C-Diff and infants?

[javanurse2000, BSN, RN]

Has anyone heard that c-diff is common in an infants stool? My specialty is geriatrics and when a pt has c-diff we treat it. My sister's baby is breastfed and 2 months old. She has had blood tinged mucus in her stool for the last month or so. Her samples came back negative except for the c-diff and the pediatrician says that this is common for infants to carry in their first year. He is thinking maybe a "milk" allergy and my sister is now on a dairy-free diet. My neice is continuing to have sx. I'm told her stool color varies from yellow to every shade of green there is....I won't actually see her for the first time until March. Any info you can share on C-diff experience with infants would be helpful. Thanks.

[javanurse2000, BSN, RN]

Has anyone heard that c-diff is common in an infants stool? My specialty is geriatrics and when a pt has c-diff we treat it. My sister's baby is breastfed and 2 months old. She has had blood tinged mucus in her stool for the last month or so. Her samples came back negative except for the c-diff and the pediatrician says that this is common for infants to carry in their first year. He is thinking maybe a "milk" allergy and my sister is now on a dairy-free diet. My neice is continuing to have sx. I'm told her stool color varies from yellow to every shade of green there is....I won't actually see her for the first time until March. Any info you can share on C-diff experience with infants would be helpful. Thanks.

[Spacklehead, MSN, NP]

Nursewendy,

It is very interesting what you posted. My son started having the same symptoms around the same age and I have also been placed on a dairy-free diet. However, I still see minute amounts of blood on and off in his stool. I know that it can take up to 2 weeks for dairy to be eliminated from the body, but I have been on this diet for over a month now. I never heard about the C-diff, wouldn't the stool have that tell-tale odor and why would infants have C-diff infections, I wonder? I don't believe the whole milk-protein allergy theory, I have researched it and it seems that very seldom do infants who are breastfed develop this type of allergy, unless they are super-sensitive. Recently, I have been to other message boards where other breastfed infants around the same age had similar symptoms, and that the dairy-free diets (as well as diets that didn't include wheat, eggs, and other foods considered highly-allergic) weren't eliminating the symptoms. Maybe it is the C-diff., or maybe it is something else totally different! Please keep me posted on what your sister's doctor figures out, because maybe it will help me and others, too. :)

[javanurse2000, BSN, RN]

Softballmama said:

Nursewendy,

It is very interesting what you posted. My son started having the same symptoms around the same age and I have also been placed on a dairy-free diet. However, I still see minute amounts of blood on and off in his stool. I know that it can take up to 2 weeks for dairy to be eliminated from the body, but I have been on this diet for over a month now. I never heard about the C-diff, wouldn't the stool have that tell-tale odor and why would infants have C-diff infections, I wonder? I don't believe the whole milk-protein allergy theory, I have researched it and it seems that very seldom do infants who are breastfed develop this type of allergy, unless they are super-sensitive. Recently, I have been to other message boards where other breastfed infants around the same age had similar symptoms, and that the dairy-free diets (as well as diets that didn't include wheat, eggs, and other foods considered highly-allergic) weren't eliminating the symptoms. Maybe it is the C-diff., or maybe it is something else totally different! Please keep me posted on what your sister's doctor figures out, because maybe it will help me and others, too. ?

To Softballmama

Thank you for your response. Baby is making a loose-loose/watery stool after approx. every other feeding. As for the odor...I don't know if my sister can differentiate between normal stinky and "c-diff" stinky...I actually have had pts whose lax results smelled questionable. I was reading on a c-dif info web site that it is common for newborns to carry c-dif (70%) and only 3% of adults. It still concerns me that she is having symptoms. Is your son gaining weight? Irritable? My neice has a grouchy time each evening but other than that my sister said she is a content baby. Also gaining fine. I mentioned her stool samples had come back positive. Did they have you obtain samples of your son's stool? I will keep in touch and if you find anything else out please let me know too :0). Thanks again, nursewendy

[Spacklehead, MSN, NP]

