What is infant constipation?

Constipation is a situation where the stool is firm, dry and pebbly. This can last for an undetermined amount of time but is usually not serious if treated properly.

Signs?

• Infrequent, irregular bowel movements or very large stools with hard consistency.

• Long gap or interval with no bowel movement

• Blood in or on stools

• Pain and discomfort when passing motion

• Reduced appetite

• Crying while passing motion

Causes?

• Inadequate fluid

• Formula type

• New foods

• Low fiber

• Lack of activity

• Food intolerance

• Medications

Milk facts?

It is considered normal for bowel movement in infants (0-6 months old) to be several times a day or as little as once a week. In rare cases, there can be up to three weeks between bowel movements. Breastfed babies usually have frequent bowel movements because breast milk is more easily digested. Their stools are softer and typically yellow. Excretion is further aided by the presence of hormones that increases the movement of the bowels. Conversely, bottle-fed babies frequently suffer from constipation because formula milk is harder for a baby to digest. A baby who receives only formula milk will typically have fewer bowel movements than a breastfed child. Their stools will be thicker and have a different, more greenish color.

Solids?

The stools of babies four months up will depend on the food they eat. Your baby's stools will begin to look a bit more like ordinary stools in consistency and smell. Once your baby starts eating solid food, the pattern in bowel movements will change. Your infant will have movements several times a day or as infrequently as once every two to three days. Constipation is more rife. This is because the intestines have to get used to the new composition of the nutrients. Constipation may be caused by dehydration. Introduce more water, bran-rich foods and increase your child’s activity. Also pay attention to any new foods introduced.

A vicious circle

Constipation can set off a vicious cycle. This is because passing the large hard stools that have gathered in the intestine becomes a painful experience. Cracks around the anus may appear; these may start to bleed and cause more pain. To avoid the pain, your baby may subconsciously start holding back stools, which makes the food stay longer in the large intestine. This in turn causes water from the stools to be absorbed making stools even harder. Your baby continues to remain constipated. In some cases, the child may not want to eat and may even retch a little.

Treatment?

• Tummy massage

Start at the belly button and then massage outwards in circles in a clockwise direction. Some oil or cream on your fingers can also help. Only continue if your baby enjoys the massage and is comfortable and relaxed.

• Cycling

Place your baby his back. Hold legs and turn them gently in a quick cycling motion. This will make the stomach muscles move and, in turn, put gentle pressure on the intestines to make them move.

• Bath

A warm bath can relax your baby so the stools are passed more easily. Once your baby has relaxed in the bath, you can also massage their stomach (see above). After cleaning your baby's bottom, apply some cream or petroleum jelly (Vaseline) around the outside of the anus

• Avoid

Don't put a thermometer, suppository or enema or anything else inside your baby's anus to stimulate bowel movement, because this may cause damage. Still, check with your doctor for advice.

• Formula

If your baby is on formula milk, you should follow the instructions on the package carefully. Making the mixture too thick by putting in more than the recommended amount of powder can lead to constipation and other medical problems. It's best to stick to the same brand, because different formulas may require different dilutions. Switch to a low-iron or soy formula until constipation clears.

• Fluids

Give your baby plenty of fluids preferably cooled, boiled water.

Prevention?

Once your baby is between four to six months old, you can start introducing more bran-rich cereals and fruit or vegetable purées into their diet. These are rich in fibre and will help prevent constipation. Prune purée is particularly good for this purpose.

Stubborn constipation?

If the above suggestions don't work for your baby, consult a doctor about special laxatives for chronic constipation.