Constipation is common among infants and children. The term constipation indicates that there is infrequent intestinal evacuation of stools which is too small in amount, hard and dry. The criterion of constipation is the nature of stool and not its frequency.
Normally infants who are breast fed and receive adequate amount of milk are less constipated. It is only when the baby begins to eat solid food, he may suffer from constipation. Although most infants may have one or more bowel evacuation daily, sometimes they may pass after one or two days.In such cases, it may not be considered constipation if the consistency and amount is sufficient. The causes of constipation are many, most of them are not medical. Simple dietary change and behavioral modification at home is all that is needed to resolve. If home measures are not helpful, the infant may need a pediatric consultation.
What are the Causes?
- Whenever constipation is present after birth or shortly thereafter, it is necessary to examine the anal region. A tight anal ring occasionally is responsible for it.
- Constipation is common if the amount of milk in a breast fed or bottle fed infant is insufficient.
- In artificially fed infant, the amount of carbohydrate or fat may be less.
- Also in older children, diet too high in protein and fat tend to cause hard, firm and dry stools.
- Cracks and fissures in anus may cause spasm of anal sphincter. It is often observed after a large and hard passage of bowel movement, due to pain the infant or the older child may tend to withhold passing of stool.
- In medical conditions such as anemia, malnutrition, rickets where there is lack of muscular tone, the child may suffer from constipation.
- Injudicious use of laxatives, suppositories in older children and infants may have rebound effect of constipation.
- Anatomic abnormalities though very less may cause constipation. Unduly long and tortuous sigmoid colon (a part of long intestine), intestinal obstruction, anal stenosis are a few examples.
Signs and Symptoms of Constipation in Toddlers
The symptoms that accompany constipation in children mainly depend on the underlying cause. Below are given common symptoms of constipation in an infant.
- Abdominal discomfort.
- Evacuation of dry, hard ribbon shaped stool.
- Tiny round and ball shaped fecal matter.
- Lack of appetite.
- The child cries consistently when he tries to evacuate if there are cracks and fissures in the anal region.
- Fecal mass may be palpated as hard nodule while examining the abdominal wall.
- Bleeding from the rectum.
How to Treat Constipation in Infants
Before instituting any treatment, it is necessary to determine whether the infant is actually constipated. It is possible by examining the stool and from the medical history. It is also necessary to examine the anal region to find any abnormality. A doctor should always be consulted if constipation is present in the first few months.
Mother should ensure that the infant is properly breast fed.
In artificially fed child, simply increasing the amount of fluid and sugar may correct constipation in the first few months of life. After this age, better results are observed by adding or increasing the amount of cereal, vegetables and fruits.
For an infant above the age of 4 months, following home measures are beneficial.
- Fruit juice, vegetable juice may benefit the child and relieve him from constipation.
- If the infant has begun to eat semisolid foods give him mashed rice, mashed vegetables and fruits as they are high in fiber. Fiber food increases motility as well as facilitates easy evacuation.
- A gentle massage over the abdomen has proved beneficial.
- Warm bath is effective and a safe home remedy for constipation in infants. Ensure that the water is not too warm.
- Prune juice is a natural laxative that has proved valuable for curing constipation among infants above the age of six. Dilute prune juice with breast milk or formula milk before feeding the infant.
- In acute constipation, a glycerin suppository may be inserted through the anus. The suppository dissolves inside the rectum and allows easy bowel movement. However it should not be used as a routine measure.