The article was prepared by a specialist for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor.
Constipation in infants is a painful condition characterized by slow and difficult bowel movements.
The body of a newborn is so different from the body of an adult that sometimes mothers are faced with an insoluble problem: is this or that condition of her baby normal or should we sound the alarm.
In the understanding of adult medicine, the diagnosis of “constipation” can be made when:
- absence of stool for more than a day;
- feeling of incomplete bowel movement after bowel movements;
- hard feces;
- applying effort (straining) during the process of emptying the intestines.
Inexperienced parents, applying these criteria to their newborn children, often completely in vain begin to suspect that they have intestinal dysfunction. It’s good if after this the mother goes to the children’s doctor and asks for his advice. It is much worse when the diagnosis is made independently and treatment begins based on the advice of friends, grandmothers and Internet forums.
Types of stool in infants: nuances
In order to understand what condition an infant actually has, constipation, it is necessary to consider the normal functioning of the baby's digestive system.
The first days of life.
A newborn's first stool is called meconium. It represents the remains of intestinal cells and products of digestion of amniotic fluid, which the child accidentally swallowed. Normally, meconium begins to pass immediately after the first feeding. The color of the first stool is dark, in some cases almost black, odorless, and the consistency resembles toothpaste.
In the first 1-2 days of life, the baby empties his intestines infrequently - 1-3 times a day. After the meconium has completely passed, the nature of the stool begins to change depending on the type of nutrition that the newborn receives.
When breastfeeding, the stool is liquid, reminiscent of mustard or pea soup. Color – yellow, yellow-brown, greenish tint is acceptable. It has a distinct smell of sour milk. May contain undigested lumps of curdled milk and a small amount of foam.
In bottle-fed babies, stools are darker in color, have a fecal odor and a thick consistency.
First 2 months of life.
When breastfeeding, the norm options are quite wide: from bowel movements after each feeding to 2 times a day.
Formula-fed babies are subject to stricter requirements. The norm is to have at least one bowel movement every day.
From 2 months to 6 months.
As the child ages, the frequency of stools per day decreases: from 5 times a day in 2-month-old infants to 1-2 times a day in six-month-old children. Some infants digest breast milk so well that they can have a bowel movement once every 2-3 days. This is considered normal if the child is cheerful, eats with appetite, gains weight well, bowel movements occur without effort, the stool is soft in consistency and does not have a putrid odor.
Children over 6 months.
After introducing complementary foods, the norm is to have bowel movements 1-2 times a day. In this case, the characteristics of the stool change noticeably. When switching to solid food, feces begin to form. They acquire a dark color, an unpleasant fecal odor and a denser consistency.
Thus, summing up everything written above, we can draw the following conclusions.
For breastfed children
:
- the number of bowel movements per day in infants before the introduction of complementary foods is strictly individual;
- when assessing the baby’s condition, one should focus not on the number of bowel movements, but on the general condition and monthly weight gain;
For bottle-fed babies:
- stool should be at least once a day.
In what cases can delayed bowel movement be considered constipation?
The diagnosis of “constipation” can be suspected if the newborn does not have stool, accompanied by the following symptoms:
- child's restlessness and loss of appetite;
- severe straining while trying to defecate;
- redness of the face, crying, tucking in the legs during feeding;
- release of intestinal gases with a putrid odor, unpleasant odor of stool;
- poor weight gain.
It does not matter how much time has passed since the last bowel movement.
Why does a small child have a problem?
To properly treat constipation, it is necessary to distinguish physiological causes related to nutrition from early intestinal pathology (possibly congenital anomalies). Therefore, parents should rely less on the advice of grandmothers and call a doctor. The child needs urgent help, and the parents need recommendations on how to get rid of constipation in the future. Let's look at the most common reasons.
Intestinal pathology
Among the causes of constipation in an infant, organic pathology must be distinguished. It is usually diagnosed in a maternity facility in the first days of a baby’s life during an examination by a pediatric neonatologist. Birth defects include:
- dolichosigma - an enlarged sigmoid colon with a high probability of torsion and intestinal obstruction, the baby quickly develops fecal intoxication;
- Hirschsprung's disease - denervation of part of the intestine (absence of nerve endings in the walls).
