Problems such as constipation occur frequently in infants. Not all parents know how to behave correctly in this case. The famous children's doctor E. O Komarovsky recommends that young mothers not worry, but carefully monitor the child’s condition. Before taking any measures, you need to know exactly what symptoms accompany constipation in an infant. Komarovsky believes that when a baby has rare bowel movements, it is not always necessary to treat it. In most cases, it is enough to adjust the child’s diet and daily routine. This is exactly what Dr. Komarovsky teaches young parents.
Constipation in infants
In medicine, it is believed that a baby up to three months old should have bowel movements two to four times a day. And constipation is a condition when there is no stool for more than two days. But here everything is individual. Sometimes it happens that a breastfed baby completely absorbs mother's milk. And he has a bowel movement every 3-5 days. Before panicking and giving the baby medication, the mother needs to find out what symptoms accompany constipation in the baby. Komarovsky says that if the baby is developing well and gaining weight, is cheerful and sleeps normally, and bowel movements do not cause him discomfort, then rare bowel movements are normal. We can talk about the disease when, in addition to constipation, the child has other symptoms: gas formation, pain, bloating, loss of appetite. In addition, it is very important to pay attention to the condition of the stool. In infants, it should be mushy, soft, and yellowish. If a child is constipated, his stool will be dark in color, have an unpleasant odor, and be hard.
The best treatment is prevention!
Such a problem as constipation in a baby can be completely avoided. To do this, you just need to take the necessary measures in time.
To prevent constipation, first of all, you should pay attention to your child’s diet. A child's diet for constipation should include only high-quality, fresh and well-processed foods. For complementary feeding, choose baby food exclusively from well-established manufacturers, paying attention to expiration dates and storage rules.
However, a diet for constipation in children is just the tip of the iceberg. When taking care of your baby's nutrition, do not forget about ensuring the cleanliness of the dishes, as well as the hygiene of your breasts.
Take care of the baby’s comfort, provide him with regular relaxation: warm baths, tummy massages, rocking to sleep in your arms, bedtime lullabies and, of course, physical contact with loving parents. Do daily exercises with your baby, which include exercises to improve peristalsis. Until a child is one year old, he needs to regularly press his legs to his tummy and do the “bicycle” exercise.
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Constipation symptoms
When do parents need to take action? It is believed that a child has constipation if the following symptoms are observed:
- stool is too hard, shaped or pea-shaped;
- the stool has a putrid aroma;
- when trying to poop, the baby strains and strains a lot;
- the child writhes his legs, groans and cries;
- baby's belly is hard and swollen;
- the baby loses his appetite;
- He has stool less than once every 3 days.
Causes of constipation
Only a doctor can determine whether a child is sick or whether such bowel movements are normal for him. Therefore, if there are any deviations in the behavior of the baby, you should contact a pediatrician. After all, before treating your baby, you need to know what causes his constipation. This condition can be caused by many factors:
- pathologies of intestinal development, for example, Hirschsprung's disease;
- various inflammatory and infectious diseases, colds;
- disturbance of intestinal microflora;
- taking certain medications, especially antibiotics;
- allergic reaction to cow's milk and some other products.
In such cases, only a doctor can treat constipation in an infant. Komarovsky advises mothers to take some measures on their own if infrequent bowel movements are caused by other reasons:
- lack of breast milk, which results in so-called “hunger” constipation;
- improper diet of the mother, because everything that a woman eats passes into her milk;
- lack of water, which helps remove feces;
- transition from breastfeeding to artificial feeding, since up to 4 months mother’s milk not only feeds the baby, but also protects against diseases;
- introduction of complementary foods, in this case the child’s intestines may react to unfamiliar food with constipation;
- changing the milk formula, which may contain a component intolerable to the baby;
- overheating the child with too warm and dry air, which causes dehydration;
- stress and anxiety of the baby due to a change in environment, his fear when he is left alone.
Mistake 2: Too late
There is also the opposite situation, when a mother is comfortable breastfeeding, and she does not want to change anything at all. After all, the introduction of complementary foods is associated, at a minimum, with the need to warm up baby purees and waste time on the process of spoon feeding. Introducing complementary foods too late will not benefit the baby. Yes, he gets everything he needs from milk, but we must remember, firstly, that by 4-6 months the baby’s nutritional needs increase significantly, and secondly, the time has come for the baby to learn to chew solid food and get to know each other with a world of tastes.
The consequences of introducing complementary foods too late (after 6 months) can be:
- iron deficiency anemia due to depletion of iron reserves in the baby’s body, which he received in utero from the mother - there is very little iron in breast milk;
- lack of interest in food - numerous observations show that with late and unsystematic introduction of complementary foods, the child subsequently refuses many of the foods he needs;
- delayed physical development (after 6 months, breast milk or formula alone is not enough for a baby - if you recalculate his needs for some nutrients, then to fully satisfy them you need to receive 2-3 liters of milk per day);
- insufficient intake of vitamins and microelements;
- significant allergenic load and digestive problems due to the need to quickly introduce a large number of products, since there is no longer enough time for their gradual introduction.
