Constipation in children. Constipation in infants. Komarovsky about constipation.

Approximately 20–25% of infants experience constipation. This disruption of the intestines causes severe discomfort, causes periodic pain and a feeling of tension in the abdomen, which leads to a bad mood, moodiness and deterioration in the baby’s well-being.

What to do if a baby is constipated and how to help your child? These questions immediately arise for parents who notice such symptoms. First of all, if there is a long delay in defecation in a child, you need to consult a doctor to conduct an examination and find out the cause of this phenomenon. In the absence of serious congenital pathologies of the intestines, conservative treatment is carried out.

First of all, nutritional correction and stimulation of intestinal function are prescribed using massage and simple exercises. These safe methods not only eliminate the problem of irregular bowel movements, but are also a measure to prevent its occurrence in the future. Medicines, enemas and mechanical stimulation of bowel movements for constipation in children are used only in extreme cases.

Nutrition for constipation in infants

Treatment of constipation in an infant should be comprehensive and necessarily include certain dietary changes. They are prescribed taking into account the baby’s age and what type of food he eats during a given period. For children under six months of age, the only food is mother's milk or formula. After reaching the age of six months, new foods are gradually introduced into the child’s diet, which can cause the child to strengthen or loosen his stool.

Maternal nutrition in case of constipation in breastfed children

For constipation in children fed exclusively on breast milk, treatment should begin with correcting the feeding mother's diet. The composition of breast milk depends on the foods a woman consumes during lactation.

If defecation is delayed in a baby, a nursing mother should adhere to the following dietary recommendations:

• eat more foods rich in coarse dietary fiber (vegetables, fruits, grains);
• exclude foods that can cause constipation (rice, semolina, white bread and sweet pastries, fatty meat, black tea, etc.);
• drink more fluids;
• include foods with a laxative effect (melon, prunes, dried apricots, figs, beets, pumpkin);
• consume fermented milk products (kefir and yogurt), which promote regular bowel movements.

Important: Sometimes a lack of breast milk in a mother can lead to constipation in an infant, which makes it necessary to introduce supplementary feeding to eliminate this problem.

Frequent breastfeeding increases the amount of fluid entering the baby's body, which is one of the ways to treat constipation

Nutrition for bottle-fed babies

Children who are bottle-fed or mixed-fed are much more likely to suffer from constipation compared to babies who are fed only breast milk. This is due to the fact that even despite the high degree of adaptation of modern milk formulas, they are too different in composition from breast milk and do not take into account the individual needs of each child at a certain period.

If constipation occurs in newborns in this case, the first thing to do is consult a pediatrician. He will most likely recommend giving the child more water, and if the desired result is still not achieved, then replacing the milk formula with another one. To normalize intestinal function and regular bowel movements, fermented milk mixtures containing beneficial lactic acid bacteria and enhancing intestinal motility are well suited.

Important: Replacing formula milk to feed your baby should be done under the supervision of a doctor.

Formula-fed babies need to be given additional water throughout the day between feedings; its daily volume should be equal to the volume of one feeding

Nutrition for children after six months

After 6 months, new adult foods begin to be introduced into the child’s diet. For children prone to constipation, it is recommended to start complementary feeding with vegetables and fruits rich in coarse dietary fiber, which enhance intestinal motility and the formation of soft stool. Vegetables and fruits are prepared into purees and freshly squeezed juices diluted with water for children.

Helps with constipation:

• carrot juice;
• puree from prunes, apricots, peach, apples;
• decoctions and compotes of dried fruits;
• porridge from grains rich in fiber (oatmeal, corn, buckwheat);
• fermented milk products adapted for a certain age of the baby.

Prunes for babies with constipation can be consumed in the form of decoctions, purees or added to porridge

Important: If your baby’s constipation is caused or accompanied by increased gas formation, then it is recommended to give him tea with fennel, which you can buy at the pharmacy or make yourself from dill seeds.

What to do if you are constipated

The following instructions are provided on what to do for constipation in children:

1. Eliminate obvious causes of constipation - normalize feeding, review the diet, change the formula.
2. If there is no proper result, it is necessary to undergo examination by a gastroenterologist, neurologist and endocrinologist. The examination will give an exact answer on what to do if a child is 4 years old or older with foamy stools - by this age children begin to eat “adult” food in full. The presence of foam and other anomalies indicate the development of pathology of the gastrointestinal tract.
3. It is recommended to lay the baby on his tummy before each feeding; be sure to cuddle him after eating - he should burp. If colic occurs, it is enough to apply a hot diaper, but not a heating pad.
4. It is recommended that infants be given more vegetables and fruits in the form of purees; they can practice drinking dried fruit compote.

Any introduction of complementary foods begins with one teaspoon per day. Next they look at the reaction of the child and the body. On the second day, if there is no allergy, you can increase the new product to 2-3 spoons. Gradually increase the amount of the new product and monitor the condition of the baby.

To relieve constipation, maintain fluid balance

Komarovsky's recommendations

Regarding constipation in infants, Dr. Komarovsky speaks as follows:

1. The main cause of constipation in children is dehydration. Starting from the first days of life, children are given a small amount of boiled water.
2. Be sure to maintain the air temperature in the room - ventilate the room, do not put several layers of clothing on the baby, and regularly give the child air baths.
3. You need to walk with your child every day, at least an hour a day. You should do morning exercises and abdominal massage.
4. With age, a child’s diet approaches that of an adult, so the amount of water and other liquids should be increased.
5. It is better to give children a decoction of raisins and other dried fruits to prevent constipation.
6. The functioning of the intestines directly depends on potassium in the body - a deficiency leads to constipation. There are a lot of trace elements in raisins, figs and prunes.
7. If constipation greatly bothers your baby, it is recommended to use lactulose syrup - these are Duphalac, Lasilac, Normaza and others. Start taking 2 ml at a time, gradually increasing the amount to 5 ml. In the first 2-3 days, severe gas formation will begin from the syrup, but it will not bother the child and will pass quickly.
8. Often, as a result of difficult bowel movements, babies develop cracks in the anus and even the colon. In such a situation, suppositories with glycerin and sea buckthorn oil are used.

