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Constipation

new_baby.jpgOkay, so you may not want to read this article over dinner but many of the families I see are concerned about whether their baby is constipated or not. I hope this article provides some information to help you recognise the symptoms and when you should seek professional advice and also some natural treatments that you as parents can do to help your baby.

If you are concerned your baby or child is constipated do remember that the number of 'poos' a baby or child does is very individual and there is not really a 'normal' number of times a bowel motion occurs. Some babies may pass a stool after each feed or there may be 2-3 days between bowel movements. Individual patterns are affected by how active your baby is, what they are eating and drinking and how quickly their body digests food and passes waste.

Signs and symptoms to look out for with constipation
  • Hard pellet like stools
  • Crying or discomfort before passing poo
  • Trouble emptying bowels: Baby becomes frustrated and show signs of being in pain
  • Fewer than 3 poos a week (although see below for more information on this)
  • Hard stomach
  • Distended stomach
  • Foul smelling stools
  • Loss of appetite
  • Less frequent bowel motions than what you normally expect from your baby
  • Dry stools which are difficult to pass
  • Very loose stools: This can happen as the stools slip past the blockage in the lower intestine
  • Pain or bleeding from fissure (anal tear or cut). Inform GP if you notice this. 
Why are some babies and children more prone to constipation?
  • There are often differences between breast and bottle fed babies
    • Breast fed babies are less likely to be constipated than bottle fed babies as the breast milk has the precise balance of protein and fat in the milk
    • If formula feeds are incorrectly measured out this can mean it is too difficult to digest. It is important to always measure out the powder correctly with the scoop provided with each tin. You also need to level off the powder with the flat edge of a knife before adding to the water.
    • Formula milk can be harder to digest and cause stools to be firm and bulky
  • Milk Intolerance
    • Constipation is often associated with cows milk protein intolerance. 
    • Explosive very loose, watery, mucus, green stools can be associated with lactose intolerance. 
  • Babies who suffer from reflux
    • Babies who have reflux can show distress when passing bowel motions due to the internal pressure which causes the stomach contents to 'reflux' when passing motions. 
    • Reflux babies will often only 'poo' when feeding as the swallowing helps to wash down the acid that 'refluxes' into oesophagus as they strain to pass a motion. 
    • If your baby is on Gaviscon as a side effect is constipation due to the alluminium content in the powder, however generally the magnesium also in the Gaviscon should act as enough of a laxative to keep the motions frequent. Initially when taking Gaviscon you may notice a change in the regularity of motions but after a few days this should normalise. 
My baby is on formula milk but shows signs of constipation, what can I do?
  • Try using a formula milk which contains pre-biotics. These are food substances which help to grow the friendly bacteria in your babies intestine which can help to reduce risk of constipation 
  • Ensure powder measured out correctly (as described above)
  • Talk to your GP about changing to Nutramigen Milk if you feel the constipation is due to the milk. Nutramigen is a hypoallergenic formula which is suitable for babies and children who have an allergy or intolerance to cows milk
What other factors may be contributing to the constipation
  • Dehydration
    • If the body does not have enough fluids (ie. milk) it responds by absorbing fluid from what your baby eats or drinks.
    • Babies under 4 months shouldn't need water. If you feel you would like to introduce speak to your GP or Health Visitor first.
    • Babies 4-6 months can have a few ounces a day but be careful not to fill them up with water causing a reduction in milk feeds
  • Weaning
    • As the body adjusts to solids this can cause a change in bowel movements. Try to avoid rice cereals which are often given as a first weaning food. Use baby porridge instead as the rice based products are very low in fibre. Also keep foods such as bananas and carrots to a minimum in the first few months and if your baby is prone to constipation.
  • Medical Conditions
    • Very occasionally a baby may have a metabolic or congenital condition which is causing or exacerbating the constipation. Your GP would be able to give more information if this was the case. 
How can you help your baby and child if they are constipated?
  • Give your baby a warm bath and then gently massage tummy...
    • Massaging correctly
      Place hand to Right side of baby's belly button (baby's right, your left). Gently sweep hand in crescent motion over belly button to the other side. Sweep hand back under belly button and repeat 5 x
  • Bicycle legs
  • Apply vaseline around anus
  • Give small amounts of apple or prune juice or if weaning a few tablespoons of pureed prunes, apricots or pears.
  • Never give a laxative without the instruction of your GP