The reason to postpone the introduction of complementary foods to a later date may be the child’s illness, identified food allergies, or other reasons. In any case, all this happens under the supervision of a doctor.
Normal stool in newborns
After birth, the functioning of all the baby’s organs improves for some time. In the first three days, the baby passes black-green plasticine-like feces - meconium. Then, until one and a half months, the baby poops as many times as he eats - 8-12. His stools are mushy, yellowish in color, with a sour odor. But before 3 or 4 months, the baby’s intestinal functions have not yet fully developed; many enzymes and beneficial bacteria are missing. Therefore, constipation in a newborn often occurs at this time. Komarovsky urges parents not to panic, but to try to improve the diet of the nursing mother or consult a doctor about choosing formula milk. Normally, a breastfed baby should poop 4-5 times a day. And in those who are artificial, bowel movements occur less frequently - 1-2 times. Moreover, the feces should be soft and mushy.
Constipation in infants during breastfeeding
A child who eats mother's milk may not poop for up to 3-4 days. This is considered normal if the baby is not bothered by anything, if he is cheerful and cheerful, sleeps well and is gaining weight. This means that breast milk is suitable for him and is well absorbed. Only in rare cases does a baby develop real constipation during breastfeeding. Komarovsky believes that measures need to be taken if the baby is not gaining weight, is restless and cries. But before using any medications, you should definitely consult your doctor. In most cases, you can cope with the problem simply by changing the mother's diet.
What rules should a woman follow so that her child has regular bowel movements?
- You need to drink at least 2 liters of water, it will help stimulate intestinal motility;
- regularly eat prunes, dried apricots, raisins and beets;
- the daily menu should include buckwheat or oatmeal, pumpkin, apricots, plums and fermented milk products;
- it is necessary to exclude coffee, tea, chocolate, smoked foods, fatty and spicy foods from the diet;
- You should limit your intake of rice, legumes, potatoes, fresh milk, walnuts and baked goods.
But even if the mother follows all the rules, sometimes a baby experiences constipation while breastfeeding. Komarovsky believes that this is due to a lack of water. He recommends feeding your baby with clean water or raisin decoction in hot weather. But it is not advisable to use a bottle with a nipple for this, so that the baby does not get used to it. You can give your child water from a spoon or a special drinking bowl, and a very small child can be given water from a syringe without a needle.
It all depends on nutrition
Up to six months, breastfeeding is an excellent prevention of many childhood diseases, including tummy problems. A child provided with breast milk feels great, sleeps well, gains weight well and develops. This wonderful dish contains the entire complex of essential nutrients. The very process of extracting milk from the mother’s breast is also a very useful activity that trains the baby’s intestinal motility.
However, there comes a time when it becomes difficult to get enough of mother’s milk alone, and the time comes for complementary feeding. A six-month-old baby looks with bewilderment at the apple or zucchini “something” in a spoon - puree, which a caring mother decided to offer him for lunch from today. A “new life” begins!
At this time, the baby enters the body not only with his usual delicacy, but also with unknown new food, which the baby will just have to learn to cope with. It is during this period that many parents are faced with a number of previously unknown problems. One of them is the occurrence of constipation during complementary feeding.
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Constipation in infants with artificial feeding
If, when breastfeeding, mothers rarely encounter real problems in emptying the baby’s intestines, then this happens more often with artificial mothers. What can you do to prevent constipation in a bottle-fed baby? Komarovsky recommends following these rules:
- The mixture must be diluted strictly according to the instructions; it cannot be made more concentrated;
- Be sure to give your baby water, maybe adding a few drops of dill seed decoction;
- if a child experiences constipation frequently, it is necessary to change the formula, choosing one that contains lactobacilli.
Constipation after introducing complementary foods
Komarovsky recommends feeding the baby only breast milk until 4-5 months. If the mother has enough of it, the baby will receive everything he needs. Very often, constipation occurs in infants when complementary foods are introduced. To prevent this, Komarovsky advises starting not with egg yolks or fruit juices, but with vegetable puree or dairy-free porridge. After some time, the baby’s diet needs to be varied so that he receives a sufficient amount of dietary fiber. Therefore, vegetable soups and purees, porridges, especially not ready-made ones, but made by the mother, are very important in the diet of children. After 7-8 months, you need to give your baby wholemeal bread, fresh fruits and vegetables.
Sometimes it happens that a baby becomes constipated after introducing complementary foods. In this case, Komarovsky advises giving the child prune juice or puree, pumpkin, and raisin decoction. It is advisable to include these products in the diet if the baby is already 6 months old. Food for a child should be prepared immediately before consumption; it is not advisable to boil it thoroughly. By following these rules, you can prevent constipation in your baby.
