Constipation in a newborn baby

Constipation in an infant is a digestive disorder in which there is no bowel movement for 24 hours. Constipation can also be considered a condition that accompanies defecation disorders - for example, a baby produces hard feces, which causes discomfort during the act of defecation.

The appearance of constipation is often associated with a violation of the child’s diet, the digestion process, the structure of the gastrointestinal tract and other pathologies of bowel movement. One thing is important: the condition requires immediate consultation with a doctor and timely correction.

Features of infant digestion

Constipation in children under one year of age has its own physiological characteristics. The fact is that a newborn child constantly adapts to new environmental factors, this also applies to changes in the digestive system, mechanisms of defecation, and stool frequency.

The urge to defecate in both infants and adults occurs when stool comes into contact with the lower part of the large intestine. In an adult, these mechanisms are more well organized: he is able to retain feces in the rectum with the help of both voluntary and involuntary movements of the sphincters - special muscle layers.

Due to the structural features of the sphincter, an adult is able to restrain the urge to defecate, but a child cannot do this.

During natural feeding, milk enters the upper gastrointestinal tract (stomach) and triggers a chain of mechanisms of peristalsis - the movement of food through the digestive canal. Feces reach the rectum and form the urge to defecate. Straining the baby leads to the release of feces and the release of the rectum.

As a rule, in infancy, the frequency of stool coincides with the frequency of feeding the child, maybe 2-3 times a day.

From the age of 2 months, the number of bowel movements per day decreases, and when feeding not only breast milk, but also additional complementary foods (at the age of 4–6 months), the number of bowel movements decreases to 2 times a day, sometimes once every 2 days.

Stool compaction occurs - this is a normal process for a child fed breast milk with complementary foods.

Constipation in Children: Facts and Factors

Do you know that:

Among children under one year of age, almost every fifth suffers from constipation;
among older children, constipation can occur in every sixth child;
A quarter of all young patients of gastroenterologists complain about constipation [1, 2].

Constipation is a very common problem in children and adults. The thing is that the process of defecation is quite complex and depends on many different factors - from the structure of the intestines to the level of physical activity. And if difficulties arise at at least one of these stages, constipation appears.

Constipation: what is it?

Translated from Latin, “constipation” (constipatio) means “congestion.” Feces accumulate in the large intestine and are not released. This condition can manifest itself in very different ways.

The classic symptom is a decrease in the number of bowel movements. Babies poop differently at different ages. A breastfed newborn has stool as many times as he eats. After 6 weeks, infants can poop either 12–15 times a day or once every 3–5 days. However, if the baby is bottle-fed, the frequency of stools is more regular - 1-4 times every 24-36 hours.

With the introduction of complementary foods, stools become thicker and appear 1–4 times a day. For preschool children, it is considered normal to have at least one bowel movement every 24–48 hours; for schoolchildren, defecation can occur 3 times a week – and this is also a variant of the norm [3–5].

But infrequent bowel movements are not the only sign of constipation. The baby may poop daily or even several times a day, but if he has pain during bowel movements, or hard, dry stools, or excessively long and strong straining , then this is still regarded as constipation.

What is the cause of constipation?

95% of all constipation in children is functional. This implies that only a small proportion of children have any congenital features of the intestinal structure. In most babies, constipation is associated with external problems. Of these, the most frequently noted are:

Water deficiency in a child's diet. When a baby is exclusively breastfed, he usually does not need supplemental feeding. But if the baby receives formula or has already started eating complementary foods, he definitely needs additional sources of liquid. Unfortunately, there are no uniform standards for how much water each child should drink. Much depends on the baby’s age, his diet, climate, etc. There are only general recommendations: use only water as an additional liquid (not compote, juices, sweet carbonated drinks!) and give the child at least 100–150 ml of water daily, in addition to soups, fermented milk drinks, milk and other sources of liquid [6, 7 ].
Deficiency of dietary fiber in the diet and excessively crushed food. Parents of growing children often encounter this. Your beloved child willingly eats bread, cereal, noodles, but spits vegetable and even fruit purees and flatly refuses to eat food in pieces. As a result, feces form very slowly, become denser, defecation becomes difficult - and constipation occurs.
Psychological problems. This is typical, in particular, for children who are potty trained too early and too aggressively. Babies hold back the urge to defecate so as not to sit on the potty again, and after a while the body stops sending signals about the need to poop. Fecal matter sits in the rectum for a long time, stretches it, dries out - defecation becomes painful. And if it was painful for the baby to poop at least once, he will try to restrain himself even more.

