Constipation in a newborn: what to do and how to help the baby?

The baby is born with the organs of the digestive system not yet fully formed. That is why during this period parents may encounter problems with colic, gas formation, rashes and diarrhea. Constipation in a baby while breastfeeding also causes a lot of trouble for parents, as the child behaves restlessly.

This problem needs to be resolved as quickly as possible. For newborns, prolonged presence of feces in the body leads to the absorption of toxins. They will negatively affect the baby's health.

Constipation during breastfeeding causes severe pain. The situation occurs against the backdrop of gas accumulation. Without an adult, the baby will not be able to cope with the problem. At the first stage of treatment, it is necessary to establish the cause of the ailment and direct all efforts to eliminate it.

Constipation or not?

A fundamentally important point in clarifying the situation is the method of feeding the baby.

A child receiving an adapted formula has feces similar to those of an “adult”. Emptying occurs no more than 2 times a day. A baby fed with breast milk is able to “go potty” as many times as he is latched to the breast - from 4 to 10 times a day. The baby's feces have a yellow color, a mild odor, and a mushy consistency. The newborn's stool continues to be soft even after the introduction of complementary foods.

A logical question arises: can a breastfed baby be constipated? The answer from experts is positive, because the influence of provoking factors also extends to babies fed on mother’s milk.

Recipes, menus and diet products

As the child grows, the frequency of stool and its consistency come to the general physiological norm - 1-2 times a day in the form of unformed feces or “sausages”.

You can suspect the development of constipation in a newborn based on a number of signs:

the child strains greatly when trying to defecate (blushes, cries);
feces have a special appearance: first a “plug” (a dense, dark mass) comes out, then hard “balls” and mush appear;
feces have a strong smell;
there are spots of blood in the discharge (not always) - the symptom indicates the formation of cracks in the rectum;
the process of removing gases is difficult;
The baby's stomach is hard and hurts;
bowel movements are observed no more than once every 3 days.

With regular manifestation of symptoms, the patient experiences loss of appetite and weight loss.

Constipation in infants: causes of the phenomenon

At the first time a problem appears, it is quite simple to solve it by identifying the cause of the pathology. The table below shows the main provoking factors of the unpleasant phenomenon:

Cause	Explanation
Lack of fluid	The most common cause of constipation (especially during the hot season and heating season). It is necessary to regularly replenish fluid losses in the child’s body to ensure soft stool consistency. To prevent constipation in infants, Komarovsky advises supplementing with water even for those children who are fed breast milk.
Incorrect nutrition of a nursing mother, inappropriate formula	A woman’s diet should include foods that stimulate the gastrointestinal tract (prunes, beets, figs, etc.). White bread, meat, rice, bananas, nuts, etc. should be excluded from the menu. When choosing a formula for a formula-fed baby, it is better to give preference to a product that is free of iron.
Lack of mother's milk	“Hunger constipation” leads to the fact that the entire volume of food is absorbed by the internal organs and blood - the intestines are deprived of a source of activity
Unpreparedness of the tract for the introduction of complementary foods	The optimal time for complementary feeding for a breastfed baby is 6 months, for a bottle-fed baby – 4-5 months. Until this moment, the newborn’s digestive system is able to digest only mother’s milk (adapted formula), and responds to “overwhelming” foods in the diet with constipation
Inappropriate scheme for transferring the baby to artificial nutrition, sudden change of formulas	When transferring a newborn to artificial feeding (another formula), this must be done gradually, alternating feedings
Lack of dietary fiber in children's menus	When introducing complementary foods, it is important to ensure a sufficient proportion of fiber, fruits and vegetables in the infant's diet. The active components of the products in tandem with a sufficient amount of liquid ensure normal stool consistency.
Lactase deficiency and cow's milk intolerance	There is no digestive enzyme in the baby's body or there is an immune response to milk protein - problems with bowel movements are observed. The issue can be resolved by taking medications or switching the baby to a special formula
Psychological stress	We are talking about psychosomatic constipation (a child is separated from his mother, gets used to new living conditions, is potty trained, etc.), in which the baby reflexively retains feces. The child needs psychological support, in some cases from a specialist
Drug therapy	The cause of constipation in an infant may be the use of antibiotics, antidepressants, or antispasmodics. The solution to the problem is to cancel or replace medications for mother or baby (under the supervision of a doctor)

Constipation in infants: organic causes

A separate group of causes of problematic bowel movements in a newborn includes conditions that require urgent diagnosis and treatment. Among them:

dolichosigma (an elongated section in the sigmoid intestine);
Hirschsprung's disease (part of the intestine is free of nerve endings).

