Mucus in a child's stool - why it might appear

What can mucus in stool mean?

Mucus in the stool is a reason to consult a doctor

The appearance of mucus in a child’s stool may indicate the following:

• Breast milk is not sterile. If a mother is breastfeeding her baby and he has diarrhea with mucus, then first of all it is necessary to check him for sterility. If doctors find something, they will prescribe a course of treatment, after which everything should return to normal.
• Cow's milk intolerance, also called lactase intolerance
• If a woman is breastfeeding, it means that her diet contains allergens that cause mucus to appear.
• The child began to be introduced to complementary foods, mainly vegetable purees, and the intestines gradually adapt to them and get used to them
• There are problems with the intestines, which you can definitely find out about by getting tested
• The child has a little cold
• The mucus present in a child’s stool does not always indicate that there are serious problems.
• Most often, this is simply a reaction of the immune system and intestines to new foods.

Causes of mucus

There is almost always mucus in a child's stool, but the amount is so small that it is not even noticeable. But when there is a lot of it, it is a sign of developing problems with the intestines, namely a signal that the body is fighting an infection. There are several reasons why mucus may appear in a baby’s stool:

1. Cold. It would seem how a cold can affect the intestines. But often in children this is a defensive reaction; moreover, the amount of mucus will be small and it will not cause concern.
2. Taking medications that can have a negative effect on the child’s intestinal mucosa. These include antibiotics, since horses kill all the beneficial bacteria in the intestines, and it becomes vulnerable
3. An intestinal infection, during which, in addition to mucus in the stool, many other dangerous symptoms appear. In addition, a large amount of mucus indicates a strong process of fighting infection, since the intestines are protected as best they can. Depending on what kind of infection has penetrated the intestines, the nature of the mucus secretions, as well as its color and smell, will depend.
4. Rotavirus infection, during which the child experiences general malaise and a small amount of mucus
5. Parasites that gradually destroy the mucous membrane, forcing it to defend itself
6. Thrush, or as it is also called, candidiasis Autoimmune origin of infections in the intestines
7. Colitis
8. Inflammation of the rectum
9. Inflammation of the intestinal wall
10. Dysbacteriosis, especially periods of exacerbation, when there is more mucus and stool becomes thinner
11. Breast-feeding. Of course, this is a rare cause of mucus in the stool, but it does occur

One of the most dangerous reasons for the appearance of mucus in a child’s stool is an intestinal infection, since during it many symptoms appear that lead to a significant deterioration in the child’s condition, as well as to dehydration. It is known that if a child loses even a small amount of water, it can be fatal.

Therapy of lactase deficiency in children in the first months of life

Conditions associated with impaired intestinal digestion and absorption, united by the term “malabsorption,” are among the common health problems in young children. The most common form of malabsorption syndrome in young children is intolerance to disaccharides (lactose, less often other carbohydrates) [1, 2].

Lactase deficiency (LD) is of particular importance for children in the first months of life, since lactose is contained in breast milk, which is the main nutrition of a child of this age. The disaccharide lactose is broken down in the small intestine by an enzyme known as lactase. A decrease in the activity of this enzyme leads to the development of a symptom complex of ln, which manifests itself in young children as diarrhea, as well as other dyspeptic disorders, anxiety, etc. The main method of treating ln is diet therapy aimed at reducing or completely eliminating lactose from the diet [3, 4]. The treatment of FN in infants is particularly challenging, since the carbohydrate component in breast milk or modern adapted infant formulas is predominantly lactose. When artificially feeding children with lactase deficiency, low-lactose formulas are used. Lactose-free mixtures are used as monotherapy only for primary alactasia and severe secondary hypolactasia [2, 5].

Considering that supporting natural feeding of children in the first year of life is a priority task of pediatrics, the problem of prevention and treatment of LI in children who are breastfed seems extremely important and relevant. At the same time, the most appropriate in the treatment of ln is not the exclusion of human milk, but replacement therapy in the form of prescribing the lactase enzyme to children. The use of lactase enzyme preparations in the treatment of ln allows one to quickly relieve the symptoms of the disease while maintaining breastfeeding [1, 6, 7].

