The baby has no stool for 3 days. Treatment and prevention of constipation. Other pathological causes

06.06.2019

Every mom knows that her baby's well-being depends on whether he is hungry and whether his tummy hurts. If the baby is worried about colic and constipation, sleepless nights and constant whims of parents are guaranteed. Constipation is more common in children who are on artificial and mixed feeding. Babies have problems with stools less often, but if the mother ignores the lists of “forbidden” foods, this trouble can happen to them too.

The immature digestive system in children under one year old is characterized by extreme instability in work. A chair in an infant can be both several times a day and once a day: both of them are a variant of the norm. Therefore, it is not always clear to parents when the lack of bowel movements is just a temporary situation, and when it is time to sound the alarm.

An attentive mother knows well the peculiarities of her baby's digestion: how many times a day he poops, what is the consistency, color, smell of feces, so he can easily determine if something has changed. A breastfed newborn can empty the intestines as many times as he ate, that is, from 4 to 10 times a day. Fecal masses are mushy, yellowish in color, without a strong odor. On mother's milk, the stool in an infant is formed soft even with the start of the introduction of complementary foods, but if it is thick and hard, this indicates a tendency to constipation.

A baby receiving formula has feces more like an "adult" and no more than 1-2 times a day. With age, both in infants and in artificials, the frequency of stool comes to a single physiological norm - once a day, sometimes a little more often. In terms of the number of bowel movements, one can speak of constipation when more than a day has already passed since the last time, and the child shows clear signs of anxiety.

Normally, the process of bowel movement, even if it is quite rare, should not cause difficulties, pain in the abdomen. If these phenomena are present, then they are one of the signs of constipation.

Thus, constipation in an infant can be identified by the following symptoms:

stool retention for more than a day;
causeless crying;
the baby does not sleep well, refuses to eat;
the baby is worried about the tummy: bloating, spasms, even vomiting is possible;
when trying to poop, the baby pushes hard, groans, the “process” is difficult;
dense feces are excreted;
incomplete defecation occurs.

When these signs appear, the baby needs help immediately, and in the future, make every effort to treat and prevent such conditions. It is advisable to show the child to the pediatrician, because in addition to physiologically occurring constipation (those that are treated with nutritional correction), there are also pathological ones - their causes are in a defect in the gastrointestinal system and other diseases. They need to be diagnosed and eliminated in time.

In order for parents to know how to help their baby release the tummy, and in the future try to save him from constipation, you need to find out what this problem can be caused by. The main causes of digestive disorders in infants are as follows:

organic constipation- a condition that requires urgent diagnosis and treatment, often surgical. Such constipation is associated with congenital defects of the large intestine, which include dolichosigma (lengthening of the sigmoid colon, with or without torsion), Hirschsprung's disease (absence of nerve endings in part of the intestine), and others. As a result of such anomalies, intestinal motility is disturbed - it is physically unable to properly respond to feces and push them to the exit. Such conditions pose a real danger to the life of the baby, as they lead to overstretching of the intestine, inflammation of the mucosa, and intoxication of the whole organism. These diseases are quite rare, more common in children with other congenital problems (for example, Down syndrome) and begin to manifest constipation immediately after birth. Eliminating them is a top priority for parents and the attending physician.
Errors in the diet of a nursing mother. The debate about the extent to which maternal nutrition affects tummy problems in newborns does not subside among pediatricians and parents themselves. Some experts believe that since breast milk is synthesized from blood and lymph, no products that are “harmful” from the point of view of digestion can penetrate it, and therefore the role of the mother’s diet in the occurrence of colic and constipation in children is greatly exaggerated. Others continue to insist that the composition of milk directly depends on the nutrition of a nursing mother, who, in order to avoid trouble, is obliged to follow a diet and avoid eating food that provokes constipation in infants. That is: bread made from white flour, meat, rice, bananas, milk, nuts, etc. Most parents themselves, through observation, determine how their children react to the dishes eaten by their mother (with constipation, diarrhea, colic or allergies) and whether they react at all.
Lactase deficiency and bovine protein allergy. In both cases, the child has milk intolerance (lack of a digesting enzyme or an immune response to milk proteins), as a result, stool retention is formed, which is treated with medication or by transferring to special mixtures.
. One of the first recommendations for treating constipation is to increase fluid intake, which is necessary for the formation of the "correct" soft consistency of stool. If the baby is exclusively breastfed, this cause of difficult bowel movements can be ruled out. Feeding on demand provides the baby's body not only with all the necessary substances, but also with a sufficient amount of liquid. With the introduction of complementary foods, the situation changes: the baby receives less breast milk and more solid food, so it is necessary to supplement it. Newborns who receive supplementary feeding with mixtures or are completely artificially fed are given water from birth according to the recommended norms, otherwise disturbances in the child's digestion occur.
unpreparedness gastrointestinal tract to receive food. Many parents strive to start feeding the child with "adult" food as early as possible, already at 2.5 - 3 months giving him juices and "mashed potatoes". While the baby's body is not adapted to the digestion of such products. The baby's enzyme system is aimed exclusively at processing breast milk, so it simply cannot cope with early feeding. The introduction of foreign products to children who are breastfed before 6 months, and on artificial and mixed - before the onset of 4 - 5 months of age - one of the most common causes of constipation in children under one year old.
Incorrect transfer to artificial feeding. The abrupt weaning of the child from the breast and the introduction of the mixture can naturally result in intestinal problems for the baby. The mixture must be introduced into the baby's diet gradually, replacing breastfeeding in turn, otherwise the unprepared body of the newborn will react with constipation. Another cause of constipation is an incorrectly selected mixture or a sharp change from one mixture to another.
Dietary fiber deficiency in the baby's diet. If the baby has already begun to eat something other than milk, his menu should contain a sufficient amount of fiber from fruits and vegetables. If the baby refuses such food, but prefers rice and semolina, constipation will not be avoided. Moms should remember that dietary fiber is involved in the formation of fecal masses, and they do it the way it should, only in the presence of a normal amount of water.
Antibiotic treatment. All modern parents know that antibacterial drugs kill not only pathogens, but also beneficial intestinal flora. In children under one year old, intestinal dysbiosis develops especially rapidly against the background of antibiotic therapy, since its microflora is already weak and unstable. In no case should you give the baby pills on your own, and if you cannot do without them in case of a serious illness, at the same time you need to take care of the entry of lactic acid bacteria into the intestines, otherwise problems with the tummy will then have to be treated for a long time and hard.
stress constipation. If the baby has received a psychological trauma, for example, for one reason or another, he is forced to be separated from his mother, his body may react with a psychosomatic delay in stool - this is how the experiences of the baby manifest themselves. Constipation in a child can begin at the time of potty training or as a result of painful bowel movements (with anal fissures) - he reflexively restrains the urge to “big”.
"hungry" constipation- a rather rare phenomenon that occurs when the baby simply has nothing to poop. If the child is exclusively breastfed, and at the same time the food he receives is not enough, mother's milk is almost completely absorbed and not excreted. This condition is accompanied by other symptoms: the baby's anxiety about lack of nutrition, poor sleep, weight loss, and rare urination.