A similar situation can arise for a preschooler, or even a first-grader, if they don’t like the toilet. Uncomfortable toilets, lack of privacy, bad smells, dirt - all this can cause a child to hold back the urge to defecate until he gets home. And at home you can forget about going to the toilet. A few days in this rhythm - and constipation formed.

Food allergies. Most often it is an allergy to cow's milk proteins, but it can also be a reaction to other foods. Sometimes constipation is the only manifestation of food allergies, sometimes they are accompanied by abdominal pain and/or skin rashes. Often, along with food allergies, a child may also experience lactase deficiency. In this case, the baby does not have enough enzymes to digest the milk. Most often, this condition is accompanied by loose stools, but in 10% of children it can manifest itself, on the contrary, as constipation.

And this is only a small part of the reasons that cause constipation. There are also infections, metabolic disorders, lack of physical activity (yes, if a child doesn’t move much, he may experience constipation!), digestive problems and much, much more.

How to help a child?

Since it can be difficult to independently determine the cause of constipation in a child, it is necessary to have the baby examined by a doctor. If necessary, he will recommend additional tests and examinations to clarify the diagnosis and select treatment.

Well, before visiting a doctor, it is recommended:

Monitor the child's drinking regime. Remove teas, sugary drinks and offer plain water as often as possible. If the baby flatly refuses to drink it, you can give him 1-2 spoons of water every 30-60 minutes. It’s not difficult to drink two spoons, and within a day the required amount of liquid will be gained at this rate.
Analyze the child’s nutrition, increase the number of foods with laxative properties.
Use laxatives to restore regular bowel movements and prevent the development of painful bowel movements, which only worsen the problem.

Which laxative is better to choose?

The choice of laxatives today is extremely large. There are candles, syrups, microenemas, and regular enemas... They all have their pros and cons.

Suppositories with glycerin. This is probably the best option, especially for children suffering from allergies. Glycerin is hypoallergenic, effectively relieves constipation and does not have side effects typical of other types of laxatives. There are both suppositories for adults and a separate form for children - Glitselax for children. Glycelax for children can be used even in babies starting from 3 months. To achieve the desired effect, 1 candle per day is enough.
Lactulose preparations. Lactulose is a dietary fiber that promotes bowel movements. It should be noted that in case of lactase deficiency, these drugs are contraindicated, and in any case, in the first days of use they can cause severe flatulence and abdominal pain.
Microclysters. These products bring very quick relief: within 10-15 minutes after use, the baby can start pooping. However, when the contents of a microenema are introduced into the rectum, the child may experience an unpleasant burning sensation due to the irritating effect of sodium citrate. Sodium lauryl sulfoacetate, also included in microenemas, can provoke the development of allergies in children predisposed to it.
Regular enemas with warm water. The remedy is simple and familiar, but... not every parent can administer an enema correctly. An incorrectly performed enema can cause a lot of problems for a child, including the need for surgical intervention.

Remember: constipation is a serious problem! Focus not only on the frequency of stool, but also on its character, abdominal pain, pain during bowel movements. And if the slightest problem arises, try to contact a pediatrician or gastroenterologist. Choosing - even before visiting the doctor! – a laxative for a child, try to give preference to low-allergenic drugs with a minimum of side effects.

https://cyberleninka.ru/article/n/hronicheskie-funktsionalnye-zapory-u-detey-ot-ponimaniya-problemy-k-adekvatnomu-lecheniyu
https://www.lvrach.ru/2008/07/5537545/
https://www.aboutconstipation.org/site/symptoms/kids-and-teens
https://www.lvrach.ru/2008/07/5537545/
https://cyberleninka.ru/article/n/hronicheskie-funktsionalnye-zapory-u-detey-ot-ponimaniya-problemy-k-adekvatnomu-lecheniyu

published 04/28/2016 08:00 updated 04/27/2016

What should a newborn's stool look like?

