Easing constipation in babies
A missed bowel movement, a little grimace on your child’s face when he/she poops, or actions resembling straining are not enough to declare a baby constipated, but often form part of the observed signs in constipated babies.
Constipation, according to Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour, refers to a change in the frequency and consistency of stools passed.
“Constipation is a common problem in infants and children, wherein stools are passed less frequently, are hard and dry, and with accompanying difficulty and pain in passing stool. It is usually associated with major transitions or changes in routine such as from breast milk to formula, addition of complementary foods, potty training, and start of school attendance. This is defined as functional constipation,” Dr Griffith said.
She pointed out that though presented less frequently, there are also medical reasons for constipation.
“These include anatomical abnormalities involving the intestines such as Hirschsprung’s disease, which usually presents shortly after birth and is characterised by delayed passage of the first stool, disorders of the nervous system, or underfunctioning of the thyroid gland or hormone (hypothyroidism),” Dr Griffith said.
Dr Griffith said that constipation in your child can be identified by way of the following symptoms:
• Decreased bowel movements
•Hard, dry stools that may be large and bulky or pellet-like.
• Painful bowel movements
• Abdominal pain
• Faecal soiling – soiling of underwear with soft stool that has passed around the hard portion
• Blood coating stool, or present on wiping.
She further explained that pain associated with bowel movements could also cause children to exhibit withholding behaviours such as ignoring the urge to have a bowel movement, crossing of the legs, twisting of the body, squeezing or clenching of the bottom, or raising the body on tiptoes in response to the urge to pass stool.
Dr Griffith said that there are a number of available treatments – natural and pharmaceutical — that have proven effective in returning normalcy to bowel movements and helping the affected to overcome the fear and anxiety associated with the unpleasantness of the process.
“Dietary adjustment, including increasing dietary fibre, including fruits and vegetables, prunes, prune juice and apples, come highly recommended. Other natural remedies including aloe vera and senna, and are incorporated as part of many over-the-counter(OTC) preparations but be used under a physician’s guidance. On the other hand there are some common OTC preparations used as laxatives that include mineral oil, milk of magnesia and fibre products,” Dr Griffith said.
Other recommendations include:
• Increasing water intake.
•Scheduled time for bowel movements, ideally within 30 minutes of a meal in order to establish a routine.
• Consistent support.
• Encouraging physical activity as this promotes peristalsis or the movement of the intestines.
• Relaxation techniques such as deep breathing to decrease anxiety associated with the process and aid in the relaxation of the pelvic muscles.
Dr Griffith said in cases where the child shows signs of distress and pain, if he or she looks ill and once there is any concern, medical attention must be sought to rule out those conditions that require medical or surgical intervention – for example to disimpact or free the bowels of stool.
She said that constipation can be recurrent and triggered by instances of stress or change of routine or illness such as post-gastroenteritis. She advised that reassurance of both child and parent should be encouraged as they face these challenges.
