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How Can I Tell If My Baby is Constipated?

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New parents often worry that their babies are not pooping enough. A baby eating formula usually has a bowel movement at least once most days, but may go 1 to 2 days between bowel movements. For breastfed infants it depends on age. During the first month of life, stooling less than once a day might mean your newborn isn’t eating enough. However, breastfed infants may go several days or even a week between bowel movements, using every drop they eat to make more baby, not poop.

Infants normally work really hard to have a bowel movement, so straining at the stool isn’t necessarily alarming, even when the infant cries or gets red in the face. For an infant to have a bowel movement can be a major effort, and it shows. Just imagine trying to poop lying on your back and you’ll get the picture.

If you're concerned your baby may be constipated, ask yourself the following questions:

• Is my baby excessively fussy?

• Is my baby spitting up more than usual?

• Is my baby having dramatically more or fewer bowel movements than before?

• Are my baby's stools unusually hard, or do they contain blood related to hard stools?

• Does my baby strain for more than 10 minutes without success?

These signs can all suggest actual constipation.

Is there anything I can give my baby for constipation?

Once your baby is at least a month old, if you think they are constipated, you can try giving them a little apple or pear juice. The sugars in these fruit juices aren’t digested very well, so they draw fluid into the intestines and help loosen stool. Although fruit juice is not recommended for babies under a year of age, as a rule of thumb, you can give 1 ounce a day for every month of life up to about 4 months (a 3-month-old baby would get 3 ounces). Once your infant is taking solid foods you can try vegetables and fruits, especially that old standby, prunes. If these dietary changes don’t help, it’s time to call your child's pediatrician.

More information

• Baby's First Days: Bowel Movements & Urination

• Common Conditions in Newborns

• Choosing a Formula

• Constipation in Children

Last Updated

5/12/2022

Source

Adapted from Dad to Dad: Parenting Like a Pro (Copyright © American Academy of Pediatrics 2012)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How to help a child with constipation? – health articles

06/16/2021

Contents

• Causes of constipation in children
• Symptoms of constipation
• Diet
• Gymnastics
• Benefits of contacting MEDSI

Constipation in a child can occur at various stages of growth and development. According to statistics, every fifth baby suffers from problems with stool. In this case, violations can occur already in infancy. With the start of complementary foods, the stool usually improves, which is associated with the introduction of fiber into the diet and an increase in physical activity. After a year, the number of children suffering from constipation is growing again. This is already due to the transition to solid food, the rejection of breastfeeding and the reduction in liquid in the diet.

It is dangerous to neglect constipation!

In fact, their consequences are quite dangerous and can cause:

• baby stress
• rectal deformities
• anal fissures
• general organism intoxication

What to do if the child has constipation?

1. Find out the cause of the pathological condition together with the doctor
2. Diet
3. Pay attention to moderate physical activity

Important! It is forbidden to self-medicate. Laxative suppositories and other means should not be given, as well as cleansing enemas.

It is forbidden to self-medicate. Laxative suppositories and other means should not be given, as well as cleansing enemas.

Causes of constipation in children

The main factors stimulating stool disorders in children include:

1. Insufficient fluid intake
2. Meals with little or no fiber
3. Lack of physical activity

Symptoms of constipation

A pathological condition can be suspected by the following signs:

• the presence of blood (scarlet, fresh) in the stool during the act of defecation and after it in the form of blots (traces) on toilet paper
• rare visits to the toilet for the purpose of defecation (2 or less times a week)
• large large compartments
• the need for strong straining during defecation
• pain in the anus and abdomen

Diet

What can be given to a child for constipation?

This question interests many parents. The fight against the problem should begin not with taking medications, but with changing the diet.

Necessary:

1. Increase fluid intake
2. Establish fractional nutrition
3. Add fiber-rich foods to the diet

You should teach your child to drink plain clean water. For babies over the age of 3, 2-3 glasses of water a day are usually sufficient. Avoid sugary carbonated drinks, coffee and tea. This is due to the fact that they have a pronounced diuretic effect and stimulate constipation and dehydration.

Especially useful is the cool water that children drink in the morning on an empty stomach. Gradually, the temperature of the liquid can be reduced. The following drinks also have a laxative effect:

• beet juice
• fermented milk (kefir, fermented baked milk, etc.)
• chamomile decoctions
• dill tea

Important! They should be introduced into the diet gradually, starting with a small amount. Otherwise, you can provoke a breakdown in digestion.