Considering the significant fluctuations in the activity and properties of lactase preparations produced by different manufacturers and isolated from various sources, it seems necessary to carry out a mandatory clinical evaluation of a lactase preparation released for the first time in the Russian Federation or coming from abroad in the form of a pharmaceutical product or dietary supplement (dietary supplement).

One of these dietary supplements containing lactase is the dietary supplement “Lactazar for Children”, produced by Pharmstandard - Leksredstva OJSC (Russia). The purpose of this work was to study the effectiveness of using the dietary supplement “Lactazar for Children” in the treatment of breastfed children in the first three months of life with LI. The study was conducted by the State Research Institute of Nutrition of the Russian Academy of Medical Sciences on the basis of the children's clinic in Khimki, Moscow region.

A brief description of . “Lactazar for Children” is intended for use as an additional source of the lactase enzyme for LF in children from the neonatal period to 7 years. The dietary supplement “Lactazar for children” is a hard gelatin capsule containing white powder with a specific odor. The average weight of the contents of “Lactazar for children” capsules is from 0.135 to 0.165 g. The lactase activity in the “Lactazar for children” dietary supplement is 700 units per capsule. To produce the dietary supplement “Lactazar for Children,” the lactase enzyme (Lactase DS) produced by Amano Enzyme Inc. is used as a raw material. (Japan).

Study design. The study was an open prospective medical observation.

Clinical observations were carried out in 25 children aged from 2 weeks to 3 months of life; the observation period was 6 weeks. Clinical and laboratory studies were carried out before the prescription of the dietary supplement “Lactazar for Children” and after taking the enzyme preparation for 1 month.

Materials and methods

Criteria for selecting children for the study:

• full-term children aged from 10 days to 3 months of life, without a burdened allergy history;
• presence of a verified diagnosis of LI in children.

Criteria for excluding children from the study:

• product intolerance.

Criteria for assessing the effectiveness of therapy:

• clinical evaluation of effectiveness:

- change in frequency and consistency of stool, presence or absence of pathological impurities in stool; — dynamics of other dyspeptic disorders (regurgitation, colic, constipation, etc.); — skin or other allergic manifestations when taking the dietary supplement “Lactazar for children”;

• dynamics of clinical and laboratory parameters:

— content of total carbohydrates in feces*; — scatological research*; — clinical blood and urine tests;

• dynamics of mass and growth indicators:

— measuring body weight once every 2 weeks using standardized scales; - height measurement - before and after the study using a standard stadiometer.

25 children (12 boys and 13 girls) aged from 2 weeks to 3 months of life were under observation. All children were breastfed. Children came under observation at the request of their mothers to the local pediatrician at the children's clinic. The children were observed on an outpatient basis and were examined weekly by a pediatrician. At home, mothers filled out a specially proposed questionnaire, which contained questions about the effectiveness indicators of the studied dietary supplement (frequency and character of stool, frequency and volume of regurgitation, etc.). Additional information was obtained through a telephone interview.

Data on the observed children and their age-sex characteristics are presented in Table 1 and

All children were full-term, from the first (20), second (4) and third (1) births; 84% of mothers had a pathological course of pregnancy (gestosis, anemia, the presence of chronic diseases, chronic placental insufficiency, etc.). All nursing mothers followed the diet suggested to them [8]. Whole cow's milk was excluded from the diets of nursing mothers in order to prevent the development of allergies to cow's milk proteins in children and thereby reduce the possibility of the formation of secondary LI.

When studying the life history, it was found that in more than half of the children examined, one of the family members does not tolerate or does not like milk and dairy products. So, in 60% of children one of the parents cannot tolerate milk, in 20% one of the family members (sisters, brothers, grandparents, etc.); In other children, there was no intolerance to dairy products in the family, according to their mothers.

