What to do against constipation?

Constipation in infants and young children is not uncommon but it is always important to seek the advice of your doctor or a Healthcare Professional to exclude any underlying problem and prevent the constipation becoming chronic.

Constipation affects up to 28% of all Children

Constipation, one of  the most common infant digestive problems reported by parents, is associated with discomforts for your baby including tummy pain, loss of  appetite, and constant soiling. How do you know if  your child is constipated? First you have to know the  normal stool frequency (number of  times in a day) and stool consistency (softness).

What is normal stool for babies and young children?

The first stool passed by your baby within the first 24-48 hours is called meconium, which is normally green and very sticky (Griffin & Beattie 2001). Breastfed infants pass a softer and greater number of  stools than formula-fed(Fontana et al). The stool consistency should be soft until weaning when it becomes firmer.

Why are stools of breast-fed infants different?

Breast milk contains lactose as carbohydrate and oligosaccharide, the food of good bacteria that stimulate their growth. Good bacteria, also called probiotics namely,lactobacilli and bifidobacteria, are necessary to promote a healthy digestive tract. A healthy digestive tract means healthy stooling in terms of  frequency and consistency. As the baby matures, normal changes occur within the digestive system that result to a decreased number of  stools.

The tell-tale signs that your child may be constipated

Signs that your baby may be constipated can be observed in the bowel frequency and consistency. For example, if  your baby is between 0-3 months old, 2 bowel movements per day is considered normal, if  formula fed. If  it differs from this normal range, you may see a health care professional for proper diagnosis and advise.

What are the possible causes of constipation in infants?

  • Transition from breast milk to infant formula. Breast milk contains lactose as its sole source of carbohydrates and prebiotic oligosaccharides, including galacto-oligosaccharides. Formula with lactose and oligosaccharides may help in supporting a healthy intestinal flora similar to that of breast fed babies.
  • Improper dilution of infant formula feed that results to higher formula concentration per ounce of water.
  • Introduction of solid food without enough fluid-intake in between meal times during weaning.
  • Not enough fiber for babies beyond 6 months old who are already getting complementary feeding with solid foods.

Simple Interventions to Help Relieve Constipation

  • Tummy massage: Consult a qualified health professional.
  • Leg exercise: Lay your baby on his or her back and gently move his or her legs in a bicycle motion. This will cause the stomach muscles to move and gently stimulate the your baby’s intestines to help make bowel movement.
  • Relaxing, warm bath: The relaxation may help your baby’s stool pass more easily. During or after the bath, try gently massaging your baby’s tummy.
  • Natural fruit juices such as apple and pear.
  • For formula fed babies, help is given with food or formula that contains oligosaccharides as prebiotic and lactose as its source of carbohydrate.

What to expect, what is “Infant Dyschezia”?

Sometimes babies can go red in the face or grunt when they have bowel movements, even if  they pass normal or soft stools.  What happens is that when infants feel the urge to go, they often stretch out their legs, which tightens their pelvic floor. This uncoordinated defecation is sometimes called ‘infant dyschezia’, which normally corrects itself  with time. The longer time the stool remains in the rectum the larger and harder the stool becomes, and usually results in uncomfortable or painful stool passage, normally occurring among toddlers.

Does your toddler suppress stooling or “hold on”?

It may only take one episode of  uncomfortable or painful experience of stooling for a toddler to develop a behavior to suppress defecation in order to avoid the further passage of  anticipated uncomfortable or painful stools.

Suppressing defecation may lead to pushing the stool higher up in the rectum that reduces the urge to defecate. If  the behavior of “holding on” or suppressing defecation continues, the rectum eventually stretches to accommodate the retained stools, then the child will very quickly become constipated.

It is important that any change in stool consistency or frequency that may indicate the potential development of  constipation is addressed quickly to prevent the cycle of  ‘holding on’ or suppressing stooling.

Working with toddlers on healthy stooling

  • Increase your child’s fluid and fiber intake.
  • Potty training should be addressed separately from resolving constipation. Some mothers address potty training and resolving constipation at the same time, this will not work on your toddler and will increase your frustration.
  • Allow your child to use a nappy to poo, if he or she insists, although it must be only in the toilet area. If your toddler poo’s in the nappy, encourage him or her to sit on the toilet or the potty with the nappy on to remove the nappy completely.
  • Ask your pediatrician about nutritional supplement or formula that has Oligosaccharides as prebiotic (food for good bacteria) and Lactose as sole source of carbohydrates that may help promote healthy stools.
  • If simple interventions, dietary and increasing fluid intake fail to resolve the problem of constipation, seek the advise of a doctor or health care professional.
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