As a result, the contents cannot overcome mechanical obstacles, the intestines “refuse” to move feces, and become overstretched
Anomalies are quite rare. In 2/3 of cases, they are diagnosed in children under one year of age. With sufficient compensation, constipation may not be noticed in a newborn; then it becomes habitual and is detected at 6–7 years of age and even in adulthood. More often found in children with genetic diseases. For example, with Down syndrome.
Such cases require urgent diagnosis and surgical treatment. It is impossible to combat the pathology with other methods, and delaying surgical intervention will only lead to serious complications in the form of inflammation, obstruction and peritonitis.
Features of nutrition of a nursing mother
There are two points of view about the effect of mother's milk on constipation in a newborn. Some experts argue that substances harmful to the baby cannot penetrate into breast milk, since it is synthesized from lymph and blood. This means that the importance of a nursing mother’s diet in the occurrence of defecation disorders in a child is exaggerated.
Others insist on changing the composition of milk when the mother’s diet is different. Therefore, in order to make the baby’s intestines easier, the mother should exclude from her diet foods that delay intestinal motility (fresh baked goods, rice porridge, fatty meat, bananas, whole milk, nuts, seeds, spicy cheese).
Lactase deficiency
Some children are born with a congenital deficiency of the lactase enzyme, which breaks down this substance in milk, and they also have an allergic reaction to cow's milk protein. As a result of intolerance, stool retention occurs.
Attentive mothers themselves determine which product their baby reacts to.
Lack of fluid
This reason occurs in cases of artificial feeding. A sufficient amount of water in the diet allows you to dilute the stool. Otherwise, they become thick and the intestines require additional efforts to move feces.
Constipation in an infant occurs due to the introduction of complementary foods. As long as nutrition comes only from breast milk, the baby receives enough fluid. But solid food requires adding and expanding the drinking regime. More water is needed at elevated temperatures, on a hot day, if the child is sweating in warm clothes.
Early introduction of complementary foods
For each baby, complementary foods are introduced at their own time. Parents should not try to speed up the transition to artificial feeding and abandonment of breast milk. At the age of three months, the child’s gastrointestinal tract is still poorly adapted to mixtures, juices, and “purees.” When artificially feeding, complementary foods are recommended to be introduced no earlier than 4 months, and when breastfeeding - at six months.
The child's digestive system does not yet produce enough enzymes. You can help your baby during the transition to artificial formula by gradually replacing one of the breastfeedings, then more. It is not recommended to give up breastfeeding during the period after your baby has suffered an infectious disease, a cold, or a severe reaction to teething.
Quality of complementary foods
The problem of constipation may indicate an incorrectly selected mixture, sudden replacement, or age inappropriateness. Advertising does not always correspond to the real properties of artificial nutrition. You need to consult with an experienced specialist.
With the timely introduction of complementary foods, it is necessary to provide for the presence of dietary fiber in the composition. They are provided by fruits and vegetables. The child needs to be accustomed to them; he eats semolina and rice porridge with much greater desire. Adding plant fiber will require additional drinking. In the presence of sufficient water, the fibers swell and pass out of the intestines naturally.
Constipation in response to antibiotic treatment
Antibacterial drugs have the negative property of destroying beneficial intestinal bacteria. This process occurs especially quickly in children under one year of age. Doctors prescribe antibiotics only when absolutely necessary for a short course. But there are serious illnesses in which one should think about preserving the life of a small patient.
Different means are used, some are replaced by others that are more sensitive. Subsequent dysbiosis manifests itself as constipation and diarrhea. Parents should not give any antibacterial drugs to their child themselves.
Constipation due to stress
While learning about the world around him, the baby encounters frightening phenomena. He experiences them in his own way. The transition to kindergarten, a new environment, punishment - these are stressful situations for a child. We must not forget about them. The body is able to react by holding stool even when trying to potty train.
Separation from mother is the most severe stress
Alimentary constipation
Also called "hungry". Due to underfeeding, a sufficient volume of feces is not formed in the intestines. Perhaps the lack of breast milk was not immediately noticed. In asocial families, the situation is complicated by the lack of funds to purchase nutritional mixtures. The child suffers and screams from colic in the stomach and hunger. He gains weight poorly and does not develop according to his age.
Causes of constipation in newborns
Constipation in breastfed newborns is associated with:
- Intestinal diseases
. These include congenital anomalies of the digestive system: megacolon - Hirschsprung's disease, absence or narrowing of the anus, lengthening of the sigmoid loop.
- Diseases of other organs and systems
. Insufficient production of thyroid hormones - hypothyroidism, rickets, damage to the nervous system - all these diseases negatively affect intestinal motility and cause constipation.
