My friends grandson, aged about 6 months and only on breast milk, has constantly had green nappies. Now the stools have fresh blood in them?

[BakersMan]

The hospital says that he has a severe lactose intolerance - with the source being his mother. She is eradicating all milk from her diet - but the little boy is still in the same situation. Very worrying! I wonder if it could be Gluten intolerance too. But have any of you heard of this happening? My friend is gluten and lactose intolerent - but not a full blown coeliac; it just affects her sinuses.

[LolaBlogger]

I am a little confused - is the mother still breast feeding? Breast milk always contains lactose, whether or not the mother eats any milk products herself or not. It is likely that the baby will need a lactose-free formula, but either a doctor or a dietitian should be advising her about it, and monitoring the situation too.

[BakersMan]

Yes - still feeding but they only advised her to cut out milk herself.

Its been a catalogue of poor advise since he was born sadly

[Sappho]

She needs to get a second opinion on this matter...the fresh blood in the stool is not a good sign....there is something wrong and it should not be neglected any longer.

[NorthernSoul]

I think you might be getting confused with cows milk protein intolerance and lactose intolerance. If the mum is being asked to eliminate all diary products from her diet then the baby has been diagnosed with the former rather than the latter. True congenital lactase deficiency (which causes lactose intolerance in children of this age) is incredibly incredibly rare. Lactose intolerance in adults or secondary to infection is much commoner and is what most people know as 'lactose intolerance'.

Cows milk protein intolerance is not uncommon and can certainly cause bloody stool in severe cases. Coeliac disease does not generally do this and is also unlikely if the baby is gaining weight at a normal velocity. My advice would be to persevere with the elimination of dairy from mum's diet. Also, 30% of children with cows milk protein intolerance also react to soy so consider eliminating this too. Make sure that there isn't another more obvious reason for the bloody stool (a fissure as a result of the diarrhoea, for example).

Finally, go back and see your doctor! There are other causes of bloody diarrhoea such as IBD but these are extremely rare in babies of this age, again especially if he's gaining weight.

I hope that helps!

[BakersMan]

Thanks all - i was asking as the advise she had been given so far was little and confusing. There is nothing better than asking those with experience.

A meeting with her consultant yesterday - he feels it as an acute Lactose deficency - which he sees 10 of per year. The worst case is something he sees once every 10 years - bowel polyps. So she has to continue with her milkless diet (thanks for the soy advise - i will pass that on :)) but if he is no better in 2 weeks then she has to take him straight to the ward - no appointments necessary. Appreciate your help, thanks