- Causes of constipation in children under one year of age
- What to do if a child under one year old has constipation?
- Massage and gymnastics
- Additional preventive measures
- Medicines to combat constipation in children
Constipation in children is not uncommon.
On average, their prevalence is 25-30%1. While the child is very young, constipation can cause mothers great anxiety, as the baby is capricious, crying, but cannot explain what exactly is bothering him. And every mother wants to help her child, but often does not know how. Therefore, regular bowel movements are not only one of the important indicators of the baby’s health, but also an important factor in the peace of mind of parents. In the period up to one year, when the baby is actively developing, his digestive system develops along with him, so there is a possibility of constipation.
Causes of constipation in children under one year of age
The following reasons can also lead to constipation in children2:
- incorrect diet of the mother if the baby is breastfed;
- insufficient drinking regime of the child during artificial feeding and during the introduction of complementary foods, regardless of the type of feeding;
- early transfer of the baby from breast milk to adapted milk formulas;
- quick transfer from one formula to another, in less than 3 days;
- adjusting the intestines to new foods and introducing complementary foods;
- underfeeding;
- prolonged and indiscriminate use of enemas, mechanical means to stimulate stool.
What types of constipation occur in newborns?
Most often they talk about two situations: when stool problems occur during breastfeeding or during artificial feeding. In the first case, constipation in infants occurs extremely rarely. The fact is that mother’s milk is the most suitable, healthy and natural nutrition option, because it contains everything necessary for the development of the baby’s body. But such situations can still exist.
In the second case, constipation is a consequence of improper complementary feeding. When switching from breastfeeding to artificial or mixed feeding, indigestion and other problems with the gastrointestinal tract may occur in the child’s body. Most often, this problem can be observed in infants under 6 months.
Depending on the cause of constipation in infants, they are also divided into several types:
- Functional. Such constipation is more common than others and occurs precisely because of poor nutrition, dysbacteriosis, and disturbances in the functioning of the nervous system. They can easily be treated with massages and improvement of the body’s digestive system.
- Organic. They arise on the basis of abnormalities in the development of the child’s organs and systems. Among them there are congenital and acquired pathologies, but the treatment is always the same: first identify the root cause and cure it, and then deal with the consequences of constipation.
- Transitional. This is a simple form of constipation in children, which occurs due to the use of strengthening products, prolonged exposure to the sun in the heat and other factors. It does not require special treatment, because eliminating the root cause will lead to normalization of the child’s stool.
- Psychological. Such constipation occurs due to psychological reasons and is mainly associated with toilet training. Therefore, infants have practically no psychological disturbances in bowel movements.
But you should not treat your child yourself, regardless of the reason. The best solution is to make an appointment with a doctor who will conduct an examination, prescribe tests and be able to find out the causes of constipation in infants and recommend the correct treatment methods.
What to do if a child under one year old has constipation?
Lifestyle
Helping breastfed children involves regulating the diet of the nursing mother, especially if she herself has problems with bowel movements.
From the list of products that a mother consumes during breastfeeding, those that contribute to gas formation should be excluded3:
- legumes;
- cabbage;
- tomatoes;
- mushrooms;
- black bread.
Also recommended3:
- exclude semolina and rice porridge, bananas;
- reduce the amount of milk consumed;
- reduce the amount of baked goods and refined foods in the diet;
- reduce consumption of foods such as blueberries, black tea, cocoa.
Breastfeeding mothers are advised to drink more fluids and eat whole grains, vegetables and fruits.
In babies, when introducing baby food from 6.5-7 months, you can use fruit purees and juices from:
- apples;
- pears;
- apricots;
- peaches;
- prunes
They contain plant fiber in the required quantities. This helps stimulate the active functioning of the baby's intestines. Children over 8 months can be given fermented milk products: kefir, yogurt.
In addition to changing your diet, there are other preventive measures that can be used to treat constipation.
Massage and gymnastics
Stroking a baby's tummy can ease his condition with colic and help treat and prevent constipation. In addition, massage has a restorative effect on the anterior abdominal wall. All movements are performed in the form of light stroking. Tactile contact, mom's smile and favorite songs will help the baby calm down. The massage is performed 1 hour before feeding and 1-2 hours after. For constipation, repeat the procedure several times a day.
- we start with circular stroking movements clockwise;
- stroke the oblique abdominal muscles from the edge of the body to the center;
- massage the area around the navel clockwise with the pad of your index finger;
- move on to the rectus abdominis muscles;
- We finish the massage with relaxing strokes of the entire tummy.
You can also supplement the massage with passive gymnastics. You can learn more about this topic in the article “Massage for the prevention of constipation.”