To prevent constipation, Komarovsky advises normalizing bowel movements in accordance with time frames and restrictions - the child must go to the toilet at a certain time. There is nothing better than a routine when it comes to bowel movements. If it is developed, no additional funds will be required.

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Massage for the treatment of constipation in babies under one year old

The cause of constipation in many newborns is underdevelopment of the nerve endings in the wall of the colon, which leads to a temporary inability for it to contract correctly and move intestinal contents to the anus. This condition is a physiological feature of the development of children and does not require any special treatment, as it goes away on its own by the age of two months. However, you can help your child improve intestinal function by massaging the tummy and exercising. These methods are safe and easy to implement and do not require any special knowledge or skills from parents.

How to help a newborn with constipation with exercises and massage? It is recommended to perform the following exercises:

1. Stroking the baby's tummy with a warm palm in a clockwise direction, avoiding sudden movements. It is enough to make only 5-10 such circular movements.
2. Alternately flexion and extension (5 times) of the baby’s legs at the knee joints in a supine position. When performing this exercise, the front surface of the child's thigh should be pressed against the tummy when flexed.
3. With the baby lying on his back, pull his legs towards his tummy, bending them at the knees and alternately straightening one or the other leg. Repeat 5 times for each leg.
4. While lying on your back, do the “bicycle” exercise for your baby.
5. Laying the baby on his tummy for 2 to 15 minutes, depending on his age.
6. With the baby lying on his stomach, make stroking movements with his palm along the back in the direction from the shoulder blades to the tailbone. Do 5 reps.

It is recommended to place the baby on his tummy during meals and throughout the day.

The exercises listed above help improve intestinal motility and make it easier to empty.

Important: Warming has a positive effect on intestinal function. They relieve spasms and help relax the muscles of the colon, which is especially important for spastic constipation. To do this, apply a warm diaper to the baby's tummy, lower him into a warm bath, or simply place his tummy against the belly of mom or dad.

Causes of constipation according to Dr. Komarovsky

Komarovsky cites the lack of moisture and potassium in the child’s body as the main reasons for poor emptying of the baby’s body. Dehydration causes dry stool and ineffective bowel function, which leads to difficulty in bowel movements. The lack of potassium in the body of babies under one year of age, in turn, negatively affects the proper functioning of intestinal motility. This leads to weak contractions of the colon, which makes defecation quite difficult for the child.

Medicines for constipation in infants

Treatment of constipation in newborns and one-year-old children with medications is undesirable and is carried out strictly as prescribed by the doctor if changes in diet and massage do not lead to the expected positive result. Laxatives used to treat infants should have a mild effect, not cause spasms in the intestines and not disturb its microflora.

Drugs approved for use for constipation in infants include:

• glycerin suppositories soften accumulated feces and promote rapid emptying of the baby’s intestines soon after the insertion of the suppository;
• lactulose-based preparations, which have a mild laxative effect, are not addictive and help normalize intestinal microflora;
• Espumisan, Plantex, are prescribed for the treatment of constipation, accompanied by increased gas formation in the intestines;
• Microlax microenemas, which are a ready-made solution of viscous consistency for introduction into the cavity of the child’s rectum;
• Hilak forte, Linex, Bifidum bacterin are used in the treatment of constipation caused by a violation of the intestinal microflora.

Duphalac contains lactulose as an active ingredient and can be used to treat constipation in children of any age.

Important: Systematic use of laxatives, and even more so mechanical irritation of the rectum using a gas tube, cotton swabs and other means, can lead to a weakening of the child’s natural bowel movement reflex.

Problems such as constipation occur frequently in infants. Not all parents know how to behave correctly in this case. The famous children's doctor E. O Komarovsky recommends that young mothers not worry, but carefully monitor the child’s condition. Before taking any measures, you need to know exactly what symptoms accompany constipation in an infant. Komarovsky believes that when a baby has rare bowel movements, it is not always necessary to treat it. In most cases, it is enough to adjust the child’s diet and daily routine. This is exactly what Dr. Komarovsky teaches young parents.

Review of approved remedies for constipation in infants according to Komarovsky

A doctor can determine drug treatment for an infant up to one year after preliminary tests and instrumental examination of the digestive tract. Komarovsky strongly advises against self-medicating constipation.

When treating infants, one should focus on the safety of the drugs, natural composition, and the absence of contraindications for the baby to take medications. The pleasant taste of the drug for constipation is especially important for children over 6 months of age.

Pharmacy drugs

The course of treatment with medications in infants depends on the severity of disorders in the body, the cause of development and duration of constipation.

Dr. Komarovsky recommends safe medications for the treatment of constipation in infants:

Dr. Komarovsky recommends a combination of establishing nutrition, water regime and, if necessary, stimulation with drugs.

Treatment of constipation should be coordinated with a doctor to avoid the development of negative consequences for the baby’s health.

Constipation in infants

In medicine, it is believed that a baby up to three months old should have bowel movements two to four times a day. And constipation is a condition when there is no stool for more than two days. But here everything is individual. Sometimes it happens that a breastfed baby completely absorbs mother's milk. And he has a bowel movement every 3-5 days. Before panicking and giving the baby medication, the mother needs to find out what symptoms accompany constipation in the baby. Komarovsky says that if the baby is developing well and gaining weight, is cheerful and sleeps normally, and bowel movements do not cause him discomfort, then rare bowel movements are normal. We can talk about the disease when, in addition to constipation, the child has other symptoms: gas formation, pain, bloating, loss of appetite. In addition, it is very important to pay attention to the condition of the stool. In infants, it should be mushy, soft, and yellowish. If a child is constipated, his stool will be dark in color, have an unpleasant odor, and be hard.

Constipation symptoms

When do parents need to take action? It is believed that a child has constipation if the following symptoms are observed:

• stool is too hard, shaped or pea-shaped;
• the stool has a putrid aroma;
• when trying to poop, the baby strains and strains a lot;
• the child writhes his legs, groans and cries;
• baby's belly is hard and swollen;
• the baby loses his appetite;
• He has stool less than once every 3 days.