Mistake 5: Not on time
You can often hear from mothers that the baby does not want to try new foods, and they simply postpone the introduction of complementary foods until later. However, behind this behavior of a naughty toddler is most often the mother’s mistake. It consists in the fact that the baby is first given breast milk to eat, and only then is offered to try delicious vegetable or fruit puree. Naturally, a well-fed child does not show the slightest interest in food. First, you need to invite your baby to eat 1-2 spoons of a new product for him, and only then supplement him with milk. And you don’t have to worry that he will remain hungry: he will eat as much milk as he needs.
What to do
Komarovsky gives some advice on how you can help your baby. After all, it is not always possible to see a doctor right away. But every mother is able to alleviate the child’s condition. And only if these measures do not help, you should definitely contact a medical facility. So, what to do if your baby is constipated? Komarovsky recommends the following methods:
- give the baby a massage, using gentle movements with a warm hand to rub the baby’s tummy clockwise;
- The “bicycle” exercise helps activate intestinal functions: you need to take the child’s legs and carefully bend them alternately at least 10 times;
- you can put a diaper heated with an iron on the baby’s tummy;
- A warm bath will help your baby relax;
- The doctor considers glycerin suppositories to be an effective remedy for constipation;
- as a last resort, you can give your child a laxative medicine prescribed by your doctor.
It is necessary to call an ambulance or consult a doctor as soon as possible if your child has the following symptoms:
- abdominal pain, gas, bloating;
- loss of appetite, refusal to eat;
- blood appears in the stool;
- frequent vomiting;
- The baby's stool and urine are dark and have an unpleasant odor.
How to help a baby
In a child, constipation after the introduction of complementary foods develops, as a rule, due to the incorrect sequence of introducing foods. For parents of a child who develops constipation when introducing complementary foods, pediatricians recommend the following. If the frequency of stool changes immediately after the introduction of complementary foods, then it is possible that the digestive system is not yet ready to expand the diet. If the baby is less than six months old, then you need to hold off on complementary feeding.
If constipation occurs after including certain products in the menu, you should avoid them. If stool retention occurred after the baby tried dairy products, then they should be excluded and introduced into the diet after one year of age. The main rule for introducing complementary foods is to introduce one product every three days and not combine it with other dishes. This will allow you to understand what product the child has an allergic reaction to and whether it is absorbed in the body.
Include more foods that enhance intestinal motility and limit foods that have strengthening properties. Cold dishes and drinks, foods containing fiber improve the motor activity of the digestive tract; it is found in vegetables, crumbly cereals, fruits, and bran. Hot dishes, starchy vegetables, baked goods and white bread, vegetable purees, pureed soups, meat, eggs slow down peristalsis.
If a child has constipation, then you should not offer him pearl barley, rice, semolina, pear, berry jelly, or baked goods. It is better to give him fermented milk products, oatmeal, buckwheat porridge, berry or dried fruit compote, and freshly squeezed juices. Vegetable oil, which can be added to baby vegetable or meat purees, is a good remedy for constipation.
Monitor your drinking regime. Constipation after introducing complementary foods may be due to a lack of fluid in the body. The amount of water a child should drink depends on his body weight. Your local pediatrician will help you calculate the daily intake (for a baby it is in the range of 120–200 ml). Increased fluid intake should be in the hot season, as well as if the room in which the child is located has low humidity.
The baby's motor activity should be increased. To speed up intestinal motility, physical activity is necessary. The baby needs to be placed on his tummy more often, allowed to roll over, sit down, stand up on his legs and crawl, put an object nearby that will interest the baby and make him reach for it, exercise on a fitball and do a “bicycle”.
Tummy massage helps improve intestinal motility
For spastic coprostasis, contact heat and warm baths will help.
If all the recommendations are followed, but constipation does not go away after complementary feeding and bowel movements are still difficult for the child, then you should consult a doctor. After a physical examination and history taking, the child’s general condition will be assessed and the necessary examination will be prescribed.
What medications can be used in infants for constipation?
It is not recommended to give babies any medications without consulting a doctor. Even the safest drugs approved for use from birth can harm the immature intestinal microflora of a child. Therefore, only in extreme cases is it recommended to use medications to cure constipation in infants.
- It is best to use preparations containing lactulose. This is the safest laxative. Lactulose syrup is a prebiotic. It stimulates the production of beneficial bacteria in the intestines and helps remove feces. The following drugs containing lactulose are recommended: Duphalac, Normaze, Portalak, Lizalak and some others. To begin with, it is better to give these medications in a reduced dosage. And if you need long-term use, you should definitely consult your doctor.
