C Diff?

[Anonymous]

Has anyone here had experience with C Diff? Particularily if your baby is under 1 year old? We went to feeding clinic this week and the head of dept-GI doctor said Ian’s stools should be tested again for c diff even though it came up negative (he had one in front of her-his typical explosive watery one). She said since it hasn’t returned to normal after antibiotic, c diff was a likely cause and that tests for it often come up as no’s when it’s really positive (although Ian was having bowel issues prior to his ear infection and medication, he occasionally had a normal one-this has been over 4 weeks now).

My urgency is this-Ian’s had a cold for 2 days (minor) but he’s now pulling his ear again. I do not want to go on another antibiotic because his bowel movements are causing him such distress already. Plus my GI is saying she doesn’t want to retest for c diff because “even if he has it, you cannot treat it under one year old.” Is that true?? She kind of drives me nuts on this one year old thing-“you can’t have miralax prior to one year, you can’t raise prevacid past 15mg under one year,…blah….” BTW-we are doing probiotics and seeing zero improvement.

Help us! Thanks!!

Tracy (Ian’s Mom 9-26-05) Elecare and prevacid

[Anonymous]

Tracy,

Oh How I HATE c-diff!!! I got it from work when I was 7 months pregnant, and had it until a few days before I delivered. I developed severe colitis from it, it was absolutely awful. I’ll spare you the details. That being said, I do have a lot of knowledge about it, but not too much about babies under a year. Here’s what I know:

C-diff is caused when the antibiotics kill off the good bacteria in the gi tract, leaving only the c-diff bacteria which proliferate. These bacteria produce spores which are very resilient and the spores can bind to the colon and cause inflammation which causes the diarrhea. The diarrhea is very watery and has a distinct smell, and often colour in adults. But it is not just a watery bm, it is diarrhea (which I know can be very hard to distinguish in babies). It is often yellow/green and smells “like a barnyard”….sorry so gross. If a person is c-diff positive there can be false negatives, but not false positives. The person should be tested 3 times, with each test done from a separate sample, and each one given 3 days apart. If all three come back negative then the person is considered not to have c-diff. If symptoms persist even after the testing, then the individual should again be retested. The test detects the spores in the stool, and could be missed. My doc didn’t know this so after a first negative test, he said I was negative. I was diagnosed 2 months later by a positive test and a scope. The scope can sometimes detect typical lesions in the colon, but these are not always present- just in more severe cases where colitis is present. The spores are very resilient and spread easily, so handwashing is key.

Sorry, here’s what you were asking. I was concerned about passing it to Hailey during delivery. I was told that if this was true then they’d treat it with metranidazole (aka flaggyl). I don’t know the research on this under a year, this is just what I was told. I would go with the GI doc’s opinion on this one rather than the ped. They likely know a lot about it.

When I was pregnant and couldn’t be treated properly due to pregnancy, I was given several other meds. Don’t know about their safety in babies but you can always research it.

1. First I took something called questran (cholestyramine), helps bind the stools. Again, don’t know about safety in babies as it also binds cholesterol.

2. There is apparently an inert clay that can kill the spores and you put it in food.

3. I found out about my lifesaver and cure, florastor. You can check it out at http://www.florastor.com. Don’t know if it is safe for babies, but if he does have c-diff it helps a lot.

4. The commonly used meds are metranidazole and only for resistant cases, vancomycin. Don’t know if either of these are safe for babies.

As I said, we were told that if you get at least 3 rounds of negative testing done in succession of 3 days apart, then it is not c-diff. But that was just what I was told, I don’t know for sure. There is a world known doctor here in Toronto on infectious diseases. His name is Jay Keystone. If he does have it, or if you are unsure, you can get your doc to call his office as he does telephone consultations. He checked all the drugs for me that I needed to take to see if they were safe in pregancy. Also to find out what’s safe and what’s not, you can contact the Motherrisk hotline out of Toronto’s sick kids hospital. If you are interested in either of these numbers, I’ll look them up and post them for you so let me know.

Also, continue with the probiotics. I really hope that Ian does not have this pesky bug. Even after successful treatment it often comes back because the spores live in the environment.

Good luck.

[Anonymous]

Wow! Thanks Lori! Yes, it sounds awful. I’m so sorry you had to go through that in pregnancy. Terrible!