What to do? How to help a baby with constipation?

When the stool is delayed, the baby feels bad, sleeps little, eats poorly and causes a lot of anxiety to his parents. Therefore, the first thing they should do is to give him "first aid", that is, to help the child "pump".

Belly massage

Do not immediately give laxatives or use an enema. First you need to determine the nature of constipation. To do this, you need to observe the process of defecation:

In the first case, parents should try to increase the tone of the baby's intestines. For this, an energetic massage of the abdomen, bringing the legs with intense flexion-extensor movements, is suitable. Such exercises activate intestinal motility and help it get rid of the accumulated. Before meals and during the day, be sure to lay the baby on the stomach.

Elimination of spastic constipation is to relieve intestinal spasm. Relaxation is facilitated by stroking the abdomen clockwise with light pressure, the use of heat (an ironed diaper, the warmth of the mother's body, a bath).

Stimulation of the intestines for a baby with constipation

If these measures did not help, you can pay attention to medicinal and folk remedies. Before giving a child a laxative, many parents try to stimulate the stool externally. This is done by irritating the anus or cleansing procedures.

It is worth noting that the frequent use of such methods is undesirable, since there is a risk of injuring the skin and intestinal mucosa, that is, all manipulations must be done very carefully, without pressure, with light movements.

Irritation can be done with a cotton swab. To do this, it is abundantly lubricated with baby cream, not deeply injected into the anus and gently scrolled several times. After a while, the child will poop, for a faster process, it is better to lay him on his tummy.
For the same purpose, a gas outlet tube is used. It is carefully, with twisting movements, injected into the rectum, after which the intestines are freed from accumulated gases and feces.
A popular remedy that is sold in a pharmacy is glycerin suppositories for constipation. For a baby, a third of the suppository is enough: the candle is cut and inserted into the baby's ass.
Our grandmothers solved the problem of constipation with a bar of soap: they made a homemade rectal candle from it. But soap contains alkalis that can cause a chemical burn to the baby. If we already use this method, then the soap should not be taken in any case, not household, but the safest - for children.
The last resort is . For the baby, the smallest syringe and 20-30 ml of cool water are taken (chamomile decoction is possible) - the liquid should not be warm, otherwise it will be absorbed into the intestinal walls and will not give the desired effect. A pear lubricated with cream or oil is inserted into the anus no deeper than 1 cm, and water is slowly injected.
A more "civilized" version of the enema is a drug that is a microclyster with a water-salt solution and glycerin, which has a laxative effect 5-15 minutes after administration.

Laxatives

Reception of laxative medicines inside at newborns has to be carried out as a last resort if nothing helps. Most laxatives for babies under one year old are contraindicated. Approved for use from the first days Duphalac syrup and its analogues based on lactulose.

About 5 ml of the drug is given to the baby to induce defecation. It is also recommended for a nursing mother to take this remedy, it is harmless and can be used for a long time. From six months it is allowed to give another laxative, Forlax which can be used continuously for up to 3 months.

Treatment and prevention of constipation in infants

It is important to understand that all of the above remedies do not cure constipation in newborns, but only cause bowel movements and provide temporary relief. Prolonged use of enemas and laxatives is only to the detriment of the child, as they disrupt the bowel reflex and lead to addiction. They can be used occasionally, when constipation in crumbs is a single occurrence. To save the baby from constipation, you need to identify their cause and eliminate it.

If the child has begun to delay bowel movements, which are persistent, the first thing to do is to rule out serious bowel disease. The doctor will prescribe an ultrasound and a series of tests, and if a congenital pathology is diagnosed, in mild cases they try to cure it conservatively, but more often you can get rid of it only through surgery.

In some cases, the child is shown to a neurologist, it is caused by neurological disorders. You will also need to consult a gastroenterologist (to identify diseases of the digestive tract) and an endocrinologist (with diabetes, hypothyroidism, constipation is possible). You need to visit an immunologist if you have a food allergy.

