also, at what point would you recommend for a baby to be sweat tested if they didn't experience any symptoms, other than tasting slightly salty at times? Not even enough to be called "salty". Do they need to be OBVIOUSLY salty all over? I realize some kids do not taste salty at all, so this question is for the ones who do.

 

[zoe4life]

I have breastfed 7 children. The only one that I knew was different was Zoe, my CF baby. Normal breastfed babies do go a bit more often, the stool should look yellow, kind of grainy like Dijon mustard, and not have much of a smell. Zoe's stools were extremely frequent, 10-12 diapers a day, the oil in the stools literally was like yellow popcorn oil, it would be all over her bottom and actually go through the diapers onto her clothes to leave an oil spot. Sometimes her stools would also be green, actually neon green! I hope that helps.

 

[jendonl]

I think, generally, yes a breast-fed baby's poopy diaper will be pretty smelly for malabsorption. Our CF daughter was exclusively breastfed for the first six months and we noticed the smell which did not change when she started eating solids. Our first non-CF daughter who was also exclusively breast fed did not smell very much at all until she started solids at 6 months and even then she didn't smell nearly as bad as our CF daughter.

I did notice our CF baby tasted salty on her head and face. I don't think I've really noticed a salty taste anywhere else. (Though remember, baby's don't really sweat much until they are a little older so you might not notice the saltiness for a very young baby.)

Jennifer
Mother of 5yro WO/CF and 2 1/2yro W/CF

 

[anonymous]

My daughter with CF has always been on enzymes with feedings but I would notice if she didn't get enough enzymes or needed her dose increased, her poops would have oil in them. Also, the size of the poop would increase, her diapers would really fill up if she needed more enzymes. I also noticed my daughter to be MUCH more gassy than my son without CF, passing gas ALOT, even with enzyme replacement.

Rebecca(mom to Sammy no CF and Maggie 3 1/2 with CF)

 

[jonandlindsay]

I exclusively breastfed my daughter who was diagnosed at 6 months. Being my first child, I didn't have too much to compare it to, but.... her dirty diapers were not foul smelling and were not oily. They were a slight green color and she did have quite a few big ones some days, but not others. After she was diagnosed, before starting enzymes, we had a stool elastase (sp?) done to test for malabsorption. It wasn't a test they did very commonly, were just starting to use.. but it entailed lining her diapers with plastic wrap and collecting her stool for at least 12 hours. Messy. It ultimately didn't tell us a whole lot, just that there was some amount of malabsorption going on. That was two years ago, so drs. might be better at analyzing elastase findings now.

As for salty, my daughter's feet always tasted salty after taking her socks off. It wasn't a knock-you-over-need-a-drink-of-water salty.... just a hint. She hadn't been sick a single day in her life and seemed as healthy as could be.... she just wasn't growing like she should. When the sweat test was done, (a couple different times) her numbers were very high... 80's - 90's.

I would say, if you have any question about a CF diagnosis, get the sweat test done. It's a relatively simple test, non-invasive, and didn't hurt/bother Ella at all. She mostly just slept or ate through it.

Good luck!

~ Lindsay
Mom to Ella - 2 1/2 w/CF

 

[Jenica]

I also exclusively breastfed my now 9-month old daughter for her first six months, and it was only at about 3 months old that she began to have signs of malabsorption. She had the fecal fat test done a little after 2 months, and I was shocked that it came back showing that there were malabsorption issues. She has a mutation that is considered Pancreatic Sufficient and she didn't have any of the symptoms at that point. She had been gaining weight well, and her diapers weren't any more frequent or smelly than what I remembered my older daughter's being.

When her test came back, she was put on enzymes immediately, and it was probably a few days or so after that that I began to notice signs of malabsorption. We went from about 3 or 4 dirty diapers a day to about 10, and the smell was without a doubt more foul. It was interesting that this all happened AFTER she was put on the enzymes, and I asked to have her tested again. It came back positive again, we adjusted her enzymes, and now she's pretty consistent.

I would definitely recommend getting your baby tested. I agree that you would definitely know the smell, but a lack of smell doesn't necessarily rule it out. Ellie was symptomless for malabsorption at that point, but apparently did have a problem. It would be good for you to know definitively, so I would press for a fecal fat test. (by the way, I've heard about the old 12 hour, or even 3 day collection requirements (YUCK!) that Lindsay mentioned, but it's much easier now ... just the contents of one diaper)

 

[anonymous]

My daughter was also breastfed. She is our first, so we don't have anything to compare to, but her stools were never smelly at all. But she went all the time! Once she started enzymes she only went once a day.

 

[JRPandTJP]

Our son was exclusively breastfed for 19 months but not diagnosed until 14 weeks. His stools were never yellow/tan or mustard like they should be. We even had professionals tell us oh that's normal for breastfed babies. Consistently green stools in breastfed babies is NOT normal, it is a sign of malabsorption due to some issue (not always CF). They were green (neon green/yellowgreen) and frothy. we did not notice oil. He went frequently but so does every newborn so that was within the normal range. They never smelled foul! The only time they were foul was when he was on formula supplements at first and once he started moving to solids. We get the foul smelling ones from time to time when teething, not feeling well, or an increase in enzymes is needed. THe main markers for us were green frothy stools, frequent nursing (every hours most of the day), very slow weigh gain and later as we went undiagnosed, vitamin deficiencies, reflux, and later swelling in hand and feet.

He never tasted salty but I notice it now. We think he was so malnurished early on he just couldn't sweat so that wasn't a marker for us. Sweat tests in infants are difficult in general especially before 8 weeks. I would suggest a Guthrey panel heel stick test if you are concerned and wish to rule it out along with sweat test. Based on what we went through, the sooner you know the better. Plus is it is negative you can relax.