How to understand that it is really constipation

A child who eats exclusively mother's milk can poop six times a day or more, after each feeding - this is the norm. But don’t panic if there is no stool for several days; this is also normal. This means that mother’s milk is suitable for the baby and he has no digestive problems. Milk is completely absorbed by the body.

Of course, provided that the child’s stomach is soft and does not hurt, his overall health is excellent. This is precisely the point of view that Dr. Komarovsky, known to all mothers, adheres to. It’s another matter if the child receives additional supplementary feeding with an adapted milk formula. In this case, regular bowel movements are a necessity.

Powdered infant formula contains more protein than breast milk, so it can cause constipation in a mixed-fed newborn. It's time to sound the alarm and take action if your one-month-old baby:

• irregular bowel movements;
• flatulence;
• stool that is thicker than normal or hard in consistency;
• Every bowel movement is accompanied by crying.

These are all signs of constipation. Start prevention immediately, otherwise it will lead to serious treatment in the future. The baby is afraid to poop because it hurts, and will constantly endure it.

Causes of constipation

Only a doctor can determine whether a child is sick or whether such bowel movements are normal for him. Therefore, if there are any deviations in the behavior of the baby, you should contact a pediatrician. After all, before treating your baby, you need to know what causes his constipation. This condition can be caused by many factors:

• pathologies of intestinal development, for example, Hirschsprung's disease;
• various inflammatory and infectious diseases, colds;
• disturbance of intestinal microflora;
• taking certain medications, especially antibiotics;
• allergic reaction to cow's milk and some other products.

In such cases, only a doctor can treat constipation in an infant. Komarovsky advises mothers to take some measures on their own if infrequent bowel movements are caused by other reasons:

• lack of breast milk, which results in so-called “hunger” constipation;
• improper diet of the mother, because everything that a woman eats passes into her milk;
• lack of water, which helps remove feces;
• transition from breastfeeding to artificial feeding, since up to 4 months mother’s milk not only feeds the baby, but also protects against diseases;
• introduction of complementary foods, in this case the child’s intestines may react to unfamiliar food with constipation;
• changing the milk formula, which may contain a component intolerable to the baby;
• overheating the child with too warm and dry air, which causes dehydration;
• stress and anxiety of the baby due to a change in environment, his fear when he is left alone.

Constipation in newborns

With mixed feeding, the child almost always experiences constipation. This is due to disruption of intestinal microflora and peristalsis when the baby digests mixed breast milk with formula. All mixtures are usually prepared from cow's milk, which has undergone careful processing. There may also be mixtures made with goat's milk, which are very difficult for a child to digest and can even damage the walls of the small intestines, resulting in sore stools.

In such cases, the reason is sometimes not only additional formula feeding, but also the structure of the child’s body. Pediatricians generally recommend using mixtures that contain pre- and probiotics of fermented milk mixture, as well as the drug Lactulose.

Many doctors advise that if breast milk gradually disappears, mothers do not despair and do not give up, but try with all their efforts to maintain lactation. Therefore, mixed feeding will very quickly develop into artificial feeding.

Normal stool in newborns

After birth, the functioning of all the baby’s organs improves for some time. In the first three days, the baby passes black-green plasticine-like feces - meconium. Then, until one and a half months, the baby poops as many times as he eats - 8-12. His stools are mushy, yellowish in color, with a sour odor. But before 3 or 4 months, the baby’s intestinal functions have not yet fully developed; many enzymes and beneficial bacteria are missing. Therefore, constipation in a newborn often occurs at this time. Komarovsky urges parents not to panic, but to try to improve the diet of the nursing mother or consult a doctor about choosing formula milk. Normally, a breastfed baby should poop 4-5 times a day. And in those who are artificial, bowel movements occur less frequently - 1-2 times. Moreover, the feces should be soft and mushy.

Causes

Komarovsky believes that the main factor that provokes constipation is poor nutrition. This applies to absolutely everyone: infants, children 3-4 years old and older. After all, the products and their quality affect what the formed feces will be like. But this is not the only reason.

Other factors worth considering:

• Intestinal diseases, spasms and other anatomical defects;
• Heredity;
• Insufficient fluid intake;
• Lack of vitamins and minerals (potassium);
• Low content of plant fiber in food;
• A sharp transition from breastfeeding to artificial feeding;
• Incorrect composition of the mixture;
• Lactose deficiency;
• Underweight;
• Antibiotics and drugs;
• Mode change;
• Insufficient amount of milk from the mother;
• Overheating of the body;
• Dysbacteriosis;
• Sedentary lifestyle;
• Psychological trauma or reaction to a stressful situation and a quarrel between parents.

Komarovsky urges parents not to panic, but to try to improve the nutrition of the nursing mother or consult a doctor about choosing formula milk. How to treat? Constipation in a one-year-old baby is a common problem that doctors recommend dealing with in every possible way. Dr. Komarovsky talks about constipation and its treatment and says that a very important point is proper nutrition for the nursing mother, as well as for the baby to drink enough water. It is necessary to exclude from the diet those foods that lead to consolidation and provoke the appearance of gas. It is necessary to give a bottle of clean water between meals.

Children 2 years of age and older need to eat foods rich in potassium and fiber. These include beets and prunes. Pumpkin, plum or apple puree helps relieve constipation in a one-year-old child. Doctors recommend using buckwheat or oatmeal as complementary foods every day. Particular attention should be paid to taking dill water, which helps improve the condition of the digestive system.

Constipation in children under one year of age is treated with special gymnastics and massage. To do this, you need to put the baby on his back and make a “bicycle” with his legs or simply bend his knees several times. A fitness ball helps a lot. You should place the child with his stomach on the ball and rock him a little. The movements can be circular or with up and down pressure. Thanks to these exercises, the intestines wake up and their activity improves. The massage consists of circular stroking of the abdomen in a clockwise direction. There are many videos that show the best measures to eliminate such problems in children, and also describe the rules for performing massage. A heated diaper placed over the stomach helps relieve spasms and relax muscles.

To prevent constipation, place your baby on his tummy as often as possible.