In case of violations of the emptying of a functional nature, a number of measures must be taken:

Establish a diet for a nursing mother and baby, excluding fixing products from it and including stimulating intestinal activity. Mom is recommended to eat more vegetables and fruits, wholemeal and bran bread products and other fiber-containing foods, drink at least 2.5 liters of liquid, eat several prunes, dried apricots, and figs every day. Feed the crumbs with vegetable purees, with a tendency to constipation, an apple, peach, pumpkin, apricot and juices from them are useful.
Restore intestinal flora: preparations with bifidobacteria and lactobacilli should be given to the baby and taken by the mother herself. Include natural yoghurts and fresh dairy products in your diet.
Observe the drinking regime. Instead of tea and juice, it is better to give the child bottled baby water (do not boil), and the nursing mother should also drink enough liquid so that the milk is not very fatty.
Regularly make baby gymnastics and tummy massage.

These activities should start the proper functioning of the intestines and save the baby from painful constipation.

A few more tips for parents to prevent stomach problems in babies:

try to breastfeed your baby for as long as possible;
the first six months the child should receive exclusively breast milk;
if breastfeeding is not possible, carefully choose the formula that suits your baby, if possible, fermented milk;
do not rush to introduce complementary foods: the child can try the first meal for about 5 months (plus or minus 1 month, depending on the type of feeding);
when introducing complementary foods, follow the recommendations on the regimen and amount of food for the child in accordance with age;
during the day, let the baby drink some water, infusion of raisins, dried fruit compote;
with a tendency to constipation, feed a child daily from 6 months with a couple of spoons of mashed prunes, do not give rice and semolina porridge;
organize an active motor mode for the child, do exercises, play outdoor games, put it on the tummy before eating;
avoid overheating of the baby: in hot weather, dress lightly, increase the amount of water you drink to avoid dehydration and constipation;
when treating with antibiotics, ask your doctor to prescribe probiotics to prevent dysbacteriosis;
watch the drugs you take during lactation: antispasmodics, antidepressants, muscle relaxants, vitamins with iron and other drugs can cause constipation in a nursing woman and child, as they penetrate into breast milk.

What is constipation? The position of official Russian medicine today is as follows. Constipation in children is considered to be independent bowel movements less than 1 time in 1.5 - 2 days. Constipation in infants is a fairly common problem. Read below to find out how to solve it.

Together with the stool, substances unnecessary to the body are excreted from the child's body. Consequently, when stool is delayed, they accumulate in the intestines, undergo decay and fermentation, substances that are harmful and toxic to the child are formed, which irritate the intestines and are absorbed into the blood.

As a result, the child may experience bloating and intestinal colic, malaise, weakness, lethargy, anxiety and whims, fever (usually insignificant 37.1 - 37.2ºС.

Conclusion- constipation is bad. If the child does not have a chair for 1.5 days or more, you need to help him.

Constipation in infants before the introduction of complementary foods

Why constipation in infants occurs less frequently than in artificial babies

Colostrum

Children who are breastfed from the first hours, and with the right approach, from the first minutes of life, receive colostrum. In addition to numerous other useful qualities, colostrum has a laxative effect due to its higher content of oligosaccharides, magnesium and potassium ions than in mature milk. This allows the child to quickly clear the intestines from the original feces (meconium), and with it, various metabolic products, hormones, and medicines that the child does not need, which came to him from his mother during or immediately after childbirth, are removed from the body. Therefore, despite the small amount of food eaten, a newborn child has frequent stools (from 1 time per day, up to a number equal to the number of feedings).

mature milk

At 2-3 weeks after birth, colostrum gradually turns into mature milk. Mature human milk also has a slight laxative effect, mainly due to dietary fiber - oligosaccharides. Human milk contains approximately 10 g/l of oligosaccharides, which are represented by more than 100 different compounds. Oligosaccharides are carbohydrates that can reach the large intestine unchanged, where they are digested under the influence of intestinal microflora; killing harmful bacteria. Oligosaccharides are able to attract water into the intestinal lumen, they form fecal masses, making them softer. In addition, in the process of their digestion, various gases are formed that irritate the intestines and cause increased peristalsis.

Most artificial feeding do not contain oligosaccharides, so constipation occurs more often in artificial feeding than in infants.

Lactose

Mature human milk contains more carbohydrates than colostrum. They are represented by lactose. (Approximately 70-75 g lactose per liter of milk). Most lactose is digested in the small intestine by the enzyme lactase, but some lactose passes unchanged into the large intestine. According to its chemical structure, lactose belongs to oligosaccharides, therefore, when it enters the large intestine, it exhibits all their properties, i.e. has a laxative effect.

How much lactose enters the large intestine, and therefore how strong its laxative effect will be, depends on the activity of the lactase enzyme and on the speed of passage of milk through the intestines.

If there is little lactase, lactose in large quantities appears in the large intestine, as a result, the child has frequent, loose, foamy stools, intestinal colic, and other unpleasant manifestations of lactase deficiency.

The duration of milk in the small intestine also matters, the longer the milk is there, the more lactose has time to be digested. The fat content of milk has a great influence on this. The fatter the milk, the longer it lingers in the small intestine, and the slower it is evacuated to the large intestine.

As you know, women's milk has a different composition at the beginning and at the end of feeding. The content of lactose and protein in all portions of milk is approximately the same, and the fat content in the first portions of milk is much less than in the milk that the child receives at the end of feeding. Therefore, if the child is at the breast for a short time, receives only the first portions of milk, with low fat content, the milk enters the large intestine very quickly and lactose, not having time to digest, has its laxative effect. And if the child sucks for a long time and sucks out the hind, fatty milk, lactose has time to be digested and there may not be a laxative effect.