You should teach your child to drink plain clean water. For babies over the age of 3, 2-3 glasses of water a day are usually sufficient.

The treatment of constipation in children also implies the introduction of laxative products into the diet, which include:

• legumes
• nuts
• prunes and dried apricots
• plum
• beets
• dates

They are also included in the diet gradually and under the supervision of a doctor. Cereal porridges can be useful: oatmeal, buckwheat, wheat, pearl barley. It is advisable to refuse rice, pears, sweets, muffins, animal fats, flour products. They have a fixing effect.

What else to feed the child so that there is no constipation?

The answer to this question should be given by the pediatrician.

Gymnastics

For the prevention of a pathological condition, walking and running, swimming, exercises to strengthen the abdominal press, squats, bends are useful.

It is believed that mobile, active children are less likely to suffer from constipation. For the prevention of a pathological condition, walking and running, swimming, exercises to strengthen the abdominal press, squats, bends are useful.

If the child is already suffering from stool problems, it is recommended to start the day with simple morning exercises. Massage may also be helpful.

It is important to pay attention to the general change in the behavior of the baby.

The child should be taught to go to the toilet at about the same time, encouraged for observing the daily routine (motivate and praise).

It is also important to create a favorable environment in the toilet. Nothing should distract the child from the act of defecation or scare him in the bathroom.

Benefits of contacting MEDSI

• Help from experienced doctors. Pediatric coloproctologists, gastroenterologists and psychologists work with patients. They know exactly how to treat constipation in a child in accordance with the reasons that provoked it
• Diagnostic options. The clinic can conduct comprehensive examinations. They allow you to identify the causes of the pathology, find out how and what causes constipation in a child, help him as soon as possible
• Comprehensive approach to troubleshooting. Doctors not only recommend diet and gymnastics. If necessary, specialists prescribe laxatives, antispasmodics, as well as agents that stimulate the evacuation of feces (enemas and suppositories). All drugs are selected individually
• Prevention of complications. To prevent the undesirable consequences of constipation, regular examinations by a coloproctologist are mandatory
• Comfort of visiting clinics. We provide timely consultations without queues at a convenient time for patients

To make an appointment, just call 8 (495) 7-800-500. Our specialist will answer all questions and suggest the best time to visit a doctor. Recording is also possible through the SmartMed application.

Constipation in children. Prevention. Diet therapy

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Sabitova Vasily Ilyasovna Gastroenterologist

06/21/2019

Constipation is widespread among both adults and children (5-30% depending on the diagnostic criteria). Symptoms become chronic in more than 30% of patients, not only cause discomfort and pain to the child himself, but also disrupt the quality of life of his family.

CONSTIPATION - a condition manifested by an increase in the intervals between bowel movements (compared to the individual norm) or systematically slow, difficult and / or insufficient bowel movements. Constipation also includes stools with “gruel”, but after defecation was absent for up to 3 days.

Constipation can be related to functional or organic causes (abnormalities, inflammation). In children, 90-95% of constipation is functional. The peak incidence of functional constipation falls on 2-4 years, when they begin to accustom the child to the potty / toilet.

Main causes of functional constipation

• Pain
• Fever
• Dehydration
• Wrong diet of a nursing mother
• Insufficient drinking regime of a child with artificial feeding
• Insufficient drinking regimen of a breast-fed child with the introduction of complementary foods
• Early transition of the child to artificial feeding
• Fast transition of the baby from one mixture to another (less than 7 days)
• Irrational nutrition of the child (for a long time the child receives food with a large amount of proteins, fats and insufficient dietary fiber, abuse of drinks containing a large amount of astringents - tea, coffee, cocoa)
• Excessive use of baby hygiene products or the development of an allergic reaction of the skin of the perianal area
• Consequences of perinatal injuries of the nervous system
• Rickets, vitamin D deficiency
• Anemia
• Impaired thyroid function (deficiency - hypothyroidism)
• Food allergy, especially cow's milk protein allergy
• Forced potty training, period of adaptation to new conditions (nursery, kindergarten)
• Physical inactivity - a sedentary lifestyle
• Mental trauma or stress
• Systematic suppression of the urge to empty the bowels, associated, for example, with the beginning of attending a kindergarten, school, etc.
• Taking certain drugs
• Constipation in family members

Frequency of defecation in children of different ages

In addition to the frequency of the chair, you should pay attention to its nature. For a more objective assessment, the “Bristol fecal shape scale” is convenient, since it is the shape of the feces, and not the frequency of the stool, that is more consistent with the time of intestinal transit.

