Constipation in a newborn baby: causes, treatment

Constipation in a newborn is a violation of a normal stool or a decrease in the number of defecations in a child of the first month of life. This problem refers to the most common reasons for contacting a doctor, which is indicative not only of its wide distribution, but also of the importance of the problem. Symptoms are different in children of different ages, but given the clinical manifestations, it is necessary to properly carry out differential diagnosis.

[1], [2]

Epidemiology

Epidemiology of constipation in newborns speaks of their high frequency in the children of the first three months of life and the connection with physiological causes. More than 40% of mothers turn to the doctor in the first three months of life precisely because of constipation, and more than 65% of such children are on artificial feeding. This proves the advantages of breastfeeding in the development of functional disorders in the baby. Speaking of symptoms, the clinical manifestations of constipation disturb the baby and mom less than colic, but in the case of a combination of constipation with colic - this becomes a serious problem for the baby's life.

[3], [4], [5], [6]

Causes of the constipation in the newborn

The cause of constipation in a child of the first month of life can be many physiological conditions or it can be one of the signs of the disease. Therefore, if there is such a symptom in the baby, you need to understand all the reasons, not excluding organic pathology.

First of all, you need to understand what constitutes constipation, and what frequency of defecation should be in a healthy child, depending on age. In newborn infants who are breastfed, the normal frequency of the stool is 6-7 times a day, and if the child is on artificial feeding, then the frequency is 4-5 times a day. In children older than six months with the beginning of feeding, the stool should be at least 2-3 times, and in children 1-6 years - 1-2 times a day. As for a newborn baby, the consistency of the stool, and not just its frequency, is considered an important criterion. For such a kid, the feces must be mushy, unformed, without hard chests. Therefore, to say that a newborn child can have constipation if the stool was not more than 36 hours or if there is hard feces with straining and anxiety of the child before defecation, even at the normal frequency of the stool itself.

The problem of constipation can already be from the first week of life, then it is more likely that the cause is the physiological immaturity of the digestive system and the functional nature of constipation. Here an important role is played by the child's nutrition. If the child is exclusively artificial feeding, then the cause of constipation may be an unsuitable mixture for the child. Sometimes parents can have a tendency to constipation, because the child is given such a propensity, and if the mixture causes a violation of motility, it can cause persistent constipation. Therefore, you just need to replace the mixture with another series or with a more adapted one. For example, constipation from Nestosis in a newborn is very often, so you just need to change the mixture to a special or another brand. If the baby is breastfed, the digestive process should be normal, since breast milk is the best food. But often the cause of constipation while this may be the wrong organization of nutrition mother. If the mother has a lot of complex foods in the diet, then this can inhibit the bowel motility in the child. Products that cause constipation in a newborn are rice and semolina porridge, grapes, pomegranate, quince, pear, breadcrumbs, white bread and bakery products, cocoa, caviar, mucous soups, kissel, boiled eggs, so they should be excluded from the diet. Necessarily nursing mother in the presence of a child's constipation should introduce into your diet tannins - increase the number of vegetables (beets, tomatoes) and fruits (plum, baked apple), porridges, liquid soups.

Risk factors

The risk factors for developing constipation in newborn babies are increased, if at least one of the parents has a tendency to constipation. Then the child with functional immaturity of the digestive system can have a pronounced constipation even against the background of a simple inclination of the parents. Among other risk factors for developing constipation is a burdened family history of fermentopathy or food intolerance. Children premature or born prematurely have a risk of developing intestinal obstruction and constipation including.

[7], [8], [9]

Pathogenesis

The pathogenesis of the development of constipation symptoms in this case is of a functional nature and is the least serious cause. Among other reasons, one can distinguish organic diseases of the newborn period - this is a group of food intolerance and organic pathology.

Among the intolerance products of pathology, which today can cause constipation, is lactose intolerance, celiac disease, intolerance to cereals. Such pathologies often have alternating diarrhea with constipation, but sometimes they can only be constipated.

Do not forget about a serious pathology, such as congenital hypothyroidism. This is an inborn deficiency of thyroid hormones, which can manifest in the eyes of the mother is constipation.

Organic diseases that can cause constipation in a baby are Hirschsprung's disease, congenital or acquired intestinal obstruction, congenital malformations of the intestine. These conditions have very serious consequences, so they should be diagnosed immediately after the onset of symptoms.

Quite often, the cause of constipation is the use of medicines. Sometimes for the purpose of treatment of intestinal colic use means that act on gas formation. But one of the properties of such drugs is the removal of these gas bubbles, but with a huge number of them, the intestine can not cope with the load and this is accompanied by a short-term stool delay. So the constipation from Espumizan and Bobotik is connected precisely with the fact that the removal of stool and gas is disturbed because of the huge number of bubbles. Characteristic in this case is the delay of the stool for no more than a day on the background of such treatment, but if it is a longer constipation, then you need to think about other reasons.