Constipation in infants Causes

1. The most common reason

Most often, constipation in a newborn or, more correctly, stool retention occurs due to imperfect intestinal motility. The contents of the intestines are quite liquid, and the child cannot empty himself on his own: peristaltic waves can be directed in different directions - everything is seething in the stomach, the child is crying, straining, but there is no stool. This is called functional constipation.

In this case, you need

gently massage the tummy in a clockwise direction,
often lay the child on his stomach, so his abdominals are strengthened, pain in the abdomen is relieved,
encourage the child's physical activity, move his legs and arms,
if there is no stool for more than 1.5 days, try to cause a bowel movement in the child, irritating the anus area with the help of a gas outlet tube, a cotton flagellum, a cotton swab.

2. Constipation in infants The child is starving

The child is malnourished, in this case, in addition to the lack of stool, the baby gains weight poorly.

Most often, this may be due to the fact that the mother does not have enough milk. It is necessary to establish lactation or consider the introduction of supplementary feeding.

A similar situation can arise when a child's appetite decreases as a result of his various diseases, both infectious and non-infectious. In this case, you need to treat the child from the underlying disease.

3. Constipation in infants The child receives little liquid

It is hot at home and outside, you wrap him up too much, the baby loses a lot of fluid with sweat, the child has a fever.

The baby needs to be supplemented with water or more frequent breastfeeding.

4. Constipation in babies due to mom's diet

Some foods can affect the composition of milk and have a fixing effect on both mother and child:

If a mother consumes a lot of fatty foods, especially with a predominance of animal fats (butter, lard, sour cream, fatty cottage cheese), the fat content of milk increases, which can lead to constipation. Therefore, you should not intentionally try to increase the fat content of milk. However, specifically dieting to reduce its fat content is even more harmful to the child.
A fixing effect is possessed by: rice, pear, pomegranate, strong tea, coffee, cocoa, chocolate, flour.
When a mother abruptly switches from a diet rich in fruits and vegetables to refined, low-fiber foods, both mother and child may become constipated.

If the child has constipation, the mother needs to analyze her diet and change it: try to make the diet dominated by vegetable fats, fresh vegetables and fruits and dried fruits (especially beets, plums and prunes), cereals from unrefined cereals (buckwheat, oatmeal, corn), dairy products. The diet should be changed slowly and gradually. Introduce new products one at a time, starting with small amounts and carefully monitor the child's reaction. With a sharp change in the mother's diet, the child may experience indigestion.

5. Constipation in infants as a side effect of medications taken by mother or child

If a child has been prescribed a medicine (smecta, enzymes, iron preparations, etc.), and after the start of taking it, constipation occurs, this should be discussed with the doctor, it may be necessary to change the dose, the medication regimen, completely stop taking it, or combine taking this drug with another with a laxative effect. Medications taken by the mother can also affect the nature of the child's stool.

Taking antibiotics by a child or mother can also cause constipation due to a violation of the intestinal microflora. Therefore, after antibiotics, probiotics (linex, bifidum or lactobacterin, etc.) are usually prescribed to restore it.

6. Various congenital diseases as the cause of constipation

In this case, constipation occurs immediately after birth, prolonged, worse or not at all treatable by conventional means.

Hirschsprung's disease is a congenital malformation of the colon. It is rare (for 15 years in the clinic there was 1 such case). Manifested by prolonged constipation from birth, not amenable to any treatment other than surgery. The operation is reduced to the removal of a non-functioning part of the intestine.
Congenital hypothyroidism is a lack of thyroid hormones. True congenital hypothyroidism is rare, but temporary, passing during the first year of life quite often (especially in premature and immature children). One of the manifestations of the disease is constipation, in addition, the child may be lethargic, gain weight poorly, lag behind in neuropsychic development, etc. A pediatric endocrinologist is involved in the treatment of hypothyroidism. The appointment of thyroid hormones leads to a cure for constipation. Hormones are prescribed for a long time, most often they are gradually canceled, but some children take thyroid hormones for life.
Cystic fibrosis is a genetic disease in which the function of the external secretion glands, including the pancreas, is impaired in a child. As a result, the feces become very dense and move poorly through the intestines. The child has severe constipation, up to complete intestinal obstruction. Symptoms of the disease are corrected by lifelong intake of enzyme preparations in large doses.
Dolichosigma is a congenital anomaly (lengthening) of the sigmoid colon. The most common symptom is constipation, dolichosigma may be asymptomatic or manifest as increased gas formation, abdominal pain. Diagnosis and treatment are carried out by a gastroenterologist and a pediatric surgeon. Most often, treatment is reduced to the selection of a diet, massage and therapeutic exercises, laxatives are used less frequently, surgical treatment is carried out only as a last resort, if all other methods fail.

7. Hereditary features

There are people (including children) in whom the passage of the food bolus from the mouth to the anus takes more than 48 hours, but this cannot be explained by any of the above reasons. But you can trace this feature in several generations in the family. This may be due to the high activity of digestive enzymes, less active intestinal motility and many other hereditary features. In such people (including children), independent bowel movements can occur 1 time in 3 days or even less often. Some people find this uncomfortable, while others don't feel any discomfort about it. But still, this cannot be considered the norm for everyone.

What is considered normal for babies

Regarding babies abroad, there is such a point of view

A breastfed child has the right to any smell, color, frequency and consistency of bowel movements, if this does not affect his growth and development.

Those. if a child who is exclusively breastfed has no stool for a week, without any other alarming symptoms, this is not a cause for concern, but a variant of the norm. This means that mother's milk is very well absorbed, so good that there is nothing to remove from the child's body.

