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Constipation in children under one year old

Usually, parents of babies are worried about the exact opposite problem - too frequent stools. Therefore, not everyone immediately understands what to do if a baby under one year old has constipation.

Gastroenterologist, hepatologist at GMS Clinic Sergey Vyalov gave an interview to the Internet portal parents.ru and spoke about constipation in children under one year old.

Introduction

Constipation, also known as diarrhea, stool retention, discolia, caprostasis, difficulty in emptying the bowel is not a universal condition with unambiguous characteristics. Each person, including a child, has his own indicators of the norm and deviations from it, associated with age, intestinal microflora, diet, state of mind and hormonal background, concomitant diseases. Yet there are a few common points of reference.

What is constipation?

Specialists diagnose constipation if the baby does "big" things:

• regularly and without problems, but passing dry and hard stools;
• with difficulty - the child has to push, the feces do not come out on the first try;
• less than 5 times per day.

In the first six months of life, constipation is a rather rare occurrence, rather, on the contrary, in the period from 0 to 6 months, 6-10 bowel movements per day are considered the norm. Breastfed babies have more frequent bowel movements, while artificial babies have less.

Up to 6 months constipation is rare

Usually, parents of babies in the first months of life are alarmed by the condition opposite to constipation - too frequent bowel movements. But in a baby, regardless of whether he eats breast milk or formula, the intestines should work exactly like this - in a mode that is considered diarrhea for older children and adults.

There should be no other option, at least until the introduction of complementary foods at 4-6 months. After all, the baby receives mostly liquid food, the waste products of which have the same consistency and leave the intestines without encountering any obstacles on the way - the baby has not yet learned to control the sphincter that restrains the release of feces.

The baby's intestines have just begun to "get acquainted" with microorganisms that come from mother's milk, from her skin (the baby licks the nipple), from the environment. Far from all new "partners" are accepted: there are rejected ones, those who have not taken root, and so on. Checking and rejection are accompanied by loose, unstable stools.

Too frequent bowel cleansing does not need correction and treatment if the child is gaining weight and developing properly. Normal appetite and sleep, gas, absence of fever and other signs of illness indicate that parents have nothing to worry about. If the mother of a baby, tired of changing diapers 10 times in one day, wants to change the situation and asks the doctor to prescribe fixing medicines for the baby, then, unwittingly, she will doom her baby to chronic constipation.

Not according to the rules

And yet, in the first 6 months, constipation in infants is not excluded. It can be called:

• microflora transmitted from the mother;
• insufficient fluid volume;
• stress.

Let's say a woman has too many methane-producing bacteria in her stomach and intestines that cause constipation. They grow rather slowly, ferment, releasing carbon dioxide, which contributes to flatulence and bloating. With this deviation, the woman lives, adapted and learned to solve the problem with the intestines in one way or another. Noticing the same thing in a child, she decides that the baby has inherited her features and "saves" him with the same means, making a mistake. Babies should not be given laxatives, especially those containing senna. The baby's body gets used to such drugs too quickly and without them it can no longer cleanse the intestines.

Constipation in a baby up to 6 months is also provoked by a lack of fluid and hormonal fluctuations. At 6 months, the baby should receive a lot of moisture - about 140 ml per kilogram of weight per day. A breastfed child gains this rate from mother's milk and does not need additional sources of liquid (but only if there is no predisposition to constipation). Little artificers are soldered from the moment they switch to a mixture.

If a woman is tense or nervous, then her level of the stress hormone cortisol rises. Through breast milk, saliva or sweat, the substance enters the baby's body and also provokes constipation.

Even if the mother does not breastfeed the baby, the constipating microorganisms sooner or later get to the gastrointestinal system of the crumbs and make negative changes in it.

Constipation after introduction of complementary foods

The kid grows, improves skills, and it's time to introduce him to new foods. These circumstances, on the one hand, help to improve peristalsis, and on the other hand, increase the risk of constipation.

By six months, the baby is already trying to control defecation, because he realized that after it there are unpleasant sensations - itching, burning and other discomfort in the areas where the feces get. In order not to experience discomfort, the child tries to restrain the urge. At first, he does not succeed, because the rectum has already learned to work - to reflexively contract and push out waste. And after a couple of months, everything works out, the baby wins and enters the path leading to chronic constipation. To get the baby out of this vicious circle, the mother must minimize the duration of the baby's skin contact with feces and expand the baby's diet by mastering complementary foods.