Bifidumbacterin is a probiotic drug that can be used in newborns only for certain indications for dysbiosis. It can cause constipation on the first day of use, until the flora in the intestine is normalized.

[10], [11], [12], [13]

Symptoms of the constipation in the newborn

The first signs of constipation appear already at the first episode of stool delay in the newborn for more than 36 hours. After this time, the chair can be, but the child cries and strongly strains to make a defecation. This is considered one of the symptoms of constipation, even if the frequency of defecation is normal. The consistency of the stool in the form of a decorated or solid feces is also considered a symptom of constipation, if it is not mushy. Therefore, in a newborn, the symptoms of constipation are not only a change in the frequency of bowel movements, but also the consistency of the stool and the bowel movement itself.

If the baby does not pump for a long time, then the stool delay strengthens the processes of fermentation in the intestine and enhances gas formation. Therefore, bloating, gas and constipation in newborns are often joint symptoms. The child begins to be capricious, crying and the feeding process is disrupted. The child, although he wants to eat, but swelling in the stomach does not allow him to eat the volume that he wants. Thus the child is hungry and even more capricious. His tummy swells because of the increased number of gazik, which can not move away from the increase in fecal masses. It can be accompanied by colic in the abdomen. The symptoms then become more expressive - the baby cries, nothing can calm him, unless just swinging on the hands for a long time or the process of defecation.

Constipation in a newborn during breastfeeding can be if the mother ate something from foods that obstruct intestinal motility. Therefore, if such constipation is the first time in a child, then the mother can follow her diet and include products with prokinetic action. This will allow the symptoms of a child's constipation to pass already against the background of correction of the diet of the mother. Constipation in a newborn with artificial and mixed feeding can occur even with the first introduction of the mixture - then this may indicate an incorrectly selected mixture.

Hungry constipation in a newborn can be caused by untimely and incorrect diet. Sometimes a mother may not know about the frequency with which to feed the baby - and this is an arbitrary regime at the request of the baby, which should be no less than eight times a day or at least every three hours. When feeding is not enough, the baby will cry and it will have constipation precisely because there is not enough food in the intestines to stimulate peristalsis. Then there will be symptoms of hypotrophy - that is, the child will stop gaining enough weight, he will be cranky and sluggish. In this case, you should always contact the doctor to assess the feeding regimen and weigh the child.

Speaking of congenital intestinal obstruction, the symptoms are evident from the first days of life. The child does not walk away from the meconium, or his departure is delayed. When examined, the asymmetry of the tummy is noted, it can be swollen from one side, and on the other, spasmodic phenomena can be noted. There may be vomiting and intoxication of the body. Not only feces are delayed, but gases are also escaping. These symptoms are dangerous and require immediate action.

Congenital hypothyroidism manifests itself in the first month of life, but such symptoms can only be seen by the doctor. Symptoms that mom can see are limited only by constipation. This is due to a lack of thyroid hormones, which in the child's body play an important role, since they ensure the differentiation of all cells of the body. They stimulate intestinal peristalsis, provide energy processes, take part in the division of nerve cells. Therefore, with hypothyroidism, in addition to constipation, there are symptoms of delayed development and a decrease in the energy potential of the child's body. When looking at such a child, it can be noted that he is larger by weight than he should be, he is calm and does not cause trouble to his mother. It has a large fontanel and sometimes the lateral can not be closed against the background of the fetal transfer. Such a baby has a weak voice, he is listless and a little behind in development. But such features can only be seen by a doctor at such a small age, and mom can only be bothered by constipation.

During the newborn period, the child should eat, sleep and have a good cough - this is the guarantee of his excellent condition. If the child has constipation, then there is already a cry, bloating, anxiety and sleep disturbances. All this must be taken into account when diagnosing constipation in children.

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Complications and consequences

The consequence of constipation in a newborn child is often a violation of the microflora, which is already so imperfect in such a small child. This further leads to an increase in the processes of food fermentation, which increases the formation of gases. And this all threatens the appearance of colic already against the backdrop of breakthrough. A prolonged stool retention leads to absorption of all harmful products and the child's condition is disrupted.

Speaking about the possible complications of constipation, it should be noted that the most common local complications are with improper home treatment. So when using enemas, chopsticks, soaps, cracks can form, which very poorly heal in a child and further disturb the condition. Such invasive interventions also increase the risk of exogenous infection.

