How do I know that my baby is having constipation? What are the symptoms of constipation?
- If your baby is passing hard stools often or he is passing less than 2 stools in a week then your child is having constipation.
- Moreover child will often cry while passing hard stools as constipation causes fissures(breach in skin) at potty site that will cause pain while passing stools.
- Fissures will also cause fresh bleeding in stools and you will see fresh red blood sticking to sides of stool.
- Due to fecal matter loading in intestines, child will have abdominal pain and loss of appetite.
- Withholding of stools (typically child may go to the corner of the room
or hide behind curtains and stand cross-legged or hold on a table and
bend forward).
- Soiling of pants with small amount of liquid stools is too a feature of
constipation.
- Urinary complaints (frequent urination).
- Passing large size stools or pellet-like stools.
- Bloating, passing a lot of gas, decreased appetite
Breastfed infants sometimes pass stools once in 5–6 days. As long as the stools soft in consistency
and baby is growing well, they are not of any concern
What causes this problem in my child?
Constipation could be due to functional (95% cases) or organic causes(5%):
- Dietary factors: Predominant milk-based diet, bottle-feeding, diet poor in
fiber, change in infant formulas.
- Withholding : too busy (morning school), too
engrossed (TV, mobile, and video games), just lazy to go to toilet.
- Forceful and too early toilet training.
- Sedentary lifestyle and decreased outdoor playtime.
- Acute stressful events : Stressful events (change of home, change of school, loss of near one, major changes in family, and sibling rivalry), intercurrent illness.
- Medicines: Some medicines too cause constipation as a side effect.
- Changes in routine : timing of defecation, nonavailability of toilets (during travel), etc.
- Organic causes (rarely): Hirschsprung’s disease, congenital anomalies (anal stenosis, anteriorly placed anus, and spinal cord anomalies), hypothyroidism, and lead poisoning.
How common is constipation in children?
Incidence is 17-40% of the cases. Overall it is prevalent in 10% of the cases.
When to consult a pediatrician for constipation in child?
- Persistence of hard stools beyond
4 weeks
- When the child is standing to pass stools
or straining significantly to defecate.
- There is fecal soiling of pants.
- Child is afraid to evacuate or cries while
passing stools due to pain.
- Pain or bleeding while passing stools.
- “Ribbon stools” (more likely in a child
younger than 1 year)
- Abdominal distention with vomiting
accompanied by constipation
- Urinary tract symptoms such as
retention of urine, urine infection or
incontinence
What are the indicators of organic cause of constipation?
- Constipation onset <1 month of age
- Passage of first stool after >48 hours of
birth
- Family history of Hirschsprung’s disease
- Ribbon stools
- Growth failure
- Persistent yellow green vomiting
- Abnormal thyroid gland
- Severe abdominal distention
- Abnormal position of area of stool
passage
- Tuft of hair or minute hole at lower back
What are the home remedies for functional constipation?
- Lifestyle modification : Increase outdoor play,water intake and regularize sleeping pattern of child.
- Dietary modifications : Avoid junk food , Increase fruits and vegetable intake, avoid intake of instant foods
- Give proper toilet training
- Take help of gastro-colic reflex by encouraging baby to pass stools after each meal if child does't get time to defecate in morning due to school.
What are the food items that help releaving constipation?
- Fruit: Berries, peaches, apricots, plums, raisins, rhubarb, and prunes are some of the best high-fiber fruits. For a fiber boost, eat the peel as well.
- Whole Grains: Oats, brown rice, whole wheat, quinoa, barley, and rye.
- Vegetables:You'll get fiber from vegetables, including what is in potato skins.
- Nuts: Walnuts and almonds will also add fiber to your diet.
- Seeds: Several kinds of seeds are excellent sources of fiber. You can add them to your smoothies or sprinkle them on yogurt or salads. Chia, ground flaxseeds, and psyllium are some of the most touted.
- Beans and Legumes (with caution): Legumes such as chickpeas, soybeans, lentils, navy beans, and kidney beans are good sources of fiber.
- Hot Tea: An herbal tea made with anise or fennel might be a soothing way to ease constipation.
What are the food items to be avoided in constipation?
- Avoid carbonated drinks and all sort of canned juices and flavoured milk
- Avoid junk food and ready to eat food like pizza,noodles
- Chocolates
What is the treatment of constipation and how long will it take?
Usually pediatricians will disimpact child's loaded colon with polyethylene glycol either orally or through enema followed by maintainance therapy with oral polyethylene glycol for 2-3 months.Polyethylene glycol is available as oral syrup or sachet form.Important thing is to complete the therapy in appropriate doses as prescribed by doctor.
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