- Immaturity of the nervous system
. Often babies are born with immature nerve endings in the intestinal wall. As a result, it cannot contract correctly, moving food gruel towards the anus. This is a physiological condition that goes away by the 2nd month of life without special treatment.
- Mother's diet
. Everything a mother eats affects the quality of breast milk. There are products that cause a strengthening effect in a newborn.
Foods that cause constipation in infants:
- fatty cheeses;
- whole cow's milk;
- fatty meats;
- White bread;
- nuts (peanuts, cashews);
- pastry products;
- strong tea, coffee;
- medications (no-spa, remedies for heartburn and treatment of gastritis, diuretics, iron supplements).
"MICROLAX® for children from 0 years old" - gentle and predictable help for a child with constipation
“MICROLAX® for children from 0 years old” is a microenema with a convenient shortened spout. The drug is designed specifically for children from birth to three years of age and is characterized by a high safety profile. The drug promotes the onset of a laxative effect within 5–15 minutes2, having a direct effect on feces, and can help relieve the unpleasant symptoms that accompany constipation. The drug acts locally without affecting the upper parts of the digestive system. It is not absorbed into the blood, does not enter into drug-drug interactions and does not affect the functioning of the body.
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Increased gas formation
Various processes occurring in the intestines of a newborn can lead to increased gas formation during the digestion of food. Gas bubbles, accumulating in the intestinal lumen, prevent the normal movement of intestinal contents.
This may be caused by:
- mother's consumption of foods that cause increased gas formation (radishes, cucumbers, spicy seasonings, chocolate, carbonated drinks, cakes, fresh onions and garlic, brown bread, cabbage, grapes, legumes, bananas);
- disturbance of intestinal microflora.
Reasons for the development of constipation in bottle-fed infants:
- Unsuitable formula
. The most common cause of constipation in formula-fed children is improperly selected formula. The best thing for the baby is breast milk, but if breastfeeding is not possible, then an age-appropriate adapted milk formula should be chosen as a replacement.
- Abrupt transfer to another mixture
. It is not recommended to suddenly change a baby’s diet by switching it to another milk formula. If such a need arises, this should be done gradually over several days.
- Lack of water
. If during breastfeeding supplementation of newborns is not recommended up to 6 months and is used only in extreme cases (fever, diarrhea, fever), then when feeding with formula milk, additional administration of clean drinking water is mandatory.
What to do for constipation in a newborn?
If a mother is sure that her baby is constipated, then the first thing she should do is go to the pediatrician. The reasons for the development of difficulty in bowel movement can be serious diseases, which only a specialist can identify. The doctor may prescribe a blood test for hormones and vitamin content, recommend an ultrasound of internal organs, x-rays, or test stool for dysbacteriosis. Then, depending on the results, prescribe professional treatment.
If during the examination no deviations from the norm are revealed, then there is a high probability that constipation is associated either with the immaturity of the baby’s nervous system, or with the quality of breast milk or formula.
All methods of helping with constipation can be divided into the following groups:
- massage;
- changing the mother's diet or replacing formula;
- medications (Bobotik, Duphalac, Espumisan, Plantex);
- mechanical methods (gas tube, irritation of the anus, glycerin suppositories).
When treating constipation, it is better to start using these methods in order from first to last, but not vice versa.
An enema is an extreme way to combat constipation. Their frequent use can lead to the development of intestinal dysbiosis and a lack of vitamins and minerals. For infants, the smallest syringe No. 1 with a soft tip is used. The enema solution most often used is boiled water at a temperature of about 30 °C or a mixture of water and a few drops of oil.
What are the signs that indicate constipation in a child?
Symptoms associated with difficulty defecating:
- delay in regular bowel movements for a day or more;
- refusal of the next feeding;
- screaming for no reason;
- poor sleep;
- bloating;
- profuse regurgitation;
- painful reaction to touching the stomach;
- increased straining with redness of the face and screaming;
- passage of dense feces in parts;
- Incomplete emptying of the intestines is confirmed by the continued restlessness of the baby.
If a baby develops such signs, it must be shown to a pediatrician; the doctor must examine the baby and determine the possible causes of constipation.
Massage for constipation in newborns
Since the nervous system of the intestine and the synthesis of digestive enzymes in a newborn are still underdeveloped, the best way to stimulate motor skills and improve the release of accumulated gases is through massage techniques. They are safe and easy to perform.