The diagnosis of FN was established on the basis of characteristic clinical symptoms (typical changes in the frequency and consistency of stools, increased flatulence, pain, etc.) and the results of clinical laboratory studies (increased content of total carbohydrates in the feces).

Research results and discussion

The dose of the dietary supplement “Lactazar for children” was prescribed depending on the severity of clinical manifestations of LI (Table 3), taking into account the amount of milk consumed by the child per feeding. Most children received one capsule at each feeding, i.e. 5-7 capsules of dietary supplements per day. The duration of taking the dietary supplement “Lactazar for children” was 1 month. It should be noted that in no case was it recommended to stop breastfeeding, and by the end of the observation all women continued to breastfeed their children.

Results of the initial examination of children

As can be seen from table. 3 and fig. 1 and 2, the clinical manifestations of LI in the examined children were very variable.

The most characteristic symptom of FN, loose stools, was found in 13 children (52%), and in 5 of them loose stools were combined with colic (Table 3). The remaining children had other manifestations of functional digestive disorders (regurgitation, flatulence, constipation). Regurgitation of varying severity was observed in 7 children (28%), and in 2 children (8%) regurgitation was the only complaint. 4 children (16%) had constipation, and constipation was the only complaint observed in 2 children. At the time of being taken under observation, 8 children had no disturbances in the frequency and consistency of stool; stool in these children was observed 2–3 times a day, with a mushy consistency.

In 2 children, there was insufficient weight gain (300–400 g per month) and a decrease in appetite (the children did not consume the entire volume of milk they needed based on their body weight and age); This is what prompted me to contact the pediatrician.

As can be seen from Fig. 1 and 2, the observed children equally often (in 12% of cases) had colic and regurgitation as the only complaint; in 8% of cases the main and only complaint was constipation. We combined 6 children into the group called “other” who had a unique combination of clinical manifestations of LI (Table 3).

Thus, our data indicate that the clinical picture of FN is very diverse and often does not coincide with the generally accepted idea of ​​diarrhea as the leading symptom of this disease.

Results of studying the effectiveness of the dietary supplement "Lactazar for children"

The conducted studies showed good tolerability of the dietary supplement in all observed children (not a single child was withdrawn from the study) and its effectiveness in eliminating the symptoms of LI.

Normalization of stool frequency and consistency was noted by the end of the first week, with positive dynamics occurring on average on the 5th day of therapy. At the same time, the frequency and consistency of stool changed differently in children. Normalization of stool consistency in children with frequent loose stools was observed on days 3–5 of dietary supplement use; and in children with constipation, the restoration of regular stool with a frequency of 3-4 times a day, which had the color and consistency usual for children of this age group who are breast-fed, takes 6-8 days. The frequency of stool in children with diarrhea before the start of therapy averaged 5.7 ± 1.2 times per day, and after its completion - 3.8 ± 0.9 times per day. In children with constipation, stool frequency was 0.8 ± 0.6 and 2.5 ± 1.7, respectively.

The use of the dietary supplement “Lactazar for Children” also turned out to be effective in eliminating other symptoms of functional digestive disorders characteristic of LI in young children (

and rice 3).

Pain syndrome, manifested by intestinal colic, and flatulence stopped in all 25 children on days 3–5 of using dietary supplements. The frequency and volume of regurgitation decreased significantly at the end of the first week of therapy and completely disappeared after two weeks of taking the drug in most children. Only one child experienced occasional regurgitation at the end of the study.

Excretion of carbohydrates in feces significantly decreased in most children from 1.1 ± 0.3% before the start of therapy to 0.6 ± 0.1% after its completion, the range of values ​​was 0.4–1.8% and 0.25– 0.6% respectively (Fig. 4).