Proteins, fats and carbohydrates that are part of the products are absorbed in the small intestine, and do not reach the large intestine, where feces are formed. What can not be said about fiber. While the baby is drinking breast milk or formula, this component of the dishes is not familiar to him. Even if a nursing woman herself consumes a lot of plant foods, the baby does not get anything. Fiber, as already noted, is not absorbed in the intestines, does not enter the bloodstream, which means that it is not in breast milk. For the first time, a baby receives fiber with complementary foods, tasting its first 25 grams of mashed potatoes from zucchini, carrots and other vegetables. Plant fibers literally attract all waste to themselves, as a result, fecal masses are formed, which help the intestines to master the correct peristalsis. There are a lot of muscles in this section of the gastrointestinal tract, in the intestines, they must learn to consistently contract - tighten and relax in order to squeeze waste out.

The next new product should be introduced one month after the previous one. The novelty is likely to cause more frequent and loose stools at first. If it does not have a green color and does not foam, there is no need to run to the doctor and ask to prescribe fixatives. Be patient, after a while the innovation will be mastered and will bear fruit. Instead of liquid and shapeless yellow-white feces, you will see brown feces that have formed.

Special constipation

There are other causes of constipation in babies. Unfortunately, they are much more difficult to deal with, since these are developmental pathologies, illnesses, and injuries.

Acute constipation. It develops for anatomical reasons, for example, due to obstruction of the large intestine, or during intussusception - the introduction of one part of the intestine into another, which causes blockage of the lumen. Against the background of complete well-being, the baby suddenly becomes restless, cries, refuses to eat. The attack ends as unexpectedly as it began, but after 3-5 minutes it repeats and intensifies: one or two vomiting appears with an admixture of green bile. If the stool passes, then blood impurities are visible in it. After 5-6 hours, the stool stops, and bloody discharge comes out of the rectum. At the same time, the baby's stomach is soft. The temperature is usually normal. The child may even lose consciousness. With such symptoms, you need to call an ambulance.

Hirschsprung disease. It is based on a violation of the innervation of the large intestine - the central nervous system cannot control this section of the gastrointestinal tract. As a result, processed food accumulates in the intestines. The picture of the disease is quite diverse. If only the short part of the intestine is affected, then constipation forms gradually, and it is possible to do without surgical intervention for quite a long time. When a longer segment is affected, the absence of stool is fraught with a serious condition and immediate surgical intervention is required.

infectious attack. If in the first months of life the baby suffered an intestinal infection, the nerve cells in the large intestine may die, which will lead to a delay in the act of defecation, accumulation of feces and the development of constipation. With dysentery, the so-called toxic megacolon is possible (a sharp expansion of the colon). The child develops impaired consciousness and repeated vomiting. The abdomen increases sharply due to a greatly enlarged intestine. The complication requires emergency surgical care.

Problems with the CNS. Injuries during childbirth and the syndrome of infantile cerebral palsy also affect the functioning of the gastrointestinal tract, as they are associated with various complications, such as impaired swallowing, regurgitation, and vomiting.

Vasculitis. Vascular inflammation extends to the nerve plexuses and sensitive cells located in the intestinal wall.

Disorders in the work of the endocrine system. With hypothyroidism (lack of thyroid function), the movement of contents through the intestines slows down. With dysfunction of the parathyroid glands, constipation occurs due to a violation of mineral metabolism, with diabetes mellitus it becomes the result of damage to the nerve plexuses of the intestine or dehydration of the child's body.

Medical constipation. Before giving your child any drug prescribed by a doctor, carefully read the instructions. For example, anemia remedies containing iron can cause constipation. Observance of the rules of intake will help to avoid it - directly during meals, reducing doses of iron when introducing foods with a high iron content into the diet - buckwheat, apples, greens. Particular attention should be paid to constipation resulting from treatment with non-steroidal anti-inflammatory drugs, neuroleptics, sorbents and antibiotics, which cause intestinal dysbacteriosis.

Diseases and conditions accompanied by constipation are not so common in infants. Many pediatricians do not immediately remember them. Before getting to the truth, they prescribe a lot of unnecessary drugs, forgetting about effective bowel examinations, such as x-rays.

Source: parents.ru

Constipation in a child: what to do?

Constipation disrupts the functioning of the gastrointestinal tract. The main manifestation of constipation is a rare stool, difficulty in emptying the intestinal tract. If emptying occurs every three days, but there is no swelling and discomfort, and the feces have a normal consistency, this is not considered constipation.