Proper stool for a healthy baby has a mushy consistency. The color of the stool is brown, yellowish, and sometimes has a mustard color. The smell should not be too strong, and when exposed to air, the stool will take on a greenish color. If a child is fed formula, the stool becomes more formed, in the form of a thick puree, and the frequency of bowel movements decreases.

The baby's diet stipulates that with exclusive breastfeeding, bowel movements occur from 1 to 8 times a day, after 6 months - 1-3 times in 24 hours.

Signs of constipation

From birth to three months, healthy children have bowel movements up to 6-10 times a day, and a deviation from this norm may indicate that constipation has occurred. But the frequency of bowel movements is far from the only sign of constipation in newborns and children in the first year of life4,5.

Parents should be wary if:

rare bowel movements are accompanied by poor appetite or complete refusal to eat;
the child often wakes up and cries, and attempts to calm him down are unsuccessful;
When bathing or washing, the child shows anxiety. This may be due to cracks in the rectum due to damage from hard feces;
when defecating, the child strains strongly and turns red;
the baby becomes restless and pulls his legs towards his stomach during and after feeding;
there is a lag in weight gain;
visually the feces are dry and dense;
stool has an unpleasant putrid odor, which indicates that it has been in the intestines for too long4.

What should be considered constipation in an infant?

Constipation is considered to be retention of stool for 2–3 days. If the baby experiences difficulty during bowel movements for 14 days or more, this is a criterion for a chronic form of the pathology. The frequency of bowel movements decreases, the feces become too hard, dense, and also have an unpleasant odor.

Constipation in a newborn baby is manifested by the following symptoms:

the child strains too hard and for a long time during bowel movements;
the baby’s face turns red, the legs are pressed tightly to the stomach;
defecation causes severe pain, the baby cries;
a red streak of blood appears on the surface of the stool (this means that the rectal mucosa was injured during defecation);
the general condition of the child is disturbed: bloating and pain are observed;
Parents note a decrease in the baby's appetite and increased irritability.

The symptoms of the disease are quite obvious: at the slightest concern, parents are advised to contact their pediatrician for a detailed consultation.

Prevention

To prevent constipation during mixed feeding, first of all, it is necessary to maintain lactation for as long as possible. You need to carefully select the mixture and include it in the diet in minimal quantities. With breast milk, the baby’s body receives the necessary enzymes and beneficial bacteria to create normal intestinal microflora. It is advisable to switch to mixed feeding only on the recommendation of a doctor; it is also better to use the mixture that is recommended by a specialist.

To prevent constipation, you also need to regularly lay your baby on his tummy and massage him. To do this, stroke the baby's tummy with light circular movements clockwise. It is also necessary to walk with the baby more often, do gymnastics, the “bicycle” exercise is especially useful. And warm baths with chamomile will help him relax. In addition, when introducing supplementary feeding into the diet, be sure to give the child additional boiled water, this will help avoid dehydration.

Constipation during mixed feeding is a fairly common occurrence. But with the right approach to this type of nutrition and following all the doctor’s recommendations, this problem can be avoided.

Why might a newborn be constipated while breastfeeding?

Approximately 95% of constipation occurs due to functional disorders: conditions develop spontaneously and disappear spontaneously. However, the remaining 5% of situations have a very specific organic nature.

Constipation in a one-month-old baby, either breast-fed or bottle-fed, is often caused by common causes.

Organic constipation

Appear in the first days or months of a baby’s life. The cause of constipation is not food, but a disruption of the normal structure of the child’s gastrointestinal tract, a neurological pathology in which the peristaltic function of the digestive canal does not work properly. Children suffer from constipation due to a decrease in the normal function of the thyroid gland and other organs of the endocrine system.

You can help your baby by consulting a doctor: if the doctor does not detect a specific organic pathology of the digestive system, we can talk about a functional disorder.

Functional constipation

The reason is the functioning of the nervous system, which in a small child is not yet well developed. Constipation is caused by poor innervation of the intestine, which causes dyskinesia to develop, peristalsis is weakened, and spasms of certain areas of the small or large intestine occur. All these factors slow down the passage of food through the gastrointestinal tract, which is one of the most common causes of constipation.