Bristol stool scale

In accordance with this scale, 3 and 4 form of feces is regarded as normal, and 1 and 2 indicate delayed transit (constipation). Quite often, in practice, there are situations when a child has a bowel movement frequency within the normal range, but the stool is dense, fragmented, in a meager amount. These signs indicate incomplete emptying of the bowels and are considered as manifestations of constipation.

The consistency of the stool in newborns and infants should be mushy. From 6 months to 1.5 - 2 years, feces can be both formalized and mushy. From the age of two, the chair must be decorated.

Signs and symptoms of constipation

• abdominal pain, often bursting, aching, sometimes colicky
• bloating
• change in the shape and consistency of the stool
• excessive flatulence
• unpleasant smell of flatus and stool
• may have pain during bowel movements
• straining to defecate
• there may be blood in the stool - on the surface of the feces or in the form of traces on a napkin (indicates an anal fissure)

If you do not eliminate constipation and do not establish bowel movements, then there is a risk of coprostasis (formation of fecal stones) and fecal intoxication:

• loss of appetite
• lack of energy
• general malaise
• depression, irritability
• nausea, vomiting
• skin symptoms - dryness, rash, peeling
• fecal incontinence, stool spotting
• urinary retention and incontinence due to pressure from a crowded bowel on the bladder
• bleeding from fissures, hemorrhoids

The treatment of constipation involves the following goals:

1. Normalization of stool consistency (soft, painless stools)

2. Regularity of bowel movements (prevention of re-accumulation of feces)

The treatment of constipation is a sequential, complex, individual process and consists of several stages:

• child and parent education
• correction of nutrition and drinking regimen
• elimination with the help of medications of existing coprostasis
• maintenance therapy

It is necessary to exclude factors that provoke and contribute to constipation (normalization of motor and nutritional regimen, discontinuation of medications that can cause constipation, identification of a food allergen, exclusion or confirmation of neuromuscular disease, celiac disease, etc.).

Lifestyle normalization includes:

• development of a conditioned reflex
• mobile lifestyle
• gymnastics
• gentle abdominal massage training
• for small children - laying out on the stomach, bending the legs to the stomach.

Education is the first step in the treatment of functional constipation. It must be remembered that episodes of fecal smearing and encopresis (fecal incontinence) are not arbitrary and should not be blamed on the child, who may already be frightened and disoriented. In some cases, when the intra-family situation is difficult, the help of a family psychologist may be needed.

It is important to understand that the treatment of functional constipation can be lengthy, based on trust, partnership and requires patience. Modern laxatives that are legal in children will not make the intestines “lazy”, will not cause “addiction”, they enter the bloodstream in minimal amounts or are not absorbed at all and are safe for long-term use.

Correction of the behavior of a child with constipation is based on the development of a routine of visiting the toilet, in order to achieve regular defecation. Defecation should be every time at the same time. The urge to defecate is based on the gastrocecal reflex, which manifests itself in the morning 1 hour after eating. A child with constipation needs to spend 3-10 minutes in the toilet (depending on age). It is necessary to plant the child on a potty or offer to visit the toilet after each meal.

A prerequisite for effective defecation is to provide a good support for the legs (a low bench on which the child can put his feet), which helps to increase intra-abdominal pressure.

If the defecation is not successful, the child should never be punished and vice versa. The daily frequency of bowel movements can be noted in a diary, which can be analyzed at a scheduled visit to the doctor.

Treatment of constipation should begin with lifestyle changes, which include dietary modification, drinking regimen and physical activity.

Calculation of fluid volume for healthy children

Children under the age of 1 year should drink at least 100 ml of water per day.

For healthy children weighing 10 to 20 kg the water requirement is calculated using the formula:

100 ml (volume of water for children under 1 year old) + 50 ml per kg for body weight over 10 kg.

For example, with a mass of 12 kg: 100 ml + 2 x 50 ml = 200 ml.