- To reduce gas formation in the intestines, doctors prescribe the following drugs to children: Espumisan, Plantex or Sub-Simplex. They help relieve cramps and gently remove gases, relieving bloating.
- Komarovsky considers glycerin suppositories to be the best remedy for constipation in infants. Children's ones are very rarely sold on sale, but regular ones can also be used. One candle needs to be cut in half lengthwise and then crosswise. You will get four parts. You need to smooth out all the edges of one piece of candle with clean hands and carefully insert it into the baby’s anus. Gently squeeze his buttocks and hold for a while. This suppository will help soften stool and gently move it out.
How to help a baby during constipation during complementary feeding?
Basic measures for stool retention in a child:
- massage and gymnastics,
- special diet,
- use of safe and effective drugs.
Probably, even the most inexperienced young mother knows about the need to often massage the baby's tummy in a clockwise direction (for example, every time you change a diaper). For a massage, you can use one of the oils from the JOHNSON'S Baby line. Special exercises that help activate the intestines are also effective: leg movements imitating cycling, pressing bent legs to the tummy and then straightening. All of them should be smooth and soft, but at the same time performed with a certain effort. Be sure to ask your pediatrician to teach you massage and gymnastics techniques and specify their required intensity.12
A competent doctor will also tell you what to feed a child with constipation. You may need to change your baby's diet slightly. A diet for constipation in children most often involves compliance with the drinking regime, as well as correction of the introduced complementary foods.
It happens that fulfilling only these conditions is not enough, then medications come to the rescue. One of these drugs is MICROLAX®, which helps relieve constipation in children from birth. The product in the form of a microenema acts within 5–15 minutes and is very convenient to use. The active substances of the drug have no effect on the body as a whole, are not absorbed into the blood, but work directly at the injection site (rectum), providing a laxative effect within 5-15 minutes*
MICROLAX® microclysters are suitable for frequent use. However, if a problem with stool retention occurs regularly in your baby, you should definitely visit a specialist. A child should never be constipated!
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How to give an enema to a baby
Many people believe that this is the only way to treat constipation in a baby. Komarovsky recommends using an enema only in extreme cases. Their frequent use washes out beneficial bacteria from the intestines and weakens its tone. How to properly give an enema to a baby?
- Take a rubber bulb with a soft tip; it should have a volume of up to 60 ml.
- Typically, chamomile decoction is used for infants. It should be at room temperature. Water that is too warm will be immediately absorbed through the intestinal walls.
- Lay the baby on his side or back. Lubricate the anus and the enema tip with baby cream.
- Squeeze the bulb a little to remove air from it. Carefully insert the tip no more than a couple of centimeters into the baby's intestines. If resistance is felt, do not press.
- Release the water slowly, but do not use force. The process of intestinal contraction occurs in waves, so if you feel resistance, you need to wait a little. Take out the enema.
- Squeeze your baby's buttocks and hold for a couple of minutes.
But more convenient to use and safer for the child are ready-made microenemas, which are sold in pharmacies. For example, you can buy Microlax. But you shouldn’t do them often to prevent addiction.
Folk remedies for constipation
Many mothers try to help their child with the help of recipes that their grandmothers used. They push a piece of soap, a cotton swab coated with Vaseline, or a thermometer into the baby’s anus. This is how constipation in an infant was often treated in the past. Komarovsky warns parents against using such means. He believes that this is child abuse. In addition, such drugs can injure the mucous membrane, cause irritation in the anus and further aggravate the problem.
Among folk remedies, the doctor prefers decoctions that help remove gases. It is best to brew dill seed, anise or fennel. Komarovsky considers raisin decoction very useful. In addition to its laxative effect, this drink enriches the body with potassium, which is very important for normal intestinal function. There is a greater choice of remedies if a baby has constipation for 6 months. Komarovsky recommends giving your baby juice, decoction or puree of prunes, and including foods rich in fiber in the diet.
Preventing constipation
Everyone knows that it is better to prevent a problem than to look for ways to cope with it. Dr. Komarovsky talks a lot about constipation in infants, but the main thing he focuses on is the need to establish proper nutrition for the baby. How should you act to prevent constipation?
- A bottle-fed baby should receive enough water.
- If the baby is fed breast milk, then the mother needs to drink at least 2 liters of liquid and eat foods rich in potassium.
- Place the baby on his tummy more often, ideally for 5 minutes each time before feeding.
- Do gymnastics with your child regularly: lift his legs, bend them at the knees, exercises on a gymnastic ball are useful.
- You need to give the baby a light tummy massage, it helps relieve muscle spasms and reduce gas formation.
- The child should not be allowed to overheat.
- The food of babies who are already receiving complementary foods should not be highly heat-treated and very soft.
You need to treat constipation in infants yourself only if it is the only symptom. And when a baby experiences abdominal pain, has increased gas formation and lacks appetite, it is necessary to urgently consult a doctor.
