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CONSTIPATION
Constipation is a common problem for children of all ages. The problem is
treated differently depending on your child’s age. To better understand the
treatment, let’s look at the definition of constipation as well as its causes.
Constipation is the passage of hard, dry stool which can be painful during
passage. The absence of daily bowel movements does not constitute constipation.
The number of bowel movements that your baby normally has is the baseline,
whether it is once every other day to several times a day. There is no normal
number of bowel movements for your baby – only what is normal for him. More
important is a change in the frequency pattern of an individual.
Rarely do breast fed babies have problems with constipation. Something in the
formula may be constipating for your infant. Constipation is often first seen
with the introduction of solid foods. Rice cereal is low in fiber. Diets low in
fiber and children that are not getting enough fluids are prone to constipation.
Also, any decrease in the frequency of using the toilet may cause constipation.
If a child has a hard and large stool and it is painful to pass he may associate
bowel movements with pain and withhold his stool. Bad toilet training
experiences may also inhibit the frequent use of the toilet and thus make
constipation more likely. Both these things can increase the time the stool is
in the large intestines. If the stool is in the large intestines for a longer
amount of time, more water is removed from the stool and absorbed back into the
body, making the stool harder.
The type of treatment for constipation depends on your child’s age. Don’t start
any new foods that your baby is not already on. For the infant, giving extra
water or fruit (apple, pear and prune) juices will help. You could also add Karo
syrup to your infant’s bottle. Switch from rice cereal to barley or oat cereal,
or add pureed fruits and vegetables. Increase the amount of fiber by adding a
teaspoon of bran to the cereal. Cut down on constipating foods like cow’s milk,
rice, banana, yogurt, cheese and cooked carrots. Add foods such as pureed
prunes, apricots or pears, when your baby is ready for these foods. Vegetables
high in fiber include beans, sweet potato, peas, turnip greens and raw tomatoes.
Vegetable soups, bran cereal, bran muffins, shredded wheat, graham crackers, and
whole wheat brad are other foods with high bran content.
For the older child, there are medications that will help until the dietary
changes start to take effect. Bulking agents, increasing the size and water
content of stools, include Metamucil, Fiberall and Citrucel. Magnesium hydroxide
(milk of magnesia) is an osmotic laxative. Because of its chalky taste it is not
tolerated by all children. Stool softeners/lubricants, which soften the feces
for easier passage, include Colace and Surfax. Malt Soup Extract (i.e.
Maltsupex), an extract of malt from barley grains,
is a plant-derived bulk-forming fiber laxatives. It has an unpleasant odor but
can be mixed with formula for infants. Mineral oil, a lubricant, can be mixed
with orange juice but can cause leakage and staining of underwear. Extract of
senna (Senokot) and Bisacodyl (Ducolax) are stimulant laxatives. It stimulates
peristaltic muscle contraction of the intestines to help move the stool along.
In severe constipation, you may need to stimulate a bowel movement from below.
Glycerin suppositories stimulate from below, help the baby pass a stool. This
help should only be for a short amount of time.
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