However, in 6 children there was no significant decrease in the level of carbohydrate excretion in feces (0.7–0.8% before the study and 0.5–0.6% after); although the clinical symptoms of digestive disorders were relieved in the first week of taking dietary supplements. Our data are consistent with literature data indicating the absence of a clear correlation between the severity of clinical manifestations of FN and the level of carbohydrate excretion in feces [1, 3, 4]. In this regard, it should be noted that, in accordance with modern scientific concepts, the main criterion for the effectiveness of therapy is the elimination of clinical symptoms of the disease, and not a reduction in carbohydrate excretion to normal.

During scatological examination, no significant pathological changes were revealed in the majority of observed children. Before therapy, the majority of children had stool of a liquid or mushy consistency, light yellow or light green color, slightly sour odor, with a pH of 5–7, and contained moderate or single amounts of neutral fat, fatty acids, and leukocytes (no more than 2–7). 3 in the field of view), small amounts of clear mucus. Taking the dietary supplement “Lactazar for Children” had no effect on these minor changes in scatological analyses.

The indicators of clinical blood and urine tests in the examined children before and after therapy were within the age norm. The hemoglobin content in the blood of children before and after the study was 135.3 ± 1.5 g/l and 132.3 ± 1.2 g/l, respectively.

The observed dynamics of weight and growth indicators were within the age norm: the average increase in body weight per day was on average 29.7 ± 2.7 g, and the increase in body length per month was 2.8 ± 0.5 cm (average increases in weight and length bodies in children in the first three months of life are 26–30 g/day and 2.5–3 cm/month, respectively). In 2 children with initially insufficient body weight gain (300–400 g per month), taking the dietary supplement “Lactazar for Children” led to a significant increase in this indicator (900 and 1000 g per month).

As the results obtained showed, the use of the lactase-containing dietary supplement “Lactazar for Children” made it possible to relieve the clinical symptoms of LI and maintain natural feeding in all observed children. The therapy was well tolerated; no cases of allergic reactions or intolerance to the studied dietary supplement were observed.

Thus, the study of the effectiveness of the use in the treatment of breast-fed children in the first months of life with LI, the dietary supplement “Lactazar for Children”, produced by Pharmstandard-Leksredstva OJSC (Russia), allowed us to draw the following conclusions:

1. The dietary supplement “Lactazar for Children” was well tolerated by all observed children;
2. taking dietary supplements leads to quick and effective elimination of the main symptoms of LI, due to which it can be used in the treatment of infants with LI who are breastfed;
3. the effectiveness of FN therapy when prescribing the dietary supplement “Lactazar for children” allows you to maintain natural feeding, which is so important for infants.

Literature

1. Mukhina Yu. G., Chubarova A. I., Geraskina V. P. Modern aspects of the problem of lactase deficiency in young children // Questions of pediatric dietology, 2003, volume 1, no. 1, pp. 50–56.
2. Nutrition for a healthy and sick child/Manual for doctors. Edited by V. A. Tutelyan, I. Ya. Kon, B. S. Kaganov. M., 2007, p. 100–103.
3. Mukhina Yu. G., Shumilov P. V., Dubrovskaya M. I. et al. Modern approaches to the diagnosis and treatment of disaccharidase deficiency in children // Difficult Patient. Pediatrics, 2006, No. 9.
4. Belmer S.V., Mukhina Yu.G., Chubarova A.I., Geraskina V.P., Gailina T.V. Lactose intolerance in children and adults // Attending Physician. January 2005, No. 1, p. 34–36.
5. Kon I. Ya. Specialized medical nutrition products: characteristics and use in young children // Children's Doctor, 2000, No. 3, p. 43–47.
6. Kornienko E. A., Mitrofanova N. I., Larchenkova L. V. Lactase deficiency in young children // Issues of modern pediatrics, No. 4, 2006, volume 5.
7. Chubarova A. I., Geraskina V. P., Kyshtymov M. V. with co-author. The effectiveness of enzyme therapy and diet therapy for lactase deficiency in newborns // Questions of pediatric dietology, 2003, volume 1, no. 4, p. 21–24.
8. Kon I. Ya., Fateeva E. M., Gmoshinskaya M. V., Basova L. I., Kameneva G. V. Modern approaches to organizing rational nutrition for pregnant women and nursing mothers // Methodological recommendations, M., 2002.