I would love those numbers. My GI is kind of like “oh well even if he has it you cant do anything about it…” Well, I’d like to start solds someday, thank you! Do you know if it goes away on it’s own if left untreated and if we don’t treat it, what are the consequences? Also, his stools are really just water so can they even test that? (The first time they tested it was at the end of the antibiotic and it was at least loose with mucous-so we were able to get a chunk-sorry..yuck). Oh, one more thing, he’s only going once -sometimes twice a day. Not really diarrhea but maybe diarrhea for him because he used to go 1-2 x a week…I’ll definitely continue the probiotics so I’m doing something. Other than the uncomfy poos, he’s really pretty happy overall-during the rest of the day. Were you miserable all day? My poor baby! Just can’t get a break.

Thanks so much again-very helpful information as we’ve been having a hard time figuring this out. And again, I’m so sorry you had to go through that last year.

Tracy

[Anonymous]

Oh one last thing-If I actually can catch some of Ian’s stool do you know if it will keep in the fridge or freezer or which is better? Before I bring to doctor? Sorry, gross, I know.

Tracy

[Anonymous]

Hi Tracy,

The number to Jay Keystone’s office is 416-340-3671. As I said, he is an expert in infectious diseases. My ped told me that he once did a phone consult with him for a 2 year old boy who had a resilient case of c-diff. I saw him when I was 38 weeks pregnant. I would wait to see if Ian does have it, and then if he does, and your GI doesn’t know how to proceed, maybe he could consider calling him. You might be able to speak to him yourself as well. The Motherrisk line is 416-813-6780. They used to address issues pertaining to safe drug use during pregancy and during the first year, but it seems that they now look at pregnancy and lactation, so not sure if they’d be of too much help. But if you’re desperate. They also have a website. I had to call about 10 times during my pregnancy, and it was quite annoying, because the call takes a long time. Just thought I’d pass on the info anyhow.

To answer some of your questions:

Some people have a very mild form of the infection and are asymptomatic. For them, it might go away on it’s own, but also is likely to return. For people who are symptomatic, it can also go away on it’s own. But if they’ve been sick with it for a long time, then they might have a more resilient case that needs treatment. For some people, leaving it untreated for a long time can cause colitis, which is what happened to me. Also, I forgot to tell you, that even when the person doesn’t have it anymore, the stool test will still likely show up positive for up to a month afterwards due to the presence of spores. They usually go by the lack of symptoms to say that it is gone. Again, you need 3 negatives to say that the person is actually negative. It is not terribly harmful, the harm is associated with the risks of continued diarrhea.

The c-diff can cause abdominal cramping which can be mild or severe. In bad cases it will be severe. I had a bad case- on top of being majorly pregnant and having my older one having seizures at the same time- I basically lived in the washroom, so yes I was uncomfortable and miserable all the time. I don’t think that’s the case for everyone. Especially once they’re treated, they usually feel better after a few days. But again, I don’t know about the safety of these drugs for babies. I did two courses of the metronidazole and it did nothing. The questran stopped the symptoms temporarily, but didn’t stop the cause. The florastor saved my life. Honestly. It helped me when the meds couldn’t stop the reinfection. I think they have a kids version that can be used for infants as well, but not sure about anything related to reflux.

Regarding the stool sample, if there’s nothing solid then you can’t really do much about it, but if there is a bit of solid pieces, it’s probably good to add them in. We were told to refrigerate the sample, but I can’t remember how long it’s okay to keep it in the refrigerator. I’d call the lab to find out for sure. The freezer isn’t good and would likely kill the spores.

I feel so bad for you and for Ian. It is possible that the bearing down movement he does is cramping related. Mucous is also common when there is inflammation in the colon. I really hope that Ian doesn’t have this, but like I said, my experience was different because I was pregnant and an adult. It might be quite different for babies. Hopefully not as bad. I would definitely ask his ped GI. They should know about it.

Good luck to you. Let me know if there’s anything I can do for you.

s&h’s mum2006-4-16 22:2:43

[Anonymous]

Just a thought on the stool sample. We just had to get a sample to test for C Diff. They gave me a bags for urine collection to put on him Because they said the sample couldn’t have urine in it. Then they said to turn the diaper inside out (so the stools aren’t exposed to the antibacterial agents in the diaper lining) and collect after he goes.

Well, with totally runny stools, there was no way this would work and the urine bags leaked as soon as he went in them so we spent two messy days with no success. What finally worked was I took a urine collection bag and taped it carefully on his little bum and then put the diaper on normal to absorb urine. When he went it wasn’t a ton so I just put the bag in the sample cut and took it that way. If it had been more, I would have clipped a corner of the bag and put some in the sample cup that way.

good luck!

Kara

[Anonymous]

I don’t know anything about C-Diff but hope you get this all figured
out soon. Also – re the ear pulling – Marisa does that when tired and
also when teething – so maybe it’s not an ear infection again?