These pathologies are accompanied by impaired intestinal motility. The conditions pose a threat to the child's life.

Causes of constipation

Constipation rarely occurs in breastfed children. The main reasons why they may occur:

Errors in maternal nutrition. For easy bowel movements, food should contain a lot of dietary fiber. If the mother's diet is filled with proteins and quickly broken down carbohydrates, this can have a bad effect on the functioning of the child's intestines. A nursing woman's diet must include cereals, whole grain bread and vegetables. If your baby is prone to constipation, you should eat foods that have a slight laxative effect - prunes, fresh kefir, beets. Nuts, baked goods, fatty foods, coffee, and some medications that the mother takes make it difficult to empty.
Intestinal motility disorders. Intestinal contractility may be impaired due to spasm or, conversely, muscle hypotension. This often occurs as a result of postpartum trauma or a difficult pregnancy. The mechanism of the pathology is a disruption of nerve conduction, which regulates the tone of intestinal smooth muscles. The symptom may be accompanied by general disorders - lethargy, sleep disturbances, increased excitability of the child. Consulting a neurologist and prescribing appropriate medications will help you cope with the problem. Sometimes a similar condition may appear due to intestinal immaturity, but after a couple of months the nerve endings improve and the problem goes away.
Anal sphincter spasm. Emptying is difficult due to a mechanical obstacle - the sphincter does not open well and allows feces to pass through. As a rule, this condition is accompanied by increased gas formation and colic. In many cases, a special children's gas outlet tube helps get rid of discomfort. Flatulence itself makes it difficult for a child to move stool, even with normal sphincter contraction. The appearance of gases is also affected by the mother's diet. You should limit your consumption of cabbage, grapes, carbonated drinks, and legumes.
Congenital anomalies. This includes megacolon, narrowing of the anus and other pathologies.
Lack of milk. When a baby is malnourished, the food is completely digested and nothing remains in the intestines. This condition differs from the norm in that the child does not gain weight well and is often capricious.
Introduction of complementary foods. Constipation can be a reaction to a new food. As a rule, after a while everything returns to normal. Sometimes the problematic food should be eliminated and reintroduced later.

Sometimes constipation can be a consequence of another disease, such as lactase deficiency, liver disease, hypothyroidism, or allergies. A doctor can determine the exact cause. To do this, he will conduct a full examination of the child and prescribe additional tests.

Constipation in a baby: what to do, do you need a doctor?

Constipation in a newborn is most often eliminated by parents on their own. However, there are symptoms that not only indicate the presence of a problem, but also “speak” about the need to visit a specialist (pediatrician or gastroenterologist):

problems with bowel movements have persisted for more than 14 days;
child weight loss;
blood spots in stool;
“bloated” stomach;
vomit;
increased body temperature;
anal fissures;
prolapse of the rectum from the anus.

How to help a baby with constipation: actions of parents

If the above signs do not make themselves felt (constipation has not developed into a chronic illness), parents can act independently, relying on the child’s condition. The algorithm of actions is as follows:

Eliminate obvious causes of problems with bowel movements (replenish fluid deficiency, improve nutrition for the baby or mother, replace formula, etc.).
Periodically place the newborn on his tummy. You can use a warm heating pad.
If the baby has reached the age of 6 months, include plum, apricot, and applesauce in the baby’s diet. Give the newborn freshly squeezed juices diluted with water and dried fruit compote.

If the measures taken do not produce results, the patient must be shown to a specialist who will proceed to diagnose the pathological condition.

Prevention

To prevent the occurrence of constipation, it is necessary to carry out light prevention. Actions that seem simple at first glance will save your baby from big problems. To prevent your baby from having problems with bowel movements, it is recommended to follow the following recommendations:

Place the baby on his tummy several times a day, at least for 1-2 minutes;
Pay special attention to the amount of fluid the child consumes;
Mothers who are breastfeeding are advised to consume foods rich in potassium;
It is not recommended to allow the child’s body to overheat;

Performing these simple steps, along with careful adherence to the diet, will prevent problems with bowel movements in infants.