Constipation in infants during breastfeeding

A child who eats mother's milk may not poop for up to 3-4 days. This is considered normal if the baby is not bothered by anything, if he is cheerful and cheerful, sleeps well and is gaining weight. This means that breast milk is suitable for him and is well absorbed. Only in rare cases does a baby develop real constipation during breastfeeding. Komarovsky believes that measures need to be taken if the baby is not gaining weight, is restless and cries. But before using any medications, you should definitely consult your doctor. In most cases, you can cope with the problem simply by changing the mother's diet.

What rules should a woman follow so that her child has regular bowel movements?

• You need to drink at least 2 liters of water, it will help stimulate intestinal motility;
• regularly eat prunes, dried apricots, raisins and beets;
• the daily menu should include buckwheat or oatmeal, pumpkin, apricots, plums and fermented milk products;
• it is necessary to exclude coffee, tea, chocolate, smoked foods, fatty and spicy foods from the diet;
• You should limit your intake of rice, legumes, potatoes, fresh milk, walnuts and baked goods.

But even if the mother follows all the rules, sometimes a baby experiences constipation while breastfeeding. Komarovsky believes that this is due to a lack of water. He recommends feeding your baby with clean water or raisin decoction in hot weather. But it is not advisable to use a bottle with a nipple for this, so that the baby does not get used to it. You can give your child water from a spoon or a special drinking bowl, and a very small child can be given water from a syringe without a needle.

Doctor Komarovsky's opinion on the treatment of constipation

Dr. Evgeniy Komarovsky notes that in the treatment of a pathological condition in infants, one should focus on the severity of the condition. In case of short-term constipation, no weight loss, fever or changes in the child’s behavior, the mother can limit herself to home methods after agreement with the pediatrician:

• tummy massage to relieve spastic phenomena, stimulate intestinal motility,
• stimulation of defecation by irritating methods - gas tube, glycerin suppository.

It is effective to administer microenemas to infants that contain drugs with laxative properties or the use of medications with Lactulose orally. According to Komarovsky, it is necessary to use these methods for prolonged constipation and the lack of effect of non-drug methods of stimulating the gastrointestinal tract.

When breastfeeding

Komarovsky’s opinion about constipation in infants during breastfeeding comes down to the need to adjust the mother’s diet and drinking regime to correct the qualitative and quantitative composition of milk. The diet includes more first courses, fresh vegetables, fruits, and milk porridges. It is recommended to drink at least 1.5 - 2 liters of clean drinking water.

Changing the feeding schedule helps - if the child is malnourished or is a “lazy sucker”, the development of constipation is inevitable. In such situations, it is recommended to feed not on demand, but according to a schedule relative to the age of the baby.

With artificial feeding

Dr. Komarovsky’s opinion when using formulas is to focus the attention of the mother and the attending physician on the mixture that the child eats. The mixture should contain exclusively natural nutrients, vitamins and probiotics to help establish normal intestinal microflora. Otherwise, constipation is possible. If necessary, the mixture is replaced with a more suitable option, the amount of mixture consumed at a time is adjusted, and it is important to monitor the quality of water for diluting the dry matter of the mixture.

In addition to the formula, the baby should receive an adequate amount of drinking water to prevent dehydration and constipation.

With mixed feeding

Komarovsky’s opinion about constipation in a baby with mixed feeding comes down to an imbalance in the consumption of milk and formula. Many mothers, believing that there is not enough breast milk, increase the dosage of the formula at a time, causing overload of the digestive tract instead of benefit for the baby.

Dr. Evgeniy Komarovsky points out that often even the best adapted formula may not be compatible with milk. This is one of the reasons why pediatricians recommend not using formula when breastfeeding. If there is a small amount of breast milk, it is worth completely switching to artificial feeding.

Constipation in infants with artificial feeding

If, when breastfeeding, mothers rarely encounter real problems in emptying the baby’s intestines, then this happens more often with artificial mothers. What can you do to prevent constipation in a bottle-fed baby? Komarovsky recommends following these rules:

• The mixture must be diluted strictly according to the instructions; it cannot be made more concentrated;
• Be sure to give your baby water, maybe adding a few drops of dill seed decoction;
• if a child experiences constipation frequently, it is necessary to change the formula, choosing one that contains lactobacilli.

Constipation after introducing complementary foods

Komarovsky recommends feeding the baby only breast milk until 4-5 months. If the mother has enough of it, the baby will receive everything he needs. Very often, constipation occurs in infants when complementary foods are introduced. To prevent this, Komarovsky advises starting not with egg yolks or fruit juices, but with vegetable puree or dairy-free porridge. After some time, the baby’s diet needs to be varied so that he receives a sufficient amount of dietary fiber. Therefore, vegetable soups and purees, porridges, especially not ready-made ones, but made by the mother, are very important in the diet of children. After 7-8 months, you need to give your baby wholemeal bread, fresh fruits and vegetables.

Sometimes it happens that a baby becomes constipated after introducing complementary foods. In this case, Komarovsky advises giving the child prune juice or puree, pumpkin, and raisin decoction. It is advisable to include these products in the diet if the baby is already 6 months old. Food for a child should be prepared immediately before consumption; it is not advisable to boil it thoroughly. By following these rules, you can prevent constipation in your baby.

What to do

Komarovsky gives some advice on how you can help your baby. After all, it is not always possible to see a doctor right away. But every mother is able to alleviate the child’s condition. And only if these measures do not help, you should definitely contact a medical facility. So, what to do if your baby is constipated? Komarovsky recommends the following methods:

• give the baby a massage, using gentle movements with a warm hand to rub the baby’s tummy clockwise;
• The “bicycle” exercise helps activate intestinal functions: you need to take the child’s legs and carefully bend them alternately at least 10 times;

• you can put a diaper heated with an iron on the baby’s tummy;
• A warm bath will help your baby relax;
• The doctor considers glycerin suppositories to be an effective remedy for constipation;
• as a last resort, you can give your child a laxative medicine prescribed by your doctor.

It is necessary to call an ambulance or consult a doctor as soon as possible if your child has the following symptoms:

• abdominal pain, gas, bloating;
• loss of appetite, refusal to eat;
• blood appears in the stool;
• frequent vomiting;
• The baby's stool and urine are dark and have an unpleasant odor.

What medications can be used in infants for constipation?