Other factors that can cause constipation include:

late development of digestive enzymes in a child;
prolonged presence of a food bolus in the stomach, intestines;
insufficient development of rectal receptors that signal the onset of defecation;
oxygen starvation in the prenatal period - the required rate of development of the central and peripheral nervous system is disrupted;
prematurity, decreased muscle strength of the child, rickets, low amounts of calcium and vitamin D in the child’s diet;
disruption of intestinal microflora (the normal ratio of bacteria necessary for digesting food).

The reasons for the violation of the act of defecation in a child may also lie in the mother’s diet. For example, a young mother loves dairy products very much, but the child is allergic to cow's milk proteins. During the breastfeeding stage, this may manifest itself as stool disturbances.

Prevention of constipation in infants during artificial feeding

An important factor determining the frequency and density of stools is the child’s physical activity. The more the baby moves, the better the intestinal motility. As a preventive measure, place the baby on the tummy more often; from 4 months, “move” the baby to the floor so that he quickly masters motor skills, since doing this on the floor is both more interesting and safer.

Do gymnastics with your baby on a regular basis - this also helps prevent constipation in a bottle-fed baby. Perform the simplest exercises (bringing your legs to your tummy, spreading them at the hip joint), but every day. It will also be helpful to do a light tummy massage on a regular basis.

If it is necessary to transfer a child to another formula (for example, by age, when they switch from “one” to “two”), do this gradually, for at least 3–5 days, alternately changing one meal at a time to a new type of formula.

Most children over 4 years old have had problems with bowel movements since early childhood, but for some reason, full treatment was not carried out. Therefore, it is important to engage in prevention and solve problems as soon as they appear.

Temporary stool disorders

Often, defecation disorders are transient. This is especially evident in the first months of a baby’s life due to insufficient formation of the child’s neuromuscular system. Over time, these disorders disappear on their own, without medical intervention.

Temporary stool disorders that do not cause harm to the baby’s health are associated with:

with a small volume of fluid consumed, which makes it difficult for feces to move through the intestines;
general intoxication and dehydration due to a general infectious process (acute respiratory viral infection, intestinal disease) - in this case, the child loses a lot of water through sweat and vomiting;
improper nutrition of a nursing woman (insufficient amount of fluid in the diet, unbalanced diet, small amount of fruits and vegetables, lack of fiber);
a small amount of breast milk, which reduces the total calorie content of the child’s diet;
introduction of complementary foods too early or improper use of baby food;
frequent use of enemas, special tubes for removing gas from the baby;
teething - the general emotional background of the child changes, he becomes irritable, nervous, which affects peristalsis.

Finally, psychological factors also become the cause of frequent constipation: excessive contact of the baby with new people, frequent moves, constant use of nanny services, low level of contact between mother and child.

As soon as these factors are eliminated, the baby’s stool returns to normal, and the baby no longer suffers from constipation.

Mixed feeding

After the birth of a child, all mothers must be given recommendations on how to organize breastfeeding. No one doubts that it is breast milk that ensures normal development of the baby and prevents many diseases. But it is not always possible to maintain breastfeeding in full. This happens for various reasons.

Most often, switching to mixed feeding is required in the following cases:

the child is gaining weight slowly;
mother has little milk;
a woman needs to take certain medications or is sick with infectious diseases, while stopping breastfeeding is a temporary phenomenon;
the mother needs to go to work or is often away from the baby, and there is not enough expressed milk.

You need to switch to mixed feeding after consulting your doctor. In this case, it is advisable for the mother to preserve breast milk and follow a special diet. If you have an infection or need to take medications, you need to express so that the lactation process does not stop. If it is recommended to simply supplement the baby’s feeding, it is advisable that the volume of breast milk be greater than that of formula.

When mixed feeding, it is very important to choose the right mixture so that its composition is as close as possible to breast milk. This will make it easier for the baby’s digestive system to adapt to unfamiliar food. To prevent the baby from refusing to breastfeed, it is recommended to feed him with a spoon or choose a tight nipple for the bottle. With this diet, the child must additionally be given boiled water. Formula milk is used to supplement the baby's feeding until about 6 months, then it is gradually replaced with vegetable or fruit purees, cereals, soups, meat, and fermented milk products.