[15], [16], [17]

Diagnostics of the constipation in the newborn

Any disturbances in the condition of the newborn in diagnosis require minimal interventions, so you need to rely on an objective examination with minimizing invasive interventions. It is very important to interview your mother about all the symptoms that the child's network has. It is also worth paying attention to the peculiarities of digestion of parents, because this plays an important role in the state of the child.

When examining the child in the diagnosis of constipation, bloating, tension before the defecation can help. At palpation the tummy is soft, but swollen, which indicates an increased number of gazik or feces. It is necessary to weigh the baby and measure height, to exclude the organic causes of swelling.

Analyzes that can be performed with constipation in newborns should rule out congenital fermentopathies or intestinal dysbiosis. Therefore, you need to start with the most simple analysis - analysis of stool and coprogram. In a child with a functional character of constipation, the coprogram will be within the norm, there may be changes only in the form of a slight intestinal dysbiosis, which can cause the functional character of constipation. If neutral fats, undigested particles, connective fibers are noted in the coprogram, pancreatic pathology, lactase intolerance, cystic fibrosis, congenital hypothyroidism should be excluded.

Analgeses with congenital hypothyroidism should be carried out as soon as possible to immediately begin treatment. In this case, a blood test with determination of thyroid hormones is mandatory. An increase in the thyroid-stimulating hormone and a decrease in T3 and T4 indicate a high probability of congenital hypothyroidism.

[18], [19], [20], [21]

Differential diagnosis

An important role in establishing a diagnosis of constipation is differential diagnosis. First of all, anxiety and bloating may be when the child has colic. In this case, if it is only a question of colic, then you need to ask your mother about the details of the child's condition. When colic, as a rule, the child begins to cry at night, and this continues for a long time. The child is a little calmed by a swing on his hands in the position on the tummy or a warm warmer on the tummy. If a child has constipation, then he can scream and worry all through the day. His condition improves after defecation, and has nothing to do with other methods. In addition, it is possible to note the errors in the diet of the mother, characteristic for the formation of constipation.

If the child has a suspicion of congenital intestinal obstruction, then necessarily conduct instrumental diagnostics - X-ray examination with contrasting. With intestinal obstruction, the radiograph of the abdominal cavity will show a contrast in the intestinal loops, according to the type of Clauber's bowls.

If any organic pathologies are excluded from the examination of the doctor, then no invasive examinations are made to the child, this is not justified by such a small age.

In any case, the mother should not engage in self-medication, it is better to show the child with constipation to the doctor, because experience and knowledge play an important role in the timely establishment of the diagnosis.

Treatment of the constipation in the newborn

Treatment of constipation in a newborn can be complex, medication methods are used as a means of choice, if a correction of the diet of the mother has already been used. Therefore, in the first place, mother should be warned about the correct nutrition and inclusion in the diet of foods that are rich in fiber and stimulate peristalsis. Such products include - sour-milk products in the amount of up to 500 milliliters per day, black bread, honey, sour fruits, mineral waters, products rich in plant fibers, vegetables. But do not forget that some products can cause an allergy in a baby, so you need to reasonably approach the diet of a nursing mother.

If there are no results from the correction of the diet for a week and the constipation continues, then already use the medication.

