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WHAT  IS  CONSTIPATION?

 

Constipation means the passage of infrequent, hard stools. Almost everyone experiences this at times and children are no different. Parents may feel it is normal to open their bowels every day and think they are constipated if this does not happen. If their child passes a painless, soft motion once every three days, they may worry. However, this is normal and does not mean that the child is constipated.

 

What causes constipation?

 

Babies can become constipated at times of change, such as moving from breast to bottle milk, and when they are being weaned on to solid foods. Bottle-fed babies are more prone to constipation - breast-fed babies rarely suffer from it. Breast-fed babies may pass one motion every week because so much of the breast milk is absorbed through the gut that there is little left to be expelled.

 

Children can suffer from brief bouts of constipation and this tends to happen at times of change. Your child may develop a vicious cycle where he passes a painful motion that frightens him enough to withhold the next. He may then tear the anal tissue, which makes the pain worse and therefore the withholding worse.

 

When to see the Doctor

 

Occasional bouts of constipation are nothing to worry about. However, you should contact your doctor if

 

For a baby:

·        Your baby has not passed a stool in the first 24 hours after birth - she may have Hirschsprung's disease, a rare congenital abnormality of the bowel.

·        There is blood in your baby's motions - she may have developed a small tear in her anus, which is quite common when she is passing hard stools.

·        Your baby seems irritable and is off her feed

 

For a child:

·        Your child has increasing pain around the anal. area when passing stools.

·        He has increased abdominal pain.

·        Your child is experiencing vomiting as well as constipation.

·        Your child's stools are bloody.

·        Your child is soiling his pants regularly.

·        The constipation lasts for more than three days

 

What you Doctor will do

 

If your child or baby is experiencing pain when passing stools, your doctor may give lactulose syrup to soften the motions. This will make them less painful to pass. 

Sometimes quite high doses of a stimulant laxative, such as senna, are given to restore the urge to defecate, which may not have returned after the bowel is cleared. 

Your doctor may prescribe a short course of glycerol suppositories for your child if the constipation is not responding to these mild measures.

Other causes of constipation in children

Not only can life changes cause constipation in your child, he may also become constipated because he is worried about something, or there may be a physical problem preventing him from passing motions. If you are concerned, discuss it with your doctor.

 

Toilet training: this can be a traumatic time for your child and may lead to him withholding his motions and to chronic constipation. It is important never to punish your child for accidents. Consider giving up until a later date and letting his bowels settle down.

 

Starting or changing school: your child may be embarrassed about asking where the toilets are and therefore hold on to his stools. It is very common for children not to drink enough water during school hours and a change in their diet may trigger constipation

 

Illness: any illnesses that are associated with fever may lead to constipation. Other illnesses that may cause constipation are cystic fibrosis, an under active thyroid and anal abnormalities.

 

Treating constipation at home

 

For babies:

Constipation can be treated at home by paying special attention to your baby's diet. Do not give her any medication without your doctor’s  instruction.

 

·        Make sure the formula feed is being made up correctly and is not too concentrated.

·        Try giving your baby sterile water between feeds

·        Add sieved fruit or vegetables to your baby's diet if she is weaned.

·        Moving your baby's legs when she is passing a stool may help.

 

For children:

Try not to make a fuss of your child. He will sense your anxiety, which may make matters worse. Constipation usually settles with simple methods.

·        Increase your child's fluid intake, especially of real fruit juices.

·        Frequent exercise often moves the bowels!

·        Increase your child's fibre intake Fibre absorbs fluid, which increases the softness of the stools.

                       

Avoiding constipation

In babies:

 

·        Do not start your baby on solids too early, i.e. before your baby is four months old.

·        Once on solids avoid too much baby rice, banana and apple and give your baby more plums, apricots, peaches, spinach and beans.

·        Avoid changing your baby's formula milk too often.

·        Offer cooled boiled water before each feed.

 

In children:

·        Some foods may cause constipation, so you should try to cut these out of your child's daily diet:

       White bread

       Fruit squash (high in sugar)

       Biscuits

·        Do not give your child too much sugar or too much processed and 'junk food'

 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.