My son is gaining well and is only fussy when he is tired. My first child was the same way(with regards to the fussiness) and did not have any allergies. I should reword what I wrote in my previous post, so that it doesn't come across the wrong way. Milk-protein allergies are very common, but mainly in infants fed cow's milk or soy based formulas. It can happen in breast-fed infants, but like I mentioned earlier, I believe it only happens in them if they are ultra-sensitive. The proteins that usually cause the allergy are the casein and whey, not the lactose, which many people think. It's amazing how many different foods have these ingredients in them - all I do any more is read labels! They have not done cultures on my son's stool yet, just hemoccults to check for the blood. You know how the hemoccult cards have the two test sites on them? Well, the weird thing was that the one card that had his stool on it had samples from two different sites on the same diaper and one box turned blue and the other did not. I don't know what to think anymore. All I know is that I used to eat cheese like crazy, so this diet is driving me nuts. However, I would do anything to ensure that my son stays healthy and does not remain allergic to milk later on in life. I have also read that sometimes infants have minimal amounts of blood in their stools for unknown reasons and it never causes a problem, so who knows? Hopefully, someone will come up with an answer soon! Thanks for getting back to me!:)

[javanurse2000, BSN, RN]

Softballmama said:

My son is gaining well and is only fussy when he is tired. My first child was the same way(with regards to the fussiness) and did not have any allergies. I should reword what I wrote in my previous post, so that it doesn't come across the wrong way. Milk-protein allergies are very common, but mainly in infants fed cow's milk or soy based formulas. It can happen in breast-fed infants, but like I mentioned earlier, I believe it only happens in them if they are ultra-sensitive. The proteins that usually cause the allergy are the casein and whey, not the lactose, which many people think. It's amazing how many different foods have these ingredients in them - all I do any more is read labels! They have not done cultures on my son's stool yet, just hemoccults to check for the blood. You know how the hemoccult cards have the two test sites on them? Well, the weird thing was that the one card that had his stool on it had samples from two different sites on the same diaper and one box turned blue and the other did not. I don't know what to think anymore. All I know is that I used to eat cheese like crazy, so this diet is driving me nuts. However, I would do anything to ensure that my son stays healthy and does not remain allergic to milk later on in life. I have also read that sometimes infants have minimal amounts of blood in their stools for unknown reasons and it never causes a problem, so who knows? Hopefully, someone will come up with an answer soon! Thanks for getting back to me!:)

Hi softballmama...I just wanted to let you know that my sister took four..yep four diapers to her friend who is a pediatric resident. Her friend said that although she hasn't had experience with c-diff yet and is not familiar with the "smell" she agrees that they smell "foul" and that its not as much a stool as diarreah with most of it consisting of mucus and water. Her resident friend is going to ask around to find a good pediatrician who can refer her to a pediatric gastroenterologist. PS. On the hemocult card if one side is neg. and the other pos. its still considered positive. I have had quite a few come up that way. Usually the MD orders hemocults x 3 to get a good sampling. I hope your son does well, it sounds like he is in very good hands ?

[Spacklehead, MSN, NP]

I just reread your first post and saw that your niece's stools range in color from yellow to different shades of green. In breastfed infants, this can be normal at times. Sometimes if the mom has foremilk/hindmilk imbalance, the stools tend to be more watery and green than the typical golden-yellow color. I had this problem with my first child and it used to cause her to be very gassy, also. What I did to help it was to make sure that she "emptied" one breast first before switching to the other side. This way she got more of the fatty hindmilk. It also helped her to sleep better. Sometimes what I eat can cause the stools to be different in color, also. I did have three hemoccult test cards done, and I did know that even if only one side turned blue, then it was considered positive...I just thought it was weird that only the one side did turn blue since I saw specks of blood scattered throughout the whole diaper. I hope your sister finds answers from the GI doc. That may be my next step if the blood keeps popping up here and there. I'm going to mention the c-diff. to my ped. and see what she thinks. I'll keep you posted! :)

[babymommy]

I was reading the c-diff posting. I would like to share my son's story so that maybe others could help to find what causes symptoms in babies.

Little History

Born Nov. 5 2007. Normal weight. Never on antibiotics before c-diff symptoms. Breast fed 5 days, not satisfied, changed to bottles of soy formula. Severe constipation at 2 weeks old, then severe diarrhea for a week. Changed to sensitive formula. Started screaming fits at 4 weeks with possible abdominal pains. Doctor visit at 5 weeks for bloody, mucousy stool. Changed to hypoallergenic formula which he stayed on throughout infancy. Finally hospitalized because of fever at 6 weeks.