It is not recommended to give babies any medications without consulting a doctor. Even the safest drugs approved for use from birth can harm the immature intestinal microflora of a child. Therefore, only in extreme cases is it recommended to use medications to cure constipation in infants.

• It is best to use preparations containing lactulose. This is the safest laxative. Lactulose syrup is a prebiotic. It stimulates the production of beneficial bacteria in the intestines and helps remove feces. The following drugs containing lactulose are recommended: Duphalac, Normaze, Portalak, Lizalak and some others. To begin with, it is better to give these medications in a reduced dosage. And if you need long-term use, you should definitely consult your doctor.
• To reduce gas formation in the intestines, doctors prescribe the following drugs to children: Espumisan, Plantex or Sub-Simplex. They help relieve cramps and gently remove gases, relieving bloating.
• Komarovsky considers glycerin suppositories to be the best remedy for constipation in infants. Children's ones are very rarely sold on sale, but regular ones can also be used. One candle needs to be cut in half lengthwise and then crosswise. You will get four parts. You need to smooth out all the edges of one piece of candle with clean hands and carefully insert it into the baby’s anus. Gently squeeze his buttocks and hold for a while. This suppository will help soften stool and gently move it out.

Experts' opinion

One of the main problems associated with children in the first year of life is constipation in infants with mixed feeding. What to do in this case? Pediatrician Evgeny Komarovsky suggests that mothers use safe medications that you can safely use for irregular bowel movements.

1. Lactulose syrup is used for irregular stool in both newborns and infants. The product is absolutely safe and, moreover, even useful, since it promotes the growth of beneficial bacteria in the digestive tract. Despite the fact that the instructions for the medication state that the dosage for children under one year of age is 5 ml, the pediatrician recommends increasing the dose gradually. Because due to excessive growth of bifidobacteria, infants may suffer from increased gas formation.
2. Glycerin suppositories have no less effect than other ways to alleviate the baby’s condition in the absence of feces.

Doctor Komarovsky about mixed feeding: video

Now you know how to independently diagnose constipation in a mixed-fed baby, as well as how to help him get rid of discomfort in the tummy, and what treatment is suitable in such a case. Do not forget that breast milk contains a large amount of useful substances that improve the functioning of the baby’s unformed gastrointestinal tract. Try to regularly feed your baby breast milk. This will only benefit him, and it will also help you forget about constipation in newborns with mixed feeding.

How to give an enema to a baby

Many people believe that this is the only way to treat constipation in a baby. Komarovsky recommends using an enema only in extreme cases. Their frequent use washes out beneficial bacteria from the intestines and weakens its tone. How to properly give an enema to a baby?

1. Take a rubber bulb with a soft tip; it should have a volume of up to 60 ml.
2. Typically, chamomile decoction is used for infants. It should be at room temperature. Water that is too warm will be immediately absorbed through the intestinal walls.
3. Lay the baby on his side or back. Lubricate the anus and the enema tip with baby cream.
4. Squeeze the bulb a little to remove air from it. Carefully insert the tip no more than a couple of centimeters into the baby's intestines. If resistance is felt, do not press.
5. Release the water slowly, but do not use force. The process of intestinal contraction occurs in waves, so if you feel resistance, you need to wait a little. Take out the enema.
6. Squeeze your baby's buttocks and hold for a couple of minutes.

But more convenient to use and safer for the child are ready-made microenemas, which are sold in pharmacies. For example, you can buy Microlax. But you shouldn’t do them often to prevent addiction.

Folk remedies for constipation

Many mothers try to help their child with the help of recipes that their grandmothers used. They push a piece of soap, a cotton swab coated with Vaseline, or a thermometer into the baby’s anus. This is how constipation in an infant was often treated in the past. Komarovsky warns parents against using such means. He believes that this is child abuse. In addition, such drugs can injure the mucous membrane, cause irritation in the anus and further aggravate the problem.

Among folk remedies, the doctor prefers decoctions that help remove gases. It is best to brew dill seed, anise or fennel. Komarovsky considers raisin decoction very useful. In addition to its laxative effect, this drink enriches the body with potassium, which is very important for normal intestinal function. There is a greater choice of remedies if a baby has constipation for 6 months. Komarovsky recommends giving your baby juice, decoction or puree of prunes, and including foods rich in fiber in the diet.

Preventing constipation

Everyone knows that it is better to prevent a problem than to look for ways to cope with it. Dr. Komarovsky talks a lot about constipation in infants, but the main thing he focuses on is the need to establish proper nutrition for the baby. How should you act to prevent constipation?

• A bottle-fed baby should receive enough water.
• If the baby is fed breast milk, then the mother needs to drink at least 2 liters of liquid and eat foods rich in potassium.
• Place the baby on his tummy more often, ideally for 5 minutes each time before feeding.
• Do gymnastics with your child regularly: lift his legs, bend them at the knees, exercises on a gymnastic ball are useful.
• You need to give the baby a light tummy massage, it helps relieve muscle spasms and reduce gas formation.
• The child should not be allowed to overheat.
• The food of babies who are already receiving complementary foods should not be highly heat-treated and very soft.

You need to treat constipation in infants yourself only if it is the only symptom. And when a baby experiences abdominal pain, has increased gas formation and lacks appetite, it is necessary to urgently consult a doctor.

The first year of a child's life is perhaps the most difficult for both him and his parents. The slightest deviations in the baby’s health cause great concern and even panic among new mothers and fathers due to the lack of the necessary knowledge and experience. One of the problems that they may encounter during this time period is constipation in infants. Difficulty defecating in newborns and babies under one year of age is in most cases associated with their nutritional characteristics and immaturity of the digestive tract.

However, more serious problems may also occur, which include congenital anomalies of the intestine, nervous system disorders and other diseases. An important point is that the absence of stool in an infant for several days does not always indicate constipation and can be quite normal.

Five rules for treating constipation

If your doctor is sure that constipation is not a symptom of something serious, you can try to cope with it on your own. What should you pay attention to?

1. The child should not have a fluid deficiency.

Lack of fluid is one of the most common causes of constipation in children. At the same time, the feces become thick, slowly move through the intestines, scratching its walls, which causes pain and colic. And the urge to go to the toilet arises only when the accumulated masses begin to put pressure on the walls of the rectum, but water helps to increase their volume, and the baby poops faster. So let's drink more and hydrate the nursery!