Note! Nowadays, the Internet is simply teeming with various videos on how to cure constipation in a baby. Remember that using traditional and modern methods to treat a child without the advice of an experienced specialist is strictly not recommended. They can negatively affect the baby's health. If you notice that your child is acting differently than usual, try to take him to the doctor as soon as possible.

01 Mar 2020 admin 1696

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Diagnostic measures

At the first appointment, the doctor collects complete information about the medical history: takes into account past pathologies, nutritional habits and the current physiological state of the patient.

Most often, a digital examination of the rectum is required to exclude developmental anomalies and identify anal fissures (if any). If compacted feces are detected in the rectum, the material can be examined for inclusions of blood.

In more severe clinical cases, the child requires additional diagnostics. The list and explanation of subsequent activities are presented in the table below:

Procedure	Explanation
X-ray of abdominal organs	Standard event. Helps diagnose intestinal obstruction
Anorectal manometry	By inserting a catheter into the rectum, the coordination of movements of muscle fibers that promote bowel movement is determined.
Contrast radiography of the intestine	Before the x-ray, the intestinal mucosa is covered with contrast (an enema is used). The measure provides the best visualization of certain parts of the organ
Rectal biopsy	A sample of the rectal mucosa is taken for examination. The measure allows you to check the condition of nerve cells
Transit research	The newborn swallows a capsule containing markers. Through subsequent x-rays, the doctor finds out how the active components pass through the gastrointestinal tract
Blood analysis	Additional blood tests are carried out (for hormones, etc.)

Treatment of pathology as recommended by a doctor

Treatment of constipation in a newborn when contacting a specialist most often includes: taking medications (in the form of syrups, suppositories, powders, etc.), enema, massage, and gymnastics.

Drug therapy

Regardless of whether constipation is diagnosed in a breastfed baby or in a bottle-fed baby, medications that stimulate intestinal motility and eliminate the symptoms of flatulence come to the rescue. Among the most popular means:

Duphalac. Syrup containing lactulose. Activates peristalsis and is practically not absorbed by the intestines. For patients up to one year old, use up to 5 ml per day;
Espumisan. Prescribed for increased gas formation. Take 50 drops;
Smecta. A universal remedy that helps with intestinal disorders. Used for flatulence, relieves the organ of toxins. Infants are prescribed 1 capsule before feeding;
Bifidumbacterin. The drug is designed to restore intestinal microflora. The product is taken 2-3 times a day for up to a week. The dose depends on the patient's age;
Glycerin suppositories. Suppositories soften stool and restore the mucous membrane of the organ;
Gas-forming candles. Suppositories containing gas. They increase the volume of the intestines, promoting the movement of stool;
Sea buckthorn candles. Herbal ingredients help soften stool and relieve intestinal irritation.

Attention! Suppositories can be used no more than 2 times a day. To insert a suppository into the anus, the baby should be placed on his left side, pressing his knees to the chest. Then you need to lubricate the child’s anus with Vaseline and, after inserting the suppository, squeeze the patient’s buttocks for several minutes.

When and how to give an enema to a newborn?

It is impossible to give an enema to a child on a regular basis or as a preventative measure: the procedure leads to washing out the intestinal microflora. Direct medical indications for administering an enema to a newborn are prolonged constipation (more than 7 days).

The enema must be performed using the following technology:

Prepare a syringe with a rubber tip by boiling it for half an hour.
Prepare the solution: heat pre-boiled water, add a little vegetable oil to it.
Bring the prepared solution to a temperature of about 30 degrees.
Remove the syringe from the boiling water and pour out the remaining boiling water.
Having previously released the air, fill the syringe with prepared water and oil. 30 ml is enough for an infant.
Lubricate the tip of the syringe with Vaseline.
Place the newborn on an oilcloth on his left side, pressing his knees to his chest.
Carefully introduce water into the anus and smoothly remove the tip.
Leave the baby lying on his side for a few more minutes. Lubricate the baby's anus with cream.

Important! The tip of the syringe can be inserted to a depth of no more than 2 cm.

The result can be expected within a few minutes after administering the enema.

Massage

If constipation occurs in a baby after switching to artificial feeding, an alternative formula, or for another reason, massage can alleviate the patient’s condition.