But this statement has weaknesses.

Why is this considered the norm only for babies?
Why can't the mixture be digested very well too? Artificers, as you know, suffer from constipation more often, but for them, stool retention for more than 3 days, according to the same foreign experts, is not considered the norm, in such cases an individual selection of a mixture or laxatives is carried out.
If you constantly eat refined, poor in fiber, and, therefore, very well digested food, adults also get constipated, and everyone recognizes that in this case the diet needs to be corrected, foods rich in dietary fiber.

Therefore, I, together with official domestic medicine, do not support the position of foreign experts and still believe that an independent chair in a child, both on breastfeeding and on artificial feeding, should not be less than 1 time in 1.5 - 2 days.

Constipation in infants What to do?

If a child has stool retention for more than 1.5 days,

Help the child using the methods outlined in paragraph 1.
If the result is not achieved, use the drug "Mikrolaks" or "glycerin suppository" or make it to the child. Microlax attracts water to the intestines and softens the stool. Glycerin suppositories irritate the rectum, stimulating bowel movements.

Enemas and suppositories are emergency options for stool retention. They are needed for sudden constipation in order to achieve results immediately, but once. It is not recommended to repeat them often. You need to achieve regular stools in a child in another way.

If a child has recurring constipation since birth, a doctor should be consulted to rule out serious congenital diseases that may be causing them (see point 6).

After that, together with Dr.

Analyze whether the child eats enough, whether he has a good appetite, how he gains weight (see point 2).
If the mother or child is taking medication, study and try to reduce their side effects (point 5).
Exclude the option with a lack of fluid in the child's body (point 3). A healthy newborn child after the establishment of lactation by the mother (and for some medical reasons even earlier) can be given 100-150 ml, for supplementation, you can use baby teas with a slight laxative effect, containing chamomile flowers, fennel seeds, dill.
Adjust mom's diet (see point 4). For artificial people, instead, you can choose the right mixture.

Laxatives

If all of the above did not lead to the establishment of a regular chair in a child, it is required to choose a laxative for the child. The only laxative that is allowed to be used in children under 1 year old is lactulose (or duphalac).

Lactulose is an oligosaccharide that is obtained artificially from lactose. Such a substance does not exist in nature. A person does not have an enzyme capable of digesting it, so it enters the large intestine unchanged, where it exhibits all the beneficial properties of oligosaccharides. Lactulose does not have a systemic effect on the body, tk. under the influence of intestinal microflora, it decomposes into galactose and fructose. Therefore, long-term use of lactulose is possible. But with an excess of lactulose, the child has diarrhea and increased gas formation in the intestines, so the dose of the drug is selected for each child individually: treatment begins with small doses with a gradual increase until the desired result is achieved.

After most often, the stool in children is getting better and the need to take lactulose disappears.

It's all about constipation in infants. Stay healthy.

In children on GV, stools may be absent for up to 7 days. An enema is the last thing, the tummy tests itself at first, it can poop 10 times a day, then once every 3-4 days, it chooses an acceptable option for itself. It's dangerous if you don't fart and your stomach is hard.

Constipation in a breastfed baby is a hard dry shaped stool, the so-called "goat balls", which are very painful for the baby.
The consistency of NORMAL feces, even with its relatively rare appearance, cannot be considered constipation. These are just the physiological features of this particular organism, like eye color, snub nose angle or nail shape. We will not treat the body for the fact that the snub nose does not coincide with the “average angle”.

Why does such a physiologically rare stool (“not constipation”) appear in the baby?

For the urge to defecate, the little man needs to experience a chain of certain sensations. The most important of which is the pressure of feces on the intestines, it is the degree of pressure that forms the skill to relax the sphincters in response to tension, and not to reduce them. The young, fully unformed intestine is still learning to respond to any external changes, gently and not stressfully at this stage of its formation, breast milk helps it - the only native and adapted product. Like any student, the intestines undergo a series of tests or even self-tests. Therefore, the feces of the baby of the first half of the year are heterogeneous - sometimes thick, sometimes liquid, sometimes often .., sometimes rarely. And our adult standards for such a young student are unacceptable, the adult intestine is very different from the intestine of the baby.
The main indicator with such a rare stool is the well-being of the child and the passage of gases from him, the most dangerous sign for constipation is the absence of gases, then you can fear for intestinal patency, but if the baby “farts like a machine gun” - then the patency is excellent. If the consistency of feces after defecation is normal, without “balls”, then the child has no problem.
The intestines are simply in a state of testing the degree of pressure of the feces inside on the walls of the intestines for optimal defecation, after the completion of such a test, the body will choose a certain period for defecation. This deadline will be set until ... the next test, after which everything will change dramatically again.
That is, the main thing is to objectively assess the condition of the child, look at the discharge of gases, and not at the calendar.

And yet it is so strange and scary when the chair is not regular and young parents so want to take care of something. What can be done so that the body is “tested” faster, and parents would see the coveted poop and at the same time not harm the child and not resort to medicines.

Usually advised:
1. Give extra fluids.

But the problem is not the consistency of the feces! The feces inside are soft, the additional liquid makes it generally liquid and ... delays the period of natural defecation. As a result, additional mechanical stimulation is required (with a cotton swab in oil, a thermometer), but more often it turns out that due to the additional liquid and the extended period, the “front” part of the feces formed into a dense hard "cork", and "above" a very liquid watery stool. Throwing out a "cork" is very painful and unpleasant for the baby.
That is, in the case of a rare physiological stool, supplementing with any liquid can worsen the situation.