2. The body must have enough potassium.

With a lack of potassium, intestinal contractions (so-called peristalsis) are sharply weakened, and this may well be the cause of constipation. The most potassium is found in raisins, dried apricots, prunes, and figs, which, by the way, can be added to compotes or simply eaten steamed.

3. A nutritious diet rich in fiber.

For constipation, foods rich in protein, such as chocolate, cottage cheese, and nuts, are undesirable. Yogurts, one-day kefir and yogurt are desirable. Brown bread is better than white bread. Apple juice is better than a whole apple. It is better to limit meat. In general, fiber is an excellent preventive measure for constipation. This means that the child needs to be given more fruits and vegetables, as well as cereals, preferably slightly undercooked.

If lactulose and glycerin suppositories do not help, go to the doctor

4. Safe medications.

There are only two medications that can be used even in infants and without a doctor's prescription. The first is lactulose syrup, which is sold under different commercial names in any pharmacy. It increases the volume of feces, retaining water in the intestines, does not cause “addiction”, and can be taken for as long as you like. However, at the first dose, the baby may develop gas as a reaction to the drug, so it is better to increase the dose gradually. The second is suppositories with glycerin. Their advantage is that glycerin is not absorbed by the body, but is released along with the contents of the intestines, and such suppositories act much more gently than an enema.

If the cause of constipation is cracks in the anus (appearing, for example, after the passage of lumps of hard feces), due to which the child simply does not want to go to the potty for fear of pain, suppositories with sea buckthorn oil will help.

5. Daily routine.

It happens that there is an urge to go big, the child feels it, but ignores it - for example, he is very busy or simply does not want to go to the toilet in the garden or at school, preferring to wait until he gets home. If this behavior becomes systematic, then the rectum begins to stretch from excess feces, and in order to feel the urge to go to the toilet, the child needs more and more time. This leads to constipation, which takes a very long time to treat.

To prevent this, it is important to accustom your baby to systematic bowel movements from childhood. Better - at the same time and in the same familiar environment. Let him go to the potty before bed or after breakfast, before leaving the house.

If all of the above does not help, you need to seek help from a doctor. It is important to understand that specialists have a much larger range of constipation treatment regimens than parents.

Normal number of bowel movements for infants

The number of bowel movements per day for children under one year of age depends on the type of food and age. There are no universal indicators of normality by which one can judge the presence or absence of problems with bowel movement in absolutely any child.

In the first days of life, the newborn excretes original feces, which is called meconium. It consists of digested intestinal cells, amniotic fluid, mucus, bile, and water. Meconium has a dark green or black color and a viscous and sticky consistency. The number of bowel movements per day in children during this period varies from 1 to 3.

Subsequently, the baby's stool changes depending on the type of feeding chosen (breastfeeding, mixed or artificial) and remains until complementary feeding is introduced. With exclusive breastfeeding, stool in babies has the following features:

• liquid mushy consistency;
• yellow or yellow with a brown tint;
• slightly sour smell of overcooked milk;
• the number of bowel movements is individual for each child (from 8 times a day to 1 time every 3–5 days).

Important: The frequency of bowel movements is highest in children in the first weeks after birth and can reach 5-8 times a day. As the baby grows, the daily number of bowel movements is reduced to 1–3 times.

With artificial or mixed type of feeding, the stool, as a rule, has a thicker consistency, an unpleasant odor and a dark, closer to brown, color. In this case, bowel movements must occur at least once a day, otherwise the baby is considered to be constipated.

In case of constipation in an infant, feces come out in the form of separate hard lumps (type 1) or in the form of a dense sausage consisting of lumps (type 2)

During the period of introducing complementary foods, the baby's feces gradually change and begin to resemble the feces of an adult. They become shaped, acquire a brown color, a dense consistency and a characteristic odor.

What symptoms indicate constipation in infants?

The lifestyle, nutrition and overall body of children under one year of age, and especially a newborn, have significant differences compared to adults. In this regard, the assessment of any violations in their health, including the functioning of the gastrointestinal tract, is carried out taking into account age and physiological characteristics. For example, if after defecation an adult has a feeling of insufficient bowel movement or a complete absence of stool for 3 days, then these signs clearly indicate the development of constipation. While in a baby who receives only breast milk as food, the absence of bowel movements for 3 or even 5 days may be normal.

This feature of the intestines in some children is due to the high degree of digestibility of breast milk and, as a result, the minimal formation of undigested residue, which is insufficient to cause the urge to defecate. In this case, bowel movement in the child occurs after the accumulation of the required amount of feces.

The main signs of constipation in an infant include the absence of full-fledged stool for more than two or three days in a row, which is additionally accompanied by one or more of the following symptoms:

• discharge of small portions of stool with a very hard consistency;
• restlessness, moodiness, frequent crying;
• loss of appetite;
• slow weight gain;
• redness of the face and tightening of the legs when feeding;
• severe straining, screaming and restlessness when trying to have a bowel movement.

Constipation in an infant is accompanied by severe gas formation, which causes the baby pain and severe discomfort in the abdominal area.

Important: If a breastfed baby has rare bowel movements that are not accompanied by changes in behavior, poor health or mood, then they are not symptoms of constipation in the baby.

Causes of constipation in children under one year of age

Difficulties in defecation in infants can be caused by a variety of reasons. Constipation in children may appear periodically or be present constantly. In most cases, periodic delays in bowel movements are caused by some kind of nutritional problem that leads to disruption of intestinal function. The causes of chronic constipation in infants can be serious pathologies of the nervous system, congenital malformations of the large intestine and other factors. Also, irregular bowel movements in children under one year of age may be associated with the physiological characteristics of the structure of the gastrointestinal tract at this age.

