Baby and Child Health

introduction

Paediatricians often answer questions from parents about their baby’s bowel movements, including

• “why won’t my baby poop?”
• “what can I give my baby for constipation?”
• “my baby has tummy pain.”

This article covers how to consider constipation in babies up to the age of one, including those in the first month of life (neonates)

What does constipation mean for my baby?

Babies with constipation have infrequent, difficult, or painful bowel movements which can cause a lot of discomfort. It is important to know the causes of constipation and how to manage it effectively.

They told me my baby doesn’t have constipation – they have dyschezia – what is that?

Dyschezia is a common cause of constipation in infants that typically occurs in the first few months of life and usually resolves on its own as your baby’s digestive system matures. Your baby may be straining or crying during bowel movements, but passes soft poop and is otherwise happy. It is important for parents to know that dyschezia is a normal part of infant physiology and typically does not require medical intervention. However, if you have any concerns about your baby’s bowel movements, it is always best to consult with your healthcare provider to rule out constiption and any underlying medical conditions.

CAUSES OF CONSTIPATION IN BABIES

There are several factors that can contribute to constipation in babies, including:

1. Formula feeding: Formula-fed babies may be more prone to constipation than breastfed babies because formula is not as easily digested.
2. Introduction of solids: When solid foods are introduced, they can sometimes cause constipation as the baby’s digestive system adjusts.
3. Dehydration: If your baby is not getting enough fluids, for example during illness, their stools may become hard and difficult to pass.

Flags TO SEE YOUR GP

Rarely, constipation may be a sign of a medical problem. It is essential to contact your healthcare provider if your baby has any of the following symptoms:

1. Blood in their stool
2. Vomiting
3. Abdominal swelling or distension
4. Faltering growth
5. High fever
6. Severe or persistent diarrhea
7. Signs of dehydration (e.g not wetting nappies)
8. Severe abdominal pain or discomfort
9. Rectal prolapse

Hirschsprung’s disease is a condition where the nerves in the large intestine are missing, which can cause constipation, abdominal swelling, vomiting – often within the first few days of life

Cystic fibrosis is a genetic condition that affects the lungs and digestive system. Constipation can be a symptom of cystic fibrosis, along with poor weight gain, frequent lung infections, and greasy or foul-smelling stools.

Hypothyroidism can also cause constipation in babies, along with other symptoms such as poor weight gain, fatigue, and a decreased appetite.

i have read that babies with dairy allergy can have constipation? should i cut out dairy?

Delayed (Non-IgE) mediated cow’s milk protein allergy can cause a range of symptoms in babies, including constipation, but this is not a common symptom.

More typical symptoms of this type of allergy may include a combination of being unsettled, vomiting, diarrhea, skin rashes, and blood in the stool.

If you think your baby may have a cow’s milk protein allergy, it is important to consult with your healthcare provider – there is evidence that milk allergy is being overdiagosed and excluding milk from babies can cause milk allergy

how do deal with my baby’s constipation?

The management of constipation in babies depends on the severity of the symptoms and cause. Here are some tips:

1. Feeding and Fluids: If your baby is formula-fed, double check the amount of powder needed to make it up, and consider switching to a different formula that may be easier to digest. Offer your baby plenty of fluids, whether breastmilk or/or formula, and avoid giving them juice or water before 6 months of age. According to guidance from the NHS guidance (see below), babies who are fully breastfed do not require any additional water until they begin consuming solid foods. However, during periods of hot weather, they may desire more frequent breastfeeding sessions to stay hydrated. Formula-fed babies, on the other hand, may benefit from small amounts of cooled boiled water during hot weather in addition to their regular formula feeds, particularly if they are under six months of age. It is important to remember to boil the water and allow it to cool before offering it to your baby.
2. Fiber-Rich Foods: Once your baby has started eating solid foods, it is important to ensure they are consuming enough fiber. Foods such as whole-grain cereals, fruits like apples, pears, and prunes, and vegetables like broccoli and sweet potatoes are all great sources of fiber. It is also important to offer plenty of fluids alongside these fiber-rich foods to keep your baby hydrated.
3. Natural Laxatives: If your baby is weaned and still struggling with constipation despite dietary changes, natural laxatives such as prune juice, pear juice, and pureed prunes can be used sparingly and under the guidance of a healthcare provider.
4. Medication: After assessment, your GP may recommend medication to relieve your baby’s constipation.

conclusion

In conclusion, constipation is a common issue that affects many babies, but it can be managed effectively. If you have any concerns about your baby’s bowel movements or suspect an underlying medical condition, it is always best to consult with your GP

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