1st Case

My son was diagnosed with an intestinal bacterial infection...c-diff when he was only 6 weeks old (Dec. 22, 2007). He displayed the tell tale symptoms; blood tinged, mucousy stool, fever, agonizing abdominal pains lasting several minutes to hours, and a slight rash on his face and torso. He had watery stools about 25-35 times a day accompanied by a very foul, sour odor. His pediatrician hospitalized him because of the fever. His blood and stool were tested at the hospital. Everything came back negative except c-diff. After a consultation with a gastrointestinal specialist, my son was treated with compounded Vancomyacin and released after 4 days. His 1st Christmas was in the hospital. Since he was passing the mucousy stools every few minutes, we had to constantly keep ointments on his butt. His skin was blistered and bled even though we were quick to change his diapers.

2nd Case

At 2 months old, he had the same symptoms. He was evaluated and released from our local hospital. We took him to Arnold Palmer Children's Hospital but they could not do anything because the symptoms had subsided. We were referred to a GI doctor. He told us that it was probably just a fluke thing and that our baby should be fine. He treated him with Flagyl for 3 weeks.

3rd Case

At 4 months old, he was hospitalized for the same symptoms but this time he was also vomiting. His GI suspected he had a virus and c-diff at the same time. Again he was treated with Flagyl, but for 8 weeks.

Since then

We changed GI doctors to get a second opinion. We were still given no explanation as to why he got these "fluke" symptoms in the first place. At 9 months he started displaying the same symptoms, but he actually had salmonella. No doctor is able to tell us how he might have come in contact with the salmonella either. If anyone has any answers to the cause of symptomatic c-diff in babies, please respond to my post. My son is 11 months now and we pray he will never get c-diff symptoms again.

[core0]

nursewendy2000 said:

Has anyone heard that c-diff is common in an infants stool? My specialty is geriatrics and when a pt has c-diff we treat it. My sister's baby is breastfed and 2 months old. She has had blood tinged mucus in her stool for the last month or so. Her samples came back negative except for the c-diff and the pediatrician says that this is common for infants to carry in their first year. He is thinking maybe a "milk" allergy and my sister is now on a dairy-free diet. My neice is continuing to have sx. I'm told her stool color varies from yellow to every shade of green there is....I won't actually see her for the first time until March. Any info you can share on C-diff experience with infants would be helpful. Thanks.

Milk allergy is much more common than C-dif. In two years of doing pediatric GI I saw more than 600 infants with milk allergy. I don't remember seeing one with c-dif. C-dif colonization is quite common in newborns.

In my experience taking the mother off milk products rarely works. A better method is to put the infant on a hydrolyzed or amino acid formula and see if the symptoms go away. If there is any doubt between C-dif and milk allergy then its pretty simple to tell between the two. Any pediatric gastroenterologist can do a flex sig and look. There are obvious differences between the two and biopsies will definitely differentiate them.

David

[beachchick]

This is for Babymomma... Hi! I am going through the same problem. My daughter is 6 weeks and just got off flagyl 3 days ago and it seems the symptoms are starting up again? How is your son, did it finally go away? We sent off a sample on tuesday and just waiting for results. What was the rash like that he had? Was it from Cdiff? Thank you so much for all your info!!

[NotReady4PrimeTime, RN]

I work in an area where at least 50% of the patients are infants and every single one of them is on antibiotics of some sort or another. We frequently test for C. diff in our patients, not just the infants but in all ages and I can't remember the last time we had a positive result. I've never seen an infant treated for it in 14 years of peds nursing.

[babymommy]

Hi beachchick. My son is now 12 months old. He had c-diff 3 times (6 weeks, 3 mos, 5 months. He was put on flagyl for 8 weeks the last time & we haven't seen it again. His rash would start on his face, then his scalp, arms, and upper torso. He had fevers of around 100 degrees. He was hospitalized twice. We have no clue how he got it. I hope your daughter isn't getting it again. Did she have horrible screaming spells?