Diet-related causes of constipation in children under one year of age

The most common causes of constipation in infants are nutritional disorders. In this case, stool retention is temporary, and after eliminating the problem, normal bowel function is restored by itself. Such reasons include:

• changing your usual diet (switching from breast milk to formula or replacing formula milk);
• unsuitable formula for formula-fed babies;
• poor nutrition for a nursing mother, containing many foods that promote stool consolidation or cause increased gas formation (rice, white bread and pastries, black tea, carbonated drinks, fatty meats, whole milk, cabbage, legumes, etc.);
• introducing complementary foods too early, when the child’s gastrointestinal tract is not yet ready to digest the new food offered to him;
• insufficient amount of fluid entering the baby’s body;
• a high content in the baby’s diet during the period of introducing complementary feeding of foods that cause constipation in infants.

Important: Usually, as a result of the introduction of complementary foods, most babies' stools normalize and become regular. This is primarily due to the beginning of the baby’s intake of vegetables and fruits rich in plant fiber.

Constipation in newborns during breastfeeding is quite rare, since mother's breast milk has the optimal composition for the normal functioning of the baby's gastrointestinal tract

Diseases that cause constipation in children under one year of age

Irregular bowel movements or prolonged absence of bowel movements in infants can be associated with a number of pathological conditions. Among them:

• congenital anomalies of intestinal development;
• disorder of the nervous system caused by severe pregnancy or childbirth;
• lactase deficiency;
• hypothyroidism;
• rickets;
• hyperparathyroidism;
• diabetes mellitus, etc.

The incidence of congenital intestinal anomalies resulting in constipation in newborns is about 5%. In this case, chronic defecation delays develop gradually and progress as the child grows.

Defects of the intestinal structure include:

• elongation of the sigmoid colon without changing the diameter and thickness of the walls (dolichosigma) or with expansion of the lumen and thickening of the intestinal wall (megadolichosigma);
• Hirschsprung's disease is a disorder of the innervation of individual fragments of the colon, as a result of which the affected area is constantly in a spasmodic state;
• narrowing or absence of the anus;
• colon duplication;
• intestinal diverticula.

Important: If a child has congenital anomalies of intestinal development or other serious diseases accompanied by a prolonged absence of bowel movements, constipation is far from the only symptom of such pathologies.

Other causes of constipation in infants

Intestinal dysfunction in infants, manifested in delayed bowel movements, can occur periodically under the influence of certain provoking factors. These include:

• taking medications (antibiotics, antispasmodics, iron supplements, etc.);
• high temperature (for example, with infectious diseases);
• period of teething;
• insufficient physical activity;
• allergic reactions;
• conscious delay in defecation caused by psychological reasons.

Recommendation: If there is a prolonged absence of stool in infants, the child should be shown to a pediatrician. Only he will be able to determine the cause of such changes in intestinal function and establish whether such a condition is a normal variant or a pathology.

What does green stool mean in a breastfed baby?

The key to a baby’s health is an attentive mother. She notices everything: changes in mood, appetite, intonation in voice, duration of sleep, skin color, how many times she peed and how often she pooped, what it looked like.

You should not hastily crumple up a used diaper or diaper without examining it: the color of the stool, consistency and smell are important and can say a lot about the child’s well-being. This is one of the signals that helps parents understand whether everything is fine with the baby or if there are any problems.

Causes

Green stool in a breastfed newborn is observed on the fifth day of his life . Doctors explain it this way: the newborn’s digestive system adapts to unusual conditions.

Within a month, parents will find so-called original feces in diapers - green, thick, and sometimes with mucus.

Over time, the color will turn yellow and light brown. Mature feces have a consistency similar to sour cream and a smell like sour milk.

The baby poops up to ten times during the day, and if breast milk is well absorbed, then less often. When a mother knows “how it should be,” she will certainly be alarmed when she discovers deviations from the norm.

Here are several factors that explain the reason for the green color of stool in breastfeeding infants:

• the digestive system is in the process of formation;
• Bilirubin leaves the body along with feces (it is formed as a result of the breakdown of proteins), giving the mass a green tint;
• this is a reaction to the mother's hormones;
• a consequence of the mother taking medications containing iron;
• mother’s diet (there could be something green on the menu - cucumbers, zucchini, pears);
• If the diaper has not been changed for a long time, the stool under the influence of oxygen has oxidized and acquired a green tint.

The reasons listed do not indicate problems with the baby’s health and do not require any emergency measures to be taken.

However, there is a question that pediatricians advise to sort out: is the mother feeding her baby correctly. If not (and this is also indicated by the green color of the stool), then it is better to correct the situation.

Experts divide breast milk into two types: fore milk (it is thinner, it contains more water and carbohydrates) and hind milk (thick, rich in fats and proteins). The baby needs both in a reasonable balance.

The green color of stool in a breastfed baby signals that he is not getting enough fat, which means the situation needs to be changed.

Mother and baby need to feel comfortable while feeding: the nipple should be placed in the baby’s wide open mouth, the tip of his nose, if the baby is positioned correctly, usually touches the mother’s breast, and whistling sounds are not allowed during sucking (as if the baby is sucking in air).

Feeding cannot be artificially limited - the baby should suck as much as he wants. The tough guy, of course, will eat quickly. A weak child will need more time to do such difficult work.

During feeding, you should not put the baby first on one breast and then on the other. Experts formulated this rule (it will be in effect for six months) as follows: one breast is on duty for two hours, the other for the next two hours.

This means that during one “duty” the baby can eat two or even three times, but certainly from the same “source”. This is the only way he will get to all his mother’s supplies.

Sometimes parents notice mucus in the stool. This is not a reason to panic, but a signal that the child still needs some help. This happens during teething and during a cold.

Consult your pediatrician - he will tell you what to do.

How to recognize the problem

Sometimes green stool in a breastfed baby is a sign of some kind of ailment; several alarming symptoms are observed at once, which, like a puzzle, add up to the overall picture of the disease.

Here are some points that parents should be wary of:

• The stool of a breastfed baby is not just green, but also liquid, with bloody inclusions, an unpleasant atypical odor, more frequent than usual (12 or more times during the day);
• vomiting and frequent regurgitation;
• increased body temperature;
• decreased reaction to what is happening around;
• weight loss;
• characteristic signs of dehydration (sunken fontanel on the head, smoothed out wrinkles on the hips, dry skin all over the body);
• urination more rare than usual, the color of the urine is dark, the smell is pungent;
• bad breath;
• increased gas formation.

