When constipation in a baby occurs during breastfeeding, you should immediately contact a pediatrician. We asked Bologny magazine certified medical experts why babies are constipated and how to help them get rid of the problem. You can find the answers of the experts below, but remember that we provide this information for informational purposes only, and not to induce action.
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Causes of constipation in infants
Can a baby be constipated? Unfortunately yes. There are a huge variety of reasons that can provoke the development of constipation in infants.
- Intestinal motility. Very often, the cause of constipation in an infant is considered to be a violation of the normal motility of the intestinal tract, which have both an endocrine and a nervous nature of occurrence. Such situations account for up to 20% of all constipation.
- Intestinal infections. In particular, dysbiosis is considered an almost permanent consequence of intestinal infections. If your child is faced with such a problem, it is necessary to get a stool test immediately.
- Hereditary diseases. Do not overlook diseases such as hypothyroidism, Hirschsprung’s disease, cystic fibrosis. They can also be the cause of systematic constipation in young children. They usually appear from the very first months after the birth of the baby.
- Alimentary factors. For the normal digestive process of the child, the feeding regime is also of great importance. Moreover, not only the regime, but also the feeding ration itself. The baby’s menu should contain dietary fiber, liquid.
- Reception of pharmacological preparations. Many medications can also lead to constipation in infants. Often, doctors will warn parents about possible side effects. But the parents themselves should not be lazy and be sure to carefully read each annotation to the medications that they are going to give to their baby.
- Lack of movement. As you know, for the proper functioning of the intestine, the baby must move a lot. Of course, for children, the lack of movement is considered an irrelevant problem, because it is very difficult to keep babies in one place. But there are situations when this reason also takes place – for example, if a child is sick.
- Psychological reasons. In many situations, constipation is of a psychological nature of origin, for example, resentment of a baby or fear. For example, if a baby has an anal fissure, then he will be able to restrain the urge to defecate, being afraid of pain.
Read also: How to end breastfeeding correctly?
Pediatrician Elizaveta Gammel tells about the causes and treatment of constipation in infants
Often parents come with complaints that the infant does not have an independent chair. At the same time, stool retention occurs from 3 to 5-7 days, and then it “gives out” everything that has accumulated over these days. This condition is called dyschezia.
Dyschezia is typical for children under 3 months old. Difficulty defecation in infancy is based on the immaturity of the pathways of the lumbosacral nerve plexus, as well as the child’s inability to coordinate the abdominal muscles and relax the pelvic floor muscles at the same time. Roughly speaking, the child has not yet learned to understand that he needs to “go big”. In this case, bowel movements are accompanied by strong straining, grunting and crying.
The baby usually calms down after a bowel movement. It is important to note that the feces are mushy and without impurities. Studies show that the risk of developing dyschezia increases with a history of intrauterine hypoxia, caesarean section, prolonged jaundice. Such situations (tension – stool) can be repeated several times a day.
In case of dyschezia in a child, you can use candles or microclysters, or, if the baby is calm, wait for an independent chair (up to 3 days). Nutrition of the mother while breastfeeding can make little difference in this case. Sometimes, when the baby is eating a mixture, you can use mixtures with thickeners, they are also called antireflux. However, such activities should not be carried out without consulting a pediatrician. If the baby has a tight, dense stool, there is an admixture of mucus or blood, then in this case an urgent need to consult a doctor and conduct additional examinations to establish the cause.
Elizaveta Gammel, pediatrician, gastroenterologist
The head of the pediatric clinic of the Maternity Hospital No. 4 at the GKB im. V.V. Vinogradova Vladislav Anatolievich Zyablitsky
Constipation is a disorder of bowel function. This state is expressed in:
- – an increase in the interval between acts of defecation in comparison with the individual physiological norm;
- – difficulty in the act of defecation;
- – a feeling of incomplete bowel movement;
- – discharge of a small amount of feces of increased density.
The causes of constipation in children are as follows:
- Organic (aka mechanical) – an anatomical anomaly, mechanical constipation or narrowing of the intestine (this cause can be determined in the first few days or weeks).
- Endocrine or metabolic – malnutrition of the child or mother. Possible lack of enzymes in the child’s gastrointestinal tract or disorders of the endocrine system
- Neurological – disruption of the child’s nervous system. In this case, the intestine contracts incorrectly and the act of defecation becomes difficult.