2. More "experienced" may advise giving a drop of juice to a child.
It should be noted here that the juice is a very large irritant with a high acidity factor. The complete absence of fiber, but a deadly carbohydrate environment, due to sugars. The child's intestines simply cannot digest this yet, for the digestion of juice, additional enzymes are needed that the pancreas of a child does not produce in infancy. And it turns out that an irritating product lies in the intestines - sugar from juice. Up to a certain age, the mucosa of the baby is very perceptive and sensitive, molecules penetrate into the blood through its walls, and sugars begin to strongly irritate the mucosa, the body receives a signal to get rid of the aggressors as quickly as possible, the pancreas tries to form enzymes to break down juice carbohydrates. The intestine collects additional fluid to partially neutralize aggressive sugars and begins to contract, removing the irritant. Outwardly - quite quickly after the infusion of juice, the child may have a chair. But at the cost of a huge stress on the pancreas, mucous membranes and the body as a whole. At the same time, the necessary minerals and vitamins are washed out of the body, the child loses a lot of fluid. The carbohydrate component creates in the intestines an ideal environment for the reproduction of pathogenic and opportunistic flora (Candida, Staphylococcus aureus), therefore, after co-infusion, thrush in the child's mouth is so frequent.
Juice is one of the most cruel methods of influencing the baby's body.

3 Make an enema.
The liquid will create additional pressure, the very one that the intestines were waiting for and before the physiological readiness of the body there will be a chair. The "self-test" of the body is brought down. Defecation was caused by a mechanical stimulator, bowel contraction, but the child himself needs to learn how to relax. I think everyone has heard stories from two or three year olds who have problems with their stools. Often (not always) these are babies who were either bottle-fed, or the period of “learning” in a safe stool from breast milk passed against the background of defecation stimulation.

So what do you do? Nothing. Wait. If the child behaves as usual and farts well, then this is another “test”.
But if the child pushes, blushes, the gases do not go away, the stomach is hard, the child cries on palpation - this is a completely different matter. Help is definitely needed here.

The first step is to massage the tummy. Massage clockwise, full palm. Or cycling exercises.

A warm bath - to whom only it does not help to relax. Mom and baby are immersed in warm 37 degrees water, breastfeed right in the water, then quickly get out, mom or dad will rub their arms, legs and tummy with baby oil, then you can put the baby to lie down on mom’s tummy relaxed, it’s worth remembering that it’s easier to poop lying down on the tummy or side than on the back, or the mother can feed in the planting position (so that the ass is sagging and the baby is almost vertical) and in 80% you can expect a “desired poop”.

It is very good to hold a child complaining about the tummy over the sink under the knees, lubricating the anus area with baby oil ... Posture as when planting.

Only when these methods did not help, you can use the first step of mechanical stimulation. Take a hygienic stick, a thermometer, generously lubricate the tip with petroleum jelly or baby oil and insert a little into the ass. Not more than a centimeter! It is to enter and twist a little. Put away. Put on a diaper and put mom on her stomach, tummy to tummy ... Or press her knees to her stomach in a pose on her back ...

And only if this did not help, then the next step is a glycerin suppository.
But as a rule, everything works out at the first step.

I would like to single out the appointment of any treatment, parents should analyze what they are treating, the child's condition or analysis? Does your doctor prescribe bifidobacteria? Is there a correlation with the start of taking and the onset of stool retention? Have you been warned that bacteriological preparations containing bifidoculures affect the stool and can cause chronic constipation, which will already be constipation, and not physiological reactions?.. Always carefully monitor the child's stool at the time of using any medication.

is a painful condition that is characterized by slow and difficult bowel movements.
The body of a newborn is so different from the body of an adult that sometimes mothers face an insoluble problem: is this or that condition of her baby the norm or is it necessary to sound the alarm.

In the understanding of adult medicine, the diagnosis of constipation can be made when:

no stool for more than a day;

feeling of incomplete bowel movement after a bowel movement;

solid feces;

the application of effort (straining) in the process of bowel release.

Inexperienced parents, applying these criteria to their newborn children, often begin to suspect that they have intestinal disorders in vain. It’s good if after that the mother goes to the pediatrician and asks for his advice. It is much worse when the diagnosis is made independently and treatment begins on the basis of the advice of friends, grandmothers and Internet forums.

In order to figure out what condition a baby actually has constipation, it is necessary to consider the normal functioning of the baby's digestive system.

First days of life. The first stool of a newborn is called meconium. It is the remains of intestinal cells and the products of digestion of amniotic fluid, which the child accidentally swallowed. Normally, meconium begins to depart immediately after the first feeding. The color of the first stool is dark, in some cases almost black, odorless, similar in consistency to toothpaste.

In the first 1-2 days of life, the baby empties the intestines infrequently - 1-3 times a day. After the complete discharge of meconium, the nature of the stool begins to change depending on the type of nutrition that the newborn receives.

When breastfeeding, the stool is watery, reminiscent of mustard or pea soup. Color - yellow, yellow-brown, a greenish tint is acceptable. It has a pronounced smell of sour milk. May contain undigested lumps of curdled milk and a small amount of foam.

In formula-fed babies, stools are darker in color, have a fecal odor and a thick consistency.

first 2 months of life. With breastfeeding, the norm options are quite wide: from bowel movements after each feeding to 2 times a day.

There are more stringent requirements for formula-fed babies. The norm is the daily emptying of the intestine at least 1 time.