A child weighing 20 kg should drink water: 100 ml + 50 x 10 = 600 ml

For children weighing over 20 kg the following formula is suggested for calculation:

600 ml (volume of water for a child weighing 20 kg) + 20 ml for each kg over 20 kg.

For children over 3-5 years old you can use the calculation of the amount of water: 30ml / kg of weight

Principles of Dietary Therapy for Constipation:

• satisfaction of physical needs for nutrients and energy
• exclusion of excessive consumption of proteins and fats, which can inhibit intestinal motility
• enrichment of the diet with dietary fiber
• normalization of intestinal microflora with pro- and prebiotics

If the child is breastfed, then the mother's nutrition is corrected (restriction of products that promote gas formation). With artificial feeding, special mixtures are shown. For constipation associated with an allergy to cow's milk protein, therapeutic mixtures are prescribed if the child is bottle-fed. If the child is breastfed, cow's milk and products based on it are completely excluded from the mother's diet.

After the introduction of “thick” complementary foods, boiled water is necessary for all children, regardless of the type of feeding.

For older children, it is recommended to eat foods rich in vegetable fibers. It is not recommended to “smear food”, puree, “snacks”, “eating on the go”. Food should be crumbly, meat / poultry / fish - “piece”. A “bulk” breakfast is required to stimulate the “gastrocecal reflex”.

The main source of coarse-fiber vegetable fiber, containing a large amount of dietary fiber, is cereal bran, rye bread, as well as a number of vegetables and fruits. According to the principles of evidence-based medicine, a statistically significant increase in stool frequency and improvement in its consistency was demonstrated with the use of fiber compared with placebo.

Bran, as the main source of vegetable fiber, is recommended to be added to the second and third dishes, after pouring boiling water over it and settling for 20 minutes. Bran can also be used in between meals, drinking plenty of fluids. For school-age children, the total amount of fluid when taking bran should be at least 1.5-2 liters per day, otherwise they mainly act as sorbents, absorbing fluid from the intestines, thereby increasing constipation. The dose is selected individually, it is recommended to start with 1 teaspoon 2-3 times a day, with a gradual increase to 40 g per day. When the effect is achieved, the dose is reduced and limited to one dose.

The American Academy of Pediatrics (2009) recommends a fiber intake of 0.5 g/kg/day (maximum 35 g/day) for all children. Fiber intake below the minimum recommended value has been shown to be a risk factor for chronic constipation in children.

However, long-term intake of a large amount of plant fibers due to fermentation by intestinal microflora is naturally accompanied by bloating and flatulence.

Children with constipation are shown to take cool liquids on an empty stomach (drinking and mineral water, juice, compotes, kvass), to enhance the laxative effect, it is possible to add honey, xylitol or sorbitol. It is very beneficial for bowel function to increase the intake of juices containing sorbitol/sorbitol, such as juice from plums, pears, apricots, peaches and apples,

With “sluggish” bowel function (hypomotor constipation), cool mineral water of medium and high mineralization is used, such as Essentuki 17, Batalinskaya, Arzni, Donat Magnesium, etc.; with spastic constipation (hypermotor constipation, stool form more often type 1) - warm and low mineralization (Essentuki 4). Calculation of mineral water - 3-5 ml / kg per day.

It is necessary to limit milk in its pure form and in dishes, as flatulence may occur with the appearance or intensification of abdominal pain. It is better to replace whole milk with sour-milk products - kefir, acidophilus, yogurt, yogurt, etc.

The diet of children with constipation includes dishes rich in vegetable fiber - salads from fresh vegetables, greens 2-3 times a day, baked apples, stewed vegetables, diluted vegetable and fruit juices with pulp. Food is cooked mostly unground, steamed or boiled in water.

It is preferable to take raw vegetables and fruits (in the absence of contraindications). Especially recommended are tomatoes, zucchini, pumpkin, carrots, beets, lettuce, cauliflower, apples. Dried fruits (prunes, dried apricots, figs) are given in soaked form and as part of cooked dishes. White cabbage, young green beans, green peas are allowed with good tolerance. Parsley, dill, celery are good to add to various dishes and salads.

If after reading the article you still have questions or you do not understand how to apply the recommendations in your particular case, we invite you and your child to be examined by a pediatric gastroenterologist at the DDC. For the convenience of parents, you can make an appointment with a pediatric gastroenterologist at the Children's Diagnostic Center on a weekday and on Saturdays.

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