- Anorectal – the child has irritation of the rectum and anus and the process of defecation is painful (requires a mandatory consultation with a proctologist surgeon)
- The drug cause is an adverse drug reaction. For example, on iron-containing drugs, which are prescribed for 1 year of life for the treatment and prevention of anemia
In case of constipation in an infant, first of all, it is necessary to correct the errors of the feeding process – violations of the regime, nutrition (volume), incorrect (often unreasonably early) beginning of complementary feeding, its quality. A mother nursing a baby should follow a drinking regimen and a diet that restricts the use of “trigger” foods that increase gas production and reduce the motility of the colon. These products include tea, coffee, alcohol, chocolate, citrus fruits, sweet syrups.
With artificial feeding, frequent changes of formula should be avoided. It is necessary to use only adapted milk formulas, to ensure sufficient fluid intake – boiled water and herbal teas with fennel, chamomile, dill for infants.
From 4-4.5 months, you can give slightly concentrated decoctions of prunes, dried apricots, dried fruits, berry fruit drinks. The introduction of complementary foods with vegetable, fruit purees (prunes, apricots, peaches, apples) is indicated for a child with constipation no earlier than 5.5 months of age.
If there is a suspicion of intolerance to cow’s milk proteins, the child is prescribed medicinal mixtures with a high degree of protein hydrolysis. Intolerance to cow’s milk proteins can also occur during breastfeeding, in this case, a dairy-free and hypoallergenic diet of a nursing mother is indicated.
In case of lactose deficiency, occurring in 10% of cases with constipation, enzyme replacement therapy with lactose, a dairy-free diet of a nursing mother is indicated, and for bottle-fed children – the use of low- and lactose-free therapeutic mixtures.
Also in the pediatrician’s arsenal there are medicinal mixtures with pre-, pro- and symbiotics, fermented milk mixtures, antireflux and laxative mixtures based on locust bean gum.
What can we do to improve stool? Treatment for constipation in an infant:
- Therapy of concomitant neurological pathology of an infant, massage of the abdomen before the next feeding, therapy with the position (on the stomach, with the legs bent), light massage of the perianal region in most cases help to resolve constipation.
- Medicinal laxatives that soften feces successfully replace cleansing microclysters and gas outlet tubes from everyday life (but you should not get carried away with them, you need to understand the reason, and not treat it locally).
- The use of curative water microclysters in infants is regarded as emergency therapy in case of severe impairment of well-being, their use should be limited (once every 36–48 hours). Water cleansing enemas often only partially empty the intestines, causing prolonged flatulence, inflammation of the intestinal mucosa and the phenomenon of water intoxication. Children over 1 year old.
- In the diet of a child over 1 year old, suffering from constipation, there should be food with a high content of dietary fiber (bran, vegetables, fruits), lacto- and acidophilic bacteria. Fermented milk products stimulate intestinal motility, correct secondary disorders of intestinal microbiocenosis.
For the prevention of constipation in an infant, a sufficient constant physical activity is a prerequisite. The morning set of exercises should be supplemented with physiotherapy exercises (exercise therapy), aimed at increasing the pressure in the abdominal cavity, stimulating intestinal motility. It is necessary for the child to adhere to the daily regimen, and the prevention of infectious diseases, especially intestinal infections, is mandatory.
Vladislav Anatolyevich Zyablitsky, head of the children’s clinic
Treatment of constipation in an infant. How to cure constipation in a toddler?
How to help a baby with constipation? Below are the basic recommendations of a pediatrician:
- Change the diet of nursing mothers. You should eat more prunes, fiber, beets, greens. Avoid coffee, alcohol, chocolate and cheese. It doesn’t hurt to keep a food diary and consult a doctor.
- Adhere to the infant’s feeding regimen and daily routine. Learn how to breastfeed your baby properly. Violation or change in its regime can lead to disturbances in the work of the stomach and constipation.
- If your baby is on formula or mixed food, try formula milk, which will prevent constipation and improve your baby’s digestion. Read the article about the best baby food according to moms.
- Most often, constipation in infants occurs after the introduction of complementary foods. Therefore, you should not forget that complementary foods can be introduced with plum juice or spinach.
- Give your child only boiled water.
- If constipation in an infant leads to complications (stomach pain, gas, useless urge), appropriate measures must be taken. Use a small syringe. You need to cut off half, leave only a tube, grease with baby cream or vegetable oil and insert it into the child’s anus. You need to wait about 3 minutes, then air and feces will begin to come out. If this does not help, use a special candle, but before that you should consult a doctor.
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