From 2 months to 6 months. With the age of the child, the frequency of stools per day decreases: from 5 times a day in 2-month-old babies to 1-2 times a day in six-month-old children. In some babies, mother's milk is so well absorbed that they can empty their intestines once every 2-3 days. This is considered normal if the child is cheerful, eats with appetite, gains weight well, defecates effortlessly, the stool is soft and does not have a putrid odor.

Children over 6 months old. After the introduction of complementary foods, it is considered normal to empty the intestines 1-2 times a day. At the same time, the characteristics of the chair change markedly. With the transition to solid food, fecal masses begin to form. They acquire a dark color, an unpleasant fecal odor and a denser texture.

Thus, summing up all the above written, we can draw the following conclusions.

For breastfed babies:

the number of bowel movements per day in infants before the introduction of complementary foods is strictly individual;

when assessing the condition of the baby, it is necessary to focus not on the number of bowel movements, but on the general condition and monthly weight gain;

For formula-fed babies:

the chair should be at least 1 time per day.

When is a delayed bowel movement considered constipation?

The diagnosis of "constipation" can be suspected in the absence of stool in a newborn, accompanied by the following signs:

anxiety of the child and loss of appetite;

strong straining during attempts to defecate;

reddening of the face, crying, tightening the legs during feeding;

excretion of intestinal gases with a putrid odor, an unpleasant odor of the stool;

poor weight gain.

It does not matter how much time has passed since the last bowel movement.

Constipation in breastfed newborns is associated with:

Bowel disease

These include congenital anomalies of the digestive system: megacolon - Hirschsprung's disease, absence or narrowing of the anus, lengthening of the sigmoid loop.

Diseases of other organs and systems

Insufficient production of thyroid hormones - rickets, damage to the nervous system - all these diseases negatively affect intestinal motility and cause constipation.

Immaturity of the nervous system

Often babies are born with immature nerve endings in the intestinal wall. As a result, it cannot contract properly, moving the food slurry towards the anus. This is a physiological condition that disappears by the 2nd month of life without special treatment.

Mother's diet

Everything that a mother eats affects the quality of breast milk. There are products that cause a fixing effect in a newborn.

Foods that cause constipation in babies:

fatty cheeses;

whole cow's milk;

fatty meats;

White bread;

nuts (peanuts, cashews);

pastry products;

strong tea, coffee;

medicines (no-shpa, remedies for and treatment, diuretics, iron preparations).

Increased gas production

Various processes occurring in the intestines of a newborn can lead to increased gas formation during the digestion of food. Gas bubbles, accumulating in the intestinal lumen, prevent the normal movement of intestinal contents.

This may be caused by:

mother's use of foods that cause increased gas formation (radishes, cucumbers, spicy spices, chocolate, carbonated drinks, cakes, fresh onions and black bread, cabbage, grapes, legumes, bananas);

violation of the intestinal microflora.

Causes of constipation in formula-fed babies

The following factors can be added to the above:

Inappropriate milk formula

The most common cause of constipation in formula-fed babies is improperly selected milk formula. Breast milk is best for the baby, but if breastfeeding is not possible, an age-appropriate formula should be chosen as a substitute.

Abrupt transfer to another mixture

Lack of water

If, during breastfeeding, supplementation of newborns is not recommended up to 6 months and is used only in extreme cases (, heat), then when feeding with milk formula, the additional introduction of clean drinking water is mandatory.

What to do with constipation in a newborn?

If a mother is sure that her baby has constipation, then the first thing she should do is go to the pediatrician. The causes of the development of difficulty in emptying the intestines can be serious diseases, which can only be identified by a specialist. The doctor may prescribe a blood test for hormones and vitamin content, recommend an ultrasound of the internal organs, x-rays, or donate feces for dysbacteriosis. Then, depending on the results, prescribe professional treatment.

If during the examination no deviations from the norm were found, then it is highly likely that constipation is associated either with the immaturity of the baby's nervous system, or with the quality of breast milk or formula.

All methods of helping with constipation can be divided into the following groups:

changing the mother's diet or changing formula;

medicines (duphalac, espumizan, plantex);

mechanical methods (gas tube, irritation of the anus, glycerin suppositories).

When treating constipation, it is better to start using these methods in order from first to last, but not vice versa.
Massage for constipation in newborns

Since the nervous apparatus of the intestine and the synthesis of digestive enzymes in the newborn is still underdeveloped, the best way to stimulate motor skills and improve the waste of accumulated gases is massage techniques. They are safe and easy to perform.

Reception 1. The baby lies on the back. Stroking movements are made around the navel in a clockwise direction. Make 5-10 circular movements.

Reception 2. The child lies on the back. Alternate flexion-extension of the legs in the knee joints, while the front surface of the thigh is pressed against the tummy. The legs are best held by the ankle joints. Do 5 repetitions.

Reception 3. The baby lies on the back. Pulling the legs bent at the knee joints to the tummy and alternately straightening them. Do 5 repetitions.

Reception 4. Laying the child on the tummy before each feeding for 2-15 minutes, depending on age and physical condition.

Reception 5. Put the baby on the tummy on the bed or knees of the parent. Make circular stroking movements with the palm of your hand from the area between the shoulder blades smoothly down to the sacrum. Repeat 5 times.
Maternal diet and formula selection

For breastfed babies, the problem of constipation can be solved by changing the mother's diet. It is necessary to exclude products that have a fixing effect, which are described above, and add products that give mother's milk laxative properties to the daily menu.

Foods that improve the digestion of a newborn:

fresh vegetable salads containing In cases where massage and diet do not have a sufficient effect on bowel function, medicines come to the rescue. Before using any of them, be sure to consult your doctor.