The therapeutic measure simplifies the process of moving feces through the intestines. Usually the doctor prescribes a massage session 60 minutes before feeding or 2 hours after eating. During the process, it is important to make smooth movements and communicate with the child in order to achieve the effect of relaxation.

Massage for a newborn is performed according to the following algorithm:

Circular movements in a clockwise direction.
Stroking the abdomen from the edges to the central part.
Acupressure (using the index finger) in the area around the navel.
Massaging the rectus muscles.
Lightly stroking the belly.

The optimal number of repetitions is from 2 to 5 times. If the child resists massage, the procedure should be postponed.

As a complement to massage, they resort to therapeutic exercises. The child is placed on his back and his legs are bent at the knees, imitating the “bicycle” exercise. You can press your baby's knees to his tummy. Hands fold crosswise, raise crumbs above your head, and make boxing-type movements.

Recipes, menus and diet products

What not to do?

There are a number of myths that mislead many parents. Below are arguments to counter existing misconceptions.

The baby should be fed hourly. Timed feeding is not supported by WHO; it is better to feed the baby on demand. This will allow the newborn to be fully satisfied without overeating.
Before each bowel movement, you should use a gas tube to avoid constipation. This is not entirely true. The attribute will help overcome flatulence, however, the child’s body must cope with constipation on its own.
Soap is effective against constipation. Soap is associated with an alkaline environment, which irritates the intestinal mucosa and stimulates the expected spasm. This result can be achieved without harm to the organ using glycerin suppositories.
A baby spitting up is normal. If regurgitation occurs regularly and its manifestation does not decrease, most likely the baby is overeating, which can lead to problematic bowel movements.
The newborn is malnourished. If the child is developing normally (proportional weight gain), it is impossible to transfer the baby to formula, assuming malnutrition. Adapted formulas are not able to replace breast milk and often cause constipation due to the iron content.

Massage for constipation

A light massage in the intestinal area can stimulate peristalsis and facilitate the passage of gases. The advantage of massage is that it is safe, easy to perform and is often no less effective than pharmaceutical drugs. Here are some exercises you can do for your infant:

Place the baby on his back and make stroking movements in the navel area. The hand movement should go in a circle, in a clockwise direction. This procedure will help move feces and accumulated gases from the upper intestines closer to the exit.
In a supine position, press your baby's legs toward your tummy with your knees bent. The legs should be held by the ankle joints and pressed alternately.
Before feeding, let your baby lie on his stomach for a while. The duration of the process depends on the age of the child.

Parents should pay attention to the stability of the child’s digestive system. If there is no bowel movement for several days, and this is the first time this has happened, this is a reason to consult a doctor. If for a child a rare bowel movement is the norm and does not cause him discomfort, there is no need to worry.

Preventive measures

How to prevent constipation in a baby - reviews from mothers and pediatricians indicate that the best preventative measure for difficult bowel movements in a newborn baby is proper nutrition for the nursing mother and baby. Other measures include: compliance with the drinking regime (including for breastfed children), timely and gradual transition of the baby to complementary feeding or artificial feeding.

Constipation in newborns most often occurs as a result of a lack of fluid in the body and improper nutrition of the nursing mother or baby. You can solve the problem yourself by eliminating the provoking factor, periodically laying the baby on his tummy, using a warm heating pad.

If a problem arises as a result of pathological changes in the child’s body and the manifestation of alarming symptoms (prolonged constipation, blood in the stool, fever, etc.), you should immediately consult a specialist. After diagnostic measures, the doctor determines the directions of the therapeutic course. Most often, treatment is based on taking medications, massage, and gymnastics. In some cases, they resort to using an enema.

How to quickly get rid of constipation

To eliminate signs of constipation in infants, you can use traditional medicine recipes or medications.

Folk remedies at home

Treatment of constipation using alternative medicine methods is available only in cases where this problem is irregular or appears for the first time. Then auxiliary methods of traditional medicine will help reduce the negative impact of drug therapy.

An effective way to combat constipation is porridge made from wheat germ. Grind two tablespoons of raw material into flour, then pour in 1 cup of boiling water and leave for 5-10 minutes. It is better to give your baby this porridge in the morning. There is no need to add sugar or salt to it.