[Anonymous]

Tracy

I developed c-diff during my 35th week of pregnancy and it landed me in the hospital for 4 days. I developed it by taking antibiotics (Omnicef) for bronchitis. My 3 rounds of testing came back negative, but the GI and the Infectious Disease Doc believed that I had it. They put me on 3 weeks of treatment with Vancomycin. Even though this drug is used mostly for resistant cases, I was put on it because it does not circulate throughout the body. It stays only in the digestive tract. Thus it wouldnt affect the baby in- utero. I dont know if Vancomycin is even an option for an infant with C-diff. But I would definitely talk to an infectious disease doc too. And keeping up the probiotics is a good idea. A brand that I love,that is made especially for babies, is called Baby’s Jarro-Dophilus. It can only be bought at a health food store, and it averages around $17.00 per bottle. I know of a few other moms on here who have used it as well and have seen great results. Good luck and I hope Little Ian feels better soon.

Lori – Isnt that one of the most awful things to deal with during late pregnancy?! I was sooo worried about going into labor and going through the “pushing” phase. Thank goodness I endup up with a c-section instead .

lisaann2006-4-17 9:38:9

[Anonymous]

Hi,

Just saw the vancomycin question, and the did give this to Dylan when he was septic and they didn’t know what it was. He was only 8 weeks old and still 5 weeks before his due date. It is really strong, but they do use it on babies that young if they need it.

Good luck with all of this! I hope you figure it out soon as well!

Ann Marie

[Anonymous]

Thanks everyone. Just made an appt to see a pediatric infectious disease doctor. Hopefully I can get some poop before that for a sample. May be waste of time if Ian doesn’t have C diff but should rule it out anyways-especially since GI’s opinion is ‘can’t do anything about it anyways..” NOT sure I buy that.

We’re on Baby Jardophollis as well. Wish we saw improvement but it’s only been a few weeks. Crossing my fingers.

Also, cold is much better today. And no ear pulling thankfully. Maybe it was teething?

Now, I just need to figure out how to tape a baggy to his cute little tush!

Tracy

[Anonymous]

Another idea for a stool sample is to line the diaper with syran (sp?) wrap. We had to get many, many stool samples and I finally was able to get a clean sample doing this. You just need to make sure that you strategically place the syran wrap so that no urine goes in it which is very difficult but possible.

[Anonymous]

Good idea Stacey!…and it’s probably easier for a boy than a girl.

Is another option to put a urine bag on to collect the urine and keep it out of the poop (I would think this is pretty easy in a boy, but who knows because I went NUTS trying to do it for a girl)- then just scoop out the poop from the diaper. Although i guess it’s probably not so easy, especially since you don’t know when he’s going to poop.

Does it need to be a sterile sample for c-diff? I would think it wouldn’t matter since they just detect spores anyhow. Interesting, because I’ve had to collect several samples from my 2 year old when she was still in diapers, and the docs office always told me just to scoop it out of the diaper. They never mentioned anything about keeping the pee and poo separate.

s&h’s mum2006-4-17 21:17:16

[Anonymous]

Great ideas. Just one question-what is a urine bag? Where can I get one?

Also, cant meet infectious disease doctor until May 1st? If it is C diff-is that ok? Any concerns with him waiting?

We had the foulest smelling poo yet yesterday-something I’ve never smelt before (sorry, I know tmi). His poor bottom and now back are all red with rash and some welts because its just water. We’re applying balmex like crazy!

I can’t believe my GI-is so ‘oh well..’

Tracy

[Anonymous]

Tracy – have you ever tried Pinxav? I swear its the BEST thing ever for
diaper rashes – has way more zinc oxide than Balmex and also a number
of other ingredients – http://www.pinxav.com. I have a few samples here if you
want them.

I’m sorry he’s having this problem and that Dr. M isn’t doing more. Can
you talk to the GI doc at the feeding hospital and see if he has
anything to add?

[Anonymous]

Tracy, you can get a urine bag from your doctor’s office (at least that’s where we get them from). It is a long bag with a sticky surface. It was a terrible pain when we had to use it to collect urine for Hailey because the urine kept spilling out, but I imagine it’s different for a boy (maybe??). Just wondering, did the doc and/or the lab tell you that you need a sterile sample? I wouldn’t think it would matter with a c-diff culture. Glad to hear that you got an appointment on May 1- that’s not too far away (by Canadian standards anyhow), though I agree with you, it would be better if it was sooner rather than later. Hopefully you’ll have more information after the stool sample results are in. Hope he feels better soon.

[Author]

Posts