Reception 1.
The baby lies on his back. Stroking movements are made around the navel in a clockwise direction. Make 5-10 circular movements.
Reception 2.
The child lies on his back. Alternate flexion and extension of the legs at the knee joints, while the front surface of the thigh is pressed against the tummy. It is best to hold the legs by the ankle joints. Do 5 reps.
Reception 3.
The baby lies on his back. Pulling the legs bent at the knee joints towards the tummy and straightening them alternately. Do 5 reps.
Reception 4.
Place the baby on his tummy before each feeding for 2-15 minutes, depending on age and physical condition.
Reception 5.
Place the baby on his tummy on the bed or lap of the parent. Make circular stroking movements with your palm from the area between the shoulder blades smoothly down to the sacrum. Repeat 5 times.
Probiotics will solve the problem of microflora imbalance
Probiotics have been successfully used to treat dysbiosis in infants and, importantly, to prevent it. Probiotics include drugs, dietary supplements and food products that have one thing in common - they all contain live cultures of beneficial microorganisms.
Probiotics mainly contain bifidobacteria and lactobacilli. They also contain yeast and other beneficial microflora, such as lactic acid streptococcus. Probiotics contain nothing but beneficial bacteria, so they are safe to use from a very young age.
The microorganisms contained in probiotics promote digestion, intestinal motility improves, and bowel problems disappear in the baby. Thanks to them, vitamins and microelements are more easily absorbed, in particular B6, B12, D, folic acid, calcium, iron, and also strengthens the child’s immunity.
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Mother's diet and formula selection
For breastfed babies, the problem of constipation can be solved by changing the mother's diet. It is necessary to exclude products that have a fixing effect, which are described above, and add to the daily menu products that give laxative properties to mother's milk.
Products that improve newborn digestion:
- fresh vegetable salads containing dill, parsley, seasoned with vegetable oil, preferably olive oil;
- porridge (buckwheat, oatmeal, pearl barley);
- vegetable broth soups;
- white poultry meat;
- prunes;
- dried apricots;
- boiled beets and pumpkin;
- natural unsweetened yogurt, kefir.
If a bottle-fed baby experiences constipation, then you should think about replacing the formula. You can try fermented milk mixtures from Nan, Nutrilon or Nutrilak.
Mothers who bottle-feed their babies should remember that formulas require additional supplementation with water. It should be given at the rate of 10 ml (2 teaspoons) per 1 month of life per day.
How to help your child with constipation
Consult a doctor . If you notice signs of constipation, you should not try to fix the problem yourself. First of all, you need to show the child to the pediatrician. The doctor will conduct an examination and select medications (if necessary). If the child is bottle-fed, the specialist may recommend changing the formula and tell you how to properly introduce a new one. For problems with bowel movements, mixtures containing pro- and prebiotics may be useful. They help restore intestinal microflora, eliminate dysbiosis, and normalize intestinal motility.
Offer your baby water . It is recommended to give a bottle-fed baby water in small portions several times a day.
Do not exclude breast milk (with mixed feeding) . Breast milk contains lactose and oligosaccharides, due to which it can have a prebiotic effect and help improve the composition of intestinal microflora. In addition, breast milk is usually highly digestible and helps activate digestive enzymes. In this case, the mother is recommended to include foods with a laxative effect in her diet (kefir, prunes, beets, pumpkin, cucumbers).
Do massage and gymnastics . A light abdominal massage can also have a beneficial effect. The doctor will tell you more about the technique and techniques. Moderate physical activity (for example, light exercise) is also recommended for children. Lying on your stomach can have a beneficial effect on the functioning of your digestive system.
Additionally, you can give your baby laxatives recommended by your pediatrician. The number of products approved for use in newborns includes MICROLAX® for children from 0 years of age.
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Soap for constipation in newborns is an unacceptable method!
Very often, mothers follow the lead of grandmothers or neighbors, trying to use a piece of laundry soap to combat constipation in their baby. This is an unacceptable method of intestinal stimulation!
The substances contained in soap cause severe irritation of the rectal mucosa, which can lead to the formation of ulcers, bleeding and chronic inflammation.
Author of the article:
Sokolova Praskovya Fedorovna |
Pediatrician Education: Diploma in general medicine received from Volgograd State Medical University. Immediately received a specialist certificate in 2014. Our authors