Constipation in an infant
During the first months of a baby’s life, the volume of his stomach begins to increase rapidly, and the intestines become populated with lacto- and bifidobacteria. This morphological and functional immaturity of the digestive tube contributes to slow passage of feces and excessive gas formation. This is due to the insufficiency of enzymatic processes, which leads to inadequate breakdown of nutrients
The most common causes of constipation in babies
In most cases, stool retention in children under one year of age is functional in nature, but it can also be a manifestation of a serious pathology. Among all the reasons, the most common: • Immaturity of the gastrointestinal tract due to cesarean section, use of medications during childbirth, unfavorable course of pregnancy (toxicosis, etc.). This contributes to the untimely development and maturation of the baby’s nervous system, which regulates intestinal functions. • Hypoxia suffered (in utero, during childbirth) also leads to impaired intestinal motility of the hyper- or hypotonic type in the newborn. This is manifested by stool retention as a result of weak contractility of the intestinal muscles or its spasm. • Imbalance of intestinal microflora. A decrease in the number of lactobacilli and bifidobacteria in some cases provokes constipation in infants. • Quick or early transition to artificial feeding. No modern formula is 100% capable of replacing breast milk, as it does not contain the required amount of enzymes, hormones, nutrients, and bacteria. Consequently, the child needs more time to adapt, which can also be manifested by stool retention. • Poor maternal diet and insufficient fluid intake. • Frequent changes of formulas, incorrect and untimely introduction of complementary foods, monotonous nutrition, underfeeding and the use of formulas containing large amounts of iron. Less commonly, organic pathology causes stool retention in infants: • Connective tissue dysplasia, rickets and hypothyroidism. They are accompanied by severe muscle hypotension, including intestinal muscles (do not forget that the listed diseases also have other clinical manifestations that are difficult to miss). • Food allergy, especially to cow's milk protein (in this case, swelling of the intestinal mucosa develops, its motility is impaired, and the functioning of the pancreas is affected). • Developmental anomalies of the large intestine (Hirschsprung's disease, dolichocolon, etc.). Note. Children in the first 2-3 months of life often experience dyschezia (a type of constipation). These are difficult acts of defecation, which are manifested by the baby crying and screaming for 15-30 minutes several times a day. After defecation, the child immediately calms down, and the feces have a soft consistency without any pathological impurities (blood, mucus, greens). This condition does not require treatment and usually goes away on its own by 6 months.
How to help your baby
In the absence of signs of organic pathology, stool retention is considered a functional disorder. Correction of constipation in infants should be comprehensive and include: • parental education; • prescription of rational diet therapy; • use of medications and mechanical means for bowel movement, if necessary. The pediatrician must clearly explain to the child’s parents that functional disorder is a common and harmless condition that disappears on its own over time.
It is also important to recommend that the mother of a baby continue breastfeeding for as long as possible (optimally up to 1.5 years) and correct her diet (include vegetable oil, foods containing dietary fiber and fiber; optimize the water regime). If a child has signs of a food allergy, a strict hypoallergenic diet is prescribed (dairy products and milk are excluded). If the baby is only bottle-fed, then it is better to use mixtures based on protein hydrolyzate and amino acids.
Note. In some cases, synbiotic preparations and mixtures (containing pre- and probiotics) help. However, the effect of them will be observed if there is a point of application - an imbalance of the intestinal microflora.
Sometimes it is advisable to use medicinal antireflux mixtures. They not only have a laxative effect, but also stop regurgitation. The latter appear due to the fact that gases accumulated in the intestines increase intra-abdominal pressure and irritate the diaphragm. Expert opinion. The most optimal and harmless mechanical method of bowel movement is considered to be irritation of the anus. Usually a clean ear stick is used. However, frequent use of this technique reduces its effectiveness. A cleansing enema should be the last resort in the treatment of constipation, as it causes addiction syndrome.
Additional measures to prevent constipation in children under one year of age
Preventive measures for constipation in children are not particularly difficult. The key to success is their regular implementation. Below are the main ones:
- Drinking enough. It can be water, compote, juices. It is important that the child receives enough fluid.
- Daily regime. A constant schedule of wakefulness, sleep, games and walks forms in the child’s body the habit of cleansing the intestines at the same time. It also has a beneficial effect on the nervous system.
More details on measures to prevent constipation in babies under one year of age can be found in the article “Prevention of constipation in children of the first year of life.”
Sometimes, despite all the above recommendations, you cannot cope with the problem of constipation, or it takes time to change your lifestyle, but what if your baby needs help right now? Then laxatives come to the rescue.
Constipation in a baby
Constipation in newborns and infants
– this is an increase in the intervals between acts of defecation and/or systematically incomplete bowel movement. Every fourth baby suffers from constipation in the first year of life. Dense, rare (2 or less times a week), large-diameter stools are diagnostic signs of constipation. Constipation is not always accompanied by pain, and therefore a small part of parents turn to the pediatrician immediately.
Dyschezia.
The concept of infantile dyschezia should be distinguished from constipation. In this case, stool retention is associated with immaturity of the muscles responsible for bowel movements. Therefore, before defecation, the baby is restless, cries, and calms down after passing soft stools. This condition does not require treatment; the baby will “outgrow” it by 6 months of age.
Bowel frequency.
The diagnosis of constipation in a child of the first year of life is not as simple as it seems - the frequency of stool differs in breastfed and bottle-fed children and in children of different ages: normal stool frequency in children 0-4 months. from 7 to 1 time per day, from 4 months. up to 2 years – from 3 to 1.