If your child is constipated, a specialist should be consulted. Initially, you should seek help from a gastroenterologist. The First Children's Medical Center employs the best pediatric gastroenterologists in Saratov: here you can get qualified medical care!

Symptoms of constipation

The main symptoms of constipation include:

• infrequent bowel movements;
• if the child pushes hard trying to go to the toilet;
• if there is pain during bowel movements;
• stools look like balls.

When the baby is breastfed, he can empty himself up to seven times a day, after each meal. During the first week, the frequency of emptying is three times a day.

When the baby is one month old, the chair will be daily. At two months of age and when complementary foods begin, stools can be once every two days. If the baby has a soft stool, he feels good, but at the same time he defecates once every few days, this is the norm.

Signs of constipation include: discomfort during bowel movements, moodiness, very hard stools. If this situation persists, you should contact your pediatrician.

It is important to adjust the feeding regimen. Do not overfeed the child, do not transfer to artificial feeding if the mother has little milk. The first step is to try to fix the situation. A nursing mother should drink more fluids, stop eating foods that cause flatulence, reduce intestinal motility. Only in extreme cases should be transferred to artificial mixtures.

If the baby is formula-fed, he should empty himself once a day. The main mistake in this case is that parents often change mixtures, try others. Mixtures should be adapted, sour-milk, which contain probiotics and prebiotics. It is also necessary to strictly follow the instructions, properly dilute the mixture, taking into account all proportions. The introduction of complementary foods should be on time. The diet should contain foods that contain a large amount of fiber.

After the introduction of complementary foods, the stool becomes formed, hard, less frequent. Until the age of three, bowel movements should be daily. After three years, the frequency of defecation should be at least three times a week.

Why constipation occurs

There are two types of constipation - organic and functional. The causes of organic constipation are:

• Hirschsprung's disease;
• anomalies in the development of the gastrointestinal tract;
• pathology of the endocrine system;
• violations of metabolic processes.

In a newborn child, this symptom may indicate a narrowing, lengthening or expansion of the intestinal tract.

The causes of functional constipation include:

• psychological problems, such as being in an unfamiliar environment;
• lactose deficiency;
• lack of fluid in the body;
• errors in the diet;
• negative reaction of the body to taking antibacterial drugs, drugs for the treatment of anemia, anticonvulsants;
• congestion of bile in the gallbladder and its ducts;
• Intestinal worms.

In newborns, the nervous system is immature, it is just being formed. Therefore, children are unable to control the movements of their muscles during bowel movements. You can help them by gently bending the legs, pressing them to the tummy. With these movements, the pelvic muscles relax, the bowel is released much faster.

How the therapy works

The treatment of constipation requires a holistic approach. Treatment is prescribed in each case individually, depending on the cause of constipation.

To ensure the normal functioning of all organs, it is necessary to adjust the stool in children. You will need to adjust your diet and lifestyle, do not abuse laxatives, as they help only temporarily.

The main principles of therapy include:

• Diet correction. Requires elimination of foods that can cause constipation. Among them are fermented milk products, rice, muffins, bakery products, pasta. The menu is recommended to include vegetable fiber, which is found in fresh fruits and vegetables. You should also abandon fast carbohydrates - flour products, sweets. You need to add to the menu more foods that contain potassium, for example, figs, dried apricots, prunes.
• Observe the drinking regimen. It is important to drink clean drinking water. During the day, the child should drink at least 40 milliliters of water per kilogram of his weight.
• According to the doctor's prescription, the baby should be given medicines, homeopathic remedies. These include drugs for the outflow of bile, drugs that restore the intestinal microflora. You can use antihelminthics, laxatives, drugs with lactulose in the composition. Your doctor may also prescribe medications that contain polyethylene glycol. They retain moisture in the intestines, thin the stool.
• In case of prolonged constipation, the child can be given a glycerin suppository, micro enema as a stimulant.
• Undergo physiotherapeutic procedures prescribed by the doctor, massage, do therapeutic exercises.
• Provide a calm environment, help the baby psychologically so that he is not afraid to empty his intestines. You can read fairy tales, play with your child.
• Train the intestines, after eating, put the child on the potty for a few minutes.

First you need to get rid of constipation and only then potty training. If constipation is not treated in a timely manner, this will entail unpleasant consequences for the health of the child.

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