When a mother cannot, for some reason, breastfeed her baby constantly, there is a need to switch to mixed feeding.

What to do?

If a child has prolonged constipation, it is necessary to determine the cause of the disease. Parents should contact their pediatrician to find out the cause of constipation in their baby.

If the cause is organic and associated with a specific disorder of the gastrointestinal tract, then it is necessary to take the treatment prescribed by the doctor to normalize the child’s condition.

Treatment of functional constipation to maintain the baby’s health is carried out as follows:

Mandatory breastfeeding. Natural feeding with mother's milk ensures the appearance of the correct microflora in the child's intestines, its normal functioning, and adequate development of the gastrointestinal tract.
Compliance with the mother's diet. By influencing her own nutrition, a woman also changes the composition of breast milk. During lactation, it is necessary to responsibly maintain a water regime, provide a large amount of vegetables, fruits, and other foods high in fiber in the diet (it promotes proper peristalsis).
Motor mode of the child. High activity of the baby and adequate physical activity will help eliminate chronic constipation.
After feeding, the baby should be in an upright position. In addition, it is recommended to massage the abdomen: lightly stroke the baby's stomach in a clockwise direction.

Mom should not abuse enemas and devices for removing gases from the child. This will only lead to worsening constipation and an increase in symptoms.

Why does constipation occur?

The formula that a newborn receives as a substitute for mother's milk is an unfamiliar product for his body. In addition, the innervation of the intestinal walls in most infants is not yet sufficiently developed, so peristalsis is not very active. Since the baby's food comes slowly, there is a risk of constipation. The new product can also contribute to the complete cessation of intestinal motility, which will also provoke stagnation of food and feces.

Up to contents

What not to do?

To help your baby’s body cope with constipation, you need to contact a pediatrician who will give specific recommendations for getting rid of the disease.

For example, you cannot feed a child by the hour - you need to give him food on demand, which stimulates intestinal function and the release of milk from the mother. It is also not recommended to specifically feed the baby after regurgitation, because the baby eliminated air from the stomach by regurgitation.

The use of folk remedies to stimulate defecation is prohibited: this can lead to burns or damage to the mucous membrane.

Finally, you should not use medications without a doctor’s prescription: it is unknown how they may affect the child.

Causes of constipation

Most often, constipation in a mixed-fed baby occurs when the wrong choice of milk formula occurs or when switching too abruptly to a new type of diet. The mixture must be added to the diet gradually, and if this is not possible, as much breast milk as possible must be preserved. The sudden introduction of food unfamiliar to the child can cause digestive problems. Moreover, this applies to both adapted mixtures and additional complementary foods, which are recommended to be introduced no earlier than 4-5 months of age. And if a woman has enough milk, you can introduce the baby to new foods after six months.

Constipation in an infant may be accompanied by colic, bloating, and discomfort during bowel movements.

The appearance of constipation can also be associated with the wrong choice of mixture. If such food is inexpensive or is not purchased in special stores, it may contain cow's milk, palm oil, and various chemical additives. To maintain the baby’s normal digestion, it is better to choose adapted formulas for feeding him that are closest to breast milk. A doctor or breastfeeding specialist can help you choose the right mixture. Often, for such problems, it is recommended to use mixtures with bifidobacteria, for example, “Nan” or “Humana”.

In addition, there are other causes of constipation in mixed-fed babies. Abnormal bowel movements may be associated with the mother's eating habits. If her diet includes a lot of carbohydrates, white bread, pasta, and fatty meats, the child may suffer from constipation. This problem also arises with the use of antibiotics, iron supplements, infectious diseases, and dysbacteriosis. Intestinal tone may be reduced due to a lack of calcium, limited mobility of the child, or some congenital diseases.

Often mothers also forget that the baby needs water. The body makes up for its deficiency from the intestines, which leads to compaction of stool. Even infants who receive only mother's milk are recommended to be supplemented with food, and with mixed feeding, boiled water must be offered to the baby. In addition, when introducing supplementary feeding, it is very important not to overfeed the child, as this can also lead to constipation.