Making a diagnosis is, of course, the prerogative of the pediatrician, but to help him in this matter, carefully monitor the baby and share all available information with the doctor.

If a breastfeeding baby's stools are green, watery and frequent, and the baby begins to lose weight, this may be signs of poisoning, allergies or infectious diseases.

Your child poops rarely and with difficulty, and his tummy is tense - most likely, this is constipation, the cause of which will be determined and helped you eliminate by your pediatrician.

The presence of foam in the green stool of a breastfed newborn may indicate lactase deficiency.

A rash on the body, feces with mucus and an unpleasant odor may be signs of dysbiosis or viral infections.

Among other problems that can be identified by a doctor: pathology of the digestive system (surgery may be required), the presence of parasites, rotavirus (it is treated in a hospital).

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Do I need to go to a doctor, which one?

Very often, the baby’s problems depend on the mother’s. If a woman manages to quickly eliminate them and this has a positive effect on the child, then she can postpone the visit to the doctor.

What can a nursing mother do? Stop taking medications and vitamin preparations, critically examine your menu and exclude from it “dubious” products that can cause an allergic reaction in the baby.

If you have started introducing any complementary foods into your baby’s diet in addition to breast milk, you need to temporarily give it up and observe how this affects the baby’s well-being.

In any case, you should not stop breastfeeding on your own initiative (it’s another matter if this is a doctor’s decision), because mother’s milk contains antibodies that can form the baby’s immunity and help him recover faster.

If there are several alarming symptoms (in addition to green stool in a breastfed baby), an appointment with a pediatrician or a visit to the patient’s home is required.

The doctor will recommend a consultation with an allergist or gastroenterologist and conduct tests. Your baby may be prescribed medications that contain live bacteria and sorbents.

Under no circumstances should you “prescribe” medication for your son or daughter on your own, no matter how “savvy” the parents may feel.

Diagnostic methods

To make an accurate diagnosis, a comprehensive examination is usually carried out:

• tests of feces (this type of laboratory research is called “coprogram”), blood, urine;
• Ultrasound (stomach, liver, other organs);
• tests for the presence of parasites in the body.

If the doctor suspects a patient has lactase deficiency, he will prescribe a test for the presence of lactose in the stool .

To make a diagnosis such as “candidiasis” (thrush), the analysis must detect yeast-like fungi in the stool.

The coprograms of babies look different than those of adults.

For example, if the parents are healthy, no leukocytes will be found in their stool taken for analysis. And in their healthy baby, single leukocytes, as doctors say, “in the field of view” are a normal phenomenon.

These facts suggest that a specialist should “read” research data.

What definitely should not be in a baby's stool sample is:

• blood;
• connective tissue;
• soluble protein;
• starch.

Many parents, having received an order to have their baby’s feces tested, are perplexed: how did he, who is breastfed, in a perfectly clean crib, acquire worms (the need for research is usually associated with these enemies).

However, doctors have a different task : with the help of a coprogram, they study the intestinal microflora of a tiny patient, which newborns do not have at all (because of this, colic and problems with stool occur), and is formed only two months later, after which the body should begin to work normally .

If this does not happen, colic continues, and the stool of a breastfed baby remains green, and even interspersed with blood and mucus, the analysis helps to find out what is wrong with the intestinal microflora and what treatment is necessary.

Treatment regimen, drugs and features of their use

If your baby is diagnosed with dysbiosis, you need to prepare for long-term treatment.

It begins with the doctor prescribing drugs that destroy pathogenic bacteria, and at the same time, drugs that remove toxins from the body. The duration of the course is determined by the doctor.

Then treatment continues with drugs containing lacto- and bifidobacteria. Their function is to create healthy microflora in the patient’s intestines.

At this stage, drugs such as “Lactulose” (regulator of intestinal function) are used, which are safe for the health of tiny patients.

They are produced under various commercial names. To avoid mistakes, purchase the product that your doctor recommends .

One of the popular modern means is Linex, it is recommended for children under two years of age. When prescribing the drug to newborns, the pediatrician explains that you first need to open the capsule, add water to its contents and only then use it.

Acipol and Enterol are also effective against dysbiosis in infants.

In cases where lactase deficiency is detected, the baby is prescribed drugs containing these enzymes (for example, Lactase Baby).

Mom is recommended a special diet. She will also have to express a little milk before feeding so that her baby “gets” to the deep portions, since they contain lactase in the greatest quantities.

If a stool test reveals the presence of any infections in the body, the pediatrician may prescribe antibiotics to the patient, indicating the dosage and duration of the medication. With their help, it is possible to stop diarrhea, which is dangerous due to the risk of dehydration.

Feeding your baby with breast milk more often than usual helps replenish the loss of water in the body. In severe forms of the disease, doctors prescribe the patient electrolytic drugs Oralit, Regidron, which can restore the water-salt balance.

Smecta is recommended to remove accumulated toxins. This drug has enveloping and protective functions that will be beneficial for the patient’s intestines.

If the disease is accompanied by high fever, the doctor may recommend Nurofen, Panadol for children.

Diet

To ensure that the baby does not have problems with stool, the mother needs to be very picky about her menu .

Contrary to popular belief, you should not consume too much cow's milk (it often causes allergies in children in the first year of life). Yogurt or kefir, cottage cheese and cheese will bring more benefits.

Meat, poultry and fish can be eaten boiled or steamed.

The body's need for dietary fiber is satisfied by vegetables and fruits, but not orange or red ones.

You should beware of exotic fruits and too much greenery.

To prevent foam from appearing in the stool, you will have to avoid foods that provoke fermentation processes. These are various sweet confectionery products and drinks, smoked foods and pickles, and fruits – grapes.

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Special instructions and recommendations for parents

Don't panic ahead of time. You will need a clear head in any case, and if trouble happens to your baby, your actions must be especially competent and accurate.

Do not use medications not prescribed by your doctor. While waiting for the pediatrician's visit, give your baby fluids more often to prevent dehydration.

While the child is very young, beware of traditional methods of treatment , even if they are recommended to you as “proven” and “the most reliable”.

Such products have contraindications that you simply may not be aware of.