T. V. Abramova , Candidate of Medical Sciences I. Ya. Kon , Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Natural Sciences Research Institute of Nutrition of the Russian Academy of Medical Sciences , Moscow

Diarrhea with mucus

Diarrhea with mucus is a cause for concern

Particular attention should be paid to the moment when a child experiences diarrhea with mucus. This is the main symptom of dysbiosis, which appears mainly after taking strong antibiotics that have completely killed the beneficial intestinal microflora. To find out for sure whether a child has dysbiosis, it is necessary to undergo special stool tests, which will show the content of beneficial and harmful bacteria. It is not uncommon when there are practically no beneficial bacteria, and it is during this period that the child begins to experience diarrhea with mucus, which is sometimes accompanied by sharp pains in the stomach. After the pain subsides, the child goes to the toilet.

In most cases, the urge to defecate appears literally ten minutes after eating, and the child will strain as if the stool is not liquid, but very hard.

It must be said right away that you should not be afraid of dysbiosis, since it can be controlled with the help of prebiotics, which will help restore the intestinal microflora and improve your general condition. In addition, the inclusion of fermented milk products in the diet will also have a positive effect and affect the rate of intestinal recovery. If we talk about medications, then if diarrhea with mucus appears, it is necessary to give the child Smecta. It is an excellent absorbent and removes all harmful substances, and also helps strengthen the stool. The dosage depends on the age of the baby.

If, in parallel with Smecta, the doctor prescribed some other drugs for the treatment of dysbiosis, then they should be given strictly two hours after taking Smecta, since the drug can simply be eliminated without starting to act. If diarrhea with mucus is repeated many times, and the child is small enough, it is better to call an ambulance or go to see a pediatrician, who will recommend medications that can help alleviate the child’s condition.

When to call an ambulance

Although the mucus may disappear on its own or go away over time, there are cases when it is necessary to urgently call an ambulance:

• If diarrhea with mucus is simultaneously accompanied by severe and incessant vomiting
• Body temperature has increased significantly
• There is blood in the stool
• The child poops more than twelve times a day, and loosely
• If the child is not gaining weight well, namely the increase is less than 125 grams per month
• Bad breath
• Urinating about 6 times a day, and the smell of urine is unpleasant

If the following symptoms are detected, it is best to call an emergency room so as not to delay the process for too long and to prevent complications from developing.

Assessing baby's health with dietary changes

Judging by the impurities in the baby's stool, the color of the stool and other parameters, one can understand what needs to be changed in the diet of the nursing mother or in complementary foods.

• White lumps are the first sign that the mother is eating something that is difficult for the baby’s body to accept. This could be fatty or smoked foods, fried or spicy foods.
• Too much baking can result in a change in the consistency of your stool. They become foamy and liquid. In addition, gas formation and, accordingly, colic increase.
• An allergic reaction to foods eaten by a nursing mother can manifest itself not only as red spots on the baby’s body: a large amount of mucus, liquid consistency, and increased green tint are also symptoms of an allergy.
• When a baby doesn’t have enough mother’s milk, defecation becomes more difficult: stool becomes hard for its age, dry, and constipation may appear.
• When introducing complementary foods, the consistency, color, and frequency may change. But if the child behaves restlessly, you should consult a doctor to adjust the diet and composition of the diet. For example, cow's milk will make the stool excessively fatty and shiny; vegetables may appear in undigested pieces even when grinding them into the smallest puree. Carrots can cause stool to become thin.

The norm with the introduction of any complementary foods is stool compaction, darkening of color, and heterogeneity. At first, diarrhea or constipation may be observed, but these phenomena quickly normalize.