These include:

Espumizan (other brand names are Bobotik, Sub-Simplex);

Plantex.

Candles Glitselaks (prescribed for lactose deficiency)

If the methods listed above do not show their effectiveness, then you can try mechanical methods of stimulating bowel movements.

One such remedy is glycerin suppositories. Their effect is based on irritation of the rectal mucosa, which causes an increase in its motility. In addition, melting under the influence of body temperature, they play the role of a lubricant, facilitating the discharge of feces.

An enema is an extreme way to deal with constipation. Their frequent use can lead to the development of intestinal dysbacteriosis, lack of vitamins and minerals. For babies, the smallest syringe No. 1 with a soft tip is used. Boiled water at a temperature of about 30 degrees or a mixture of water and a few drops of oil is most often used as an enema solution.
Soap for constipation in newborns is an unacceptable method!

Very often, mothers follow the lead of grandmothers or neighbors, trying to use a piece of laundry soap to combat constipation in their baby. This is an unacceptable method of stimulating the intestines! Substances in the soap cause severe irritation of the rectal mucosa, which can lead to the formation of ulcers, bleeding and chronic inflammation.

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. He also received a certificate of a specialist in 2014.

The first year of a child's life is perhaps the most difficult for both him and his parents. The slightest deviations in the state of health of the baby cause great anxiety and even panic among newly-made mothers and fathers due to the lack of the necessary knowledge and experience. One of the problems they may face during this time period is constipation in the baby. Difficult defecation in newborns and babies up to one year old in most cases is associated with the peculiarities of their nutrition and the immaturity of the digestive tract.

However, there may be more serious problems, which include congenital anomalies in the development of the intestines, disorders of the nervous system and other diseases. At the same time, an important point is that the absence of stool in an infant for several days does not always indicate constipation and may be quite normal.

The norm of the number of bowel movements for infants

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

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

In the subsequent time, the baby's stool changes depending on the type of feeding chosen (breastfeeding, mixed or artificial) and remains until the introduction of complementary foods.
With exclusive breastfeeding, the 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 individually for each child (from 8 times a day to 1 time in 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 older, 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 texture, an unpleasant odor and a dark, closer to brown, color. In this case, bowel movements should occur at least once a day, otherwise it is considered that there is constipation in the baby.

Feces from constipated infants pass in the form of separate hard lumps (type 1) or in the form of a dense, lumpy sausage (type 2)

During the period of introduction of complementary foods, the feces of the baby gradually change and begin to resemble the feces of an adult. They become formed, acquire a brown color, a dense texture and a characteristic smell.

What are the symptoms of constipation in infants?

Lifestyle, nutrition and the whole body of children under one year old, and even more so of a newborn, have significant differences compared to adults. In this regard, the assessment of any violations in the state of their health, including the work of the gastrointestinal tract, is carried out taking into account age and physiological characteristics. For example, if after an act of 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 mother's milk as food, the absence of bowel movements for 3 or even 5 days may be a variant of the norm.

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

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

the allocation of small portions of feces of a very hard consistency;
anxiety, moodiness, frequent crying;
loss of appetite;
slow weight gain;
reddening of the face and tightening of the legs when feeding;
great tension, crying and restlessness when trying to empty the bowels.

Important: If a breastfed baby has rare bowel movements that are not accompanied by a change 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

The occurrence of difficulties during bowel movements 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 defecation are due to some kind of nutritional problem that leads to disruption of the intestines. The causes of chronic constipation in infants can be serious pathologies of the nervous system, congenital malformations of the colon and other factors. Also, irregular stools in children under one year of age may be associated with the physiological characteristics of the structure of the digestive tract at this age.

Causes of constipation in children under one year of age related to nutrition

The most common causes of constipation in infants are eating disorders. At the same time, stool retention is temporary, and after the problem is eliminated, normal bowel function is restored by itself.
These reasons include:

changing habitual nutrition (switching from breast milk to formula or replacing formula milk);
unsuitable formula for formula-fed babies;
malnutrition of a nursing mother, containing a lot of foods that help fix the stool or cause increased gas formation (rice, white bread and muffins, black tea, carbonated drinks, fatty meat, whole milk, cabbage, legumes, etc.);
too early introduction of complementary foods, 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 diet of the baby during the period of introduction of complementary foods that cause constipation in infants.

Important: Usually, as a result of the introduction of complementary foods in most babies, the stool normalizes and becomes regular. This is due primarily to the beginning of the intake of fruits and vegetables rich in plant fiber into the baby's body.

Constipation in newborns during breastfeeding is observed quite rarely, since the mother's breast milk is optimal in composition for the normal functioning of the child's gastrointestinal tract

Diseases that cause constipation in children under one year old

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

congenital anomalies in the development of the intestine;
a disorder of the nervous system caused by the severe course of pregnancy or the birth process;
lactase deficiency;
hypothyroidism;
rickets;
hyperparathyroidism;
diabetes mellitus, etc.

The frequency of congenital malformations of the intestine, resulting in constipation in newborns, is about 5%. At the same time, chronic delays in defecation develop gradually and progress as the child grows.

Intestinal malformations include:

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

Important: If a child has congenital anomalies in the development of the intestine 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 preparations, etc.);
high temperature (for example, with infectious diseases);
teething period;
insufficient motor activity;
allergic reactions;
deliberate delay in defecation due to psychological reasons.

Recommendation: In case of prolonged absence of stool in infants, the child should be shown to the pediatrician. Only he will be able to determine the cause of such changes in the functioning of the intestine and determine whether such a condition is a variant of the norm or a pathology.