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Ask Dr. Y. Vasavada Your Own Question
Dr. Y. Vasavada
Dr. Y. Vasavada, Pediatrician
Category: Paediatrics
Satisfied Customers: 4494
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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My 4 month old is on Pepticate for a month now. He was on

Customer Question

Hi. My 4 month old is on Pepticate for a month now. He was on Nutramigen until then since he was 4 week old. With Nutramigen the defecation was several times a day in the beginning and at least once a day afterwards. But with Pepticate, it is usually every 3rd day. I am really worried this time when it has gone over 5 days! He has been diagnosed to have cow milk allergy.
Assistant: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?
Customer: Nothing with Pepticate. But he has gas this time when he hasn’t pooped for 5 days and he seems to be in pain. There had been hours of fussiness before bed and each nap time these two days.
Assistant: How long have you had the pain? What seems to make the pain better or worse?
Customer: I think it is today, late this evening
Assistant: Anything else in your medical history you think the Expert should know?
Customer: I am lactose intolerant. I am of Indian ethnicity. His father is Norwegian and does not have problems with milk in his family.
Submitted: 1 year ago.
Category: Paediatrics
Expert:  Dr.Sumanth replied 1 year ago.
Hi...Welcome to Just Answer. I am Dr. Sumanth Amperayani and I am here to help you today. I have 14 years of experience in the field of Pediatrics at a tertiary care referral hospital. I will do my level best to alleviate your health concern. I am currently reviewing your question. I will be back in a moment to guide you further.
If you see a premium phone call request I suggest you ignore it - as the premium request of phone call was a system generated prompt and was not initiated by me. I would be glad to continue here please.
Kind regards ***** ***** Sumanth Amperayani
Expert:  Dr.Sumanth replied 1 year ago.
Hello...I really do understand your concern.There seem to be 2 issues here.1. Not passing motion.
2. Excessive gassiness and crying.I will explain one by one.1. Coming to not passing motion, babies of this age until 6 months of age can pass motion once in 10 days or 10 times a day too.
As long as the baby is feeding well, voiding urine well and accepting feeds well, there is nothing to be worried about this.
To be frank with you, rather than breast fed babies, formula fed babies have this more.2. Now coming to gassiness. This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there.Next time check if the baby is sucking too fast and gulping in air too.
You will be more convinced.
Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is -
1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.
2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen (this is the only way we professionals get credited for our time and professional effort). We can continue here until you are satisfied, simply use the reply box and let me know.
A bonus is highly appreciated....Thank you!".
If you are happy with my interaction and guidance, next time if you have any health concern, you can approach me directly at the following link please -
https://www.justanswer.com/medical/expert-drsumanth/?rpt=3800
Kind regards ***** ***** Sumanth Amperayani
Customer: replied 1 year ago.
I don’t think that you have helped me here.
Expert:  Dr.Sumanth replied 1 year ago.
I will opt-out and return this question back to the expert pool and give other experts an opportunity to help you with your case. Please try to avoid replying to this post, otherwise this question may get locked back to me again and prevent other experts from taking up your question.
Wishing you all the very best!
Best Regards...!
Expert:  Dr. Y. Vasavada replied 1 year ago.

Please continue present brand but add little cane sugar in each feed, which will aid in bowel frequency. If on day 2-3 still there is no movement, please use a wad of sterile cotton soaked in oil or paraffin inserted into anus gently with your little finger, to lubricate and by contact action induce bowel movement if there is fecal matter in rectum. Weight curve has to be monitored for adequacy of feeding. Good luck.