1. Plantex is a drug that is used in children to treat functional disorders of digestion. The main active substance of the drug is the fennel extract, which has the ability to reduce gas formation against the background of constipation and to remove the symptoms of pain in the tummy. In the treatment of constipation, the drug can be used if there is a child and colic. The dosage of the drug is one to two sachets per day. Method of application - one packet with granules must be dissolved in 100 milliliters of warm water, without adding any sweeteners. Give the child need in a warm form after each feeding. You can also use the drug to your mother for two or three sachets a day. Side effects occur most often only in the form of allergic reactions, respiratory disorders.
2. Espumizan is a remedy whose main active ingredient is simethicone. This substance is a surface-active molecule that promotes inactivation of air bubbles in the intestines and their easy elimination. On the process of peristalsis simethicone does not affect, therefore, with constipation, espumizan can be used in complex treatment for bloating in the child's tummy. The dosage of the preparation depends on the content of the active substance. If Simethicone 40 mg, then you need to give 25 drops to the baby, and if the active ingredient content is 100 mg, then you need to dose 5-10 drops. Method of application - after each breast-feeding, give a medicine, and if the child is on the mixture, then you need to add to the bottle before each feeding. Side effects are drowsiness and addiction.
3. A bobotik is also a simethicone-based medicine that is used according to the principle of espoumisan in complex treatment. Dosage of the drug - 16 drops per each feeding.
4. Bifidumbacterin in constipation in a newborn can only be used after an examination of the state of the intestine and the determination of the state of the biocenosis. In the event that the child has dysbiosis, which may be the cause of constipation, then drugs containing beneficial bacteria are prescribed. Bifidumbacterin contains lyophilized bifidobacteria, which, when ingested, fill the deficiency of useful flora. The method of application of the preparation in the form of a powder dissolved in water. Dosage is one to two doses per day for a child up to six months. Side effects can be in the form of diarrheal syndrome. Also for complex treatment can be added lactobacterin, which contains and lactobacilli.
5. Dufalac with constipation in newborns is the most selective specialized tool that facilitates the process of defecation. The active substance of the medication is lactulose, which contributes to the excretion of feces by a three-dimensional mechanism. The dosage of the drug is up to 5 milliliters per day. You can apply a daily dose for one or two times. Side effects can be - abdominal pain, flatulence, vomiting, diarrhea, imbalance of basic electrolytes.
6. Mikrolaks is a remedy that is used to treat constipation as an enema. The preparation contains active substances, which act due to the fermentation of callum masses and their further excretion. Method of using the drug - the tube with the drug should be opened, then injected half into the rectum of the newborn and squeezed the contents into a volume of 5 milliliters. This dosage is allowed for small children. The use of such a medication by the type of enema is limited to one or two times, as this is traumatic for such a baby and cracks can form. Therefore, for a long-term treatment of constipation, the drug is not used. Side effects can be in the form of local irritation and pain in the abdomen.
7. Babi Kalm is a herbal remedy, which includes an extract of fennel, mint, anise. They have anti-inflammatory and vitrogenic properties, so the drug can be used in the complex treatment of constipation in children. Dosage of 10 drops per each feeding. Side effects can be in the form of allergic manifestations.
8. Lineks with constipation in newborns is inappropriate, because the drug has the opposite effect and except that it includes lactobacilli, it helps strengthen the stool. Smecta in constipation in newborns is also not used because of the age limit.
9. Candles for constipation in a newborn are used very widely, since in addition to local action, the drug has a softening effect on the rectum and antibacterial effect. To do this, use glycerin candles. Method of application - one candle should be inserted into the rectum once a day, preferably in the morning, which promotes bowel fecundity. Side effects can be in the form of nausea, vomiting, abdominal pain, allergic reaction.

It is not recommended to use vitamins for use in newborns, but mothers can take complex vitamin preparations during breastfeeding, which will improve the general condition and the child.

Physiotherapeutic treatment is not used in newborn babies under physiological conditions, they can be used in the postoperative period to improve peristalsis.

Alternative treatment of constipation in newborns

Alternative treatment of constipation is widely used by mothers, but it should be noted that not always such methods are safe. Sometimes there can be more complications on the background of treatment than simply because of constipation in the child. Therefore, you need to understand all the folk methods and stipulate their safety for the health of the baby.

1. Enema for constipation in a newborn is used often. You can use water for this, but it is better to use special enemas with medical products that are sold in the pharmacy. Therefore, the enema can be used once or twice symptomatically. More use of an enema in a newborn is not recommended, as there may be local complications.
2. Soap for constipation also often sounds in some recommendations, but it should be noted that this is a very old method that is dangerous in terms of pronounced allergic reactions. Therefore, this method can not be used in newborns, regardless of whether it is an economic or cosmetic soap.
3. The cotton swab is used to stimulate contractions of the distal parts of the rectum, which leads to an increase in peristalsis. But such irritation of the tender mucous membrane can cause cracks, so do not use it for treatment.
4. Vaseline oil is used for constipation, as it softens the mucous membrane and accelerates defecation. But in children, petroleum jelly because of the high concentration of essential substances can cause allergies, so it is also not recommended for use in newborns.

Herbal treatment can be used for both the baby and the nursing mother. In any case, the nutrition of the mother with constipation in the child is very important and requires correction. The diet should include foods that improve the process of bowel evacuation. It is useful to eat a salad of boiled beets and prunes, which greatly improves digestion. Speaking about herbs, the mother can take herbal infusions, which improve the digestive function.

1. Dill water from constipation can be used by the mother, which reduces bloating in the baby, improves digestion. When using a high concentration of dill water, the child may have allergic reactions, so it is better to use such a weed in the mother. To do this, a glass of boiled water needs ten grams of dill, drink for ten minutes. Drink this kind of grass no more than three times a day.
2. Chamomile from constipation can also be used in children, only if there is no allergic anamnesis in the family. To do this, take thirty grams of chamomile grass, pour warm water and give the child four drops after each feeding.
3. The sen is a herbal remedy with a very strong diarrhea effect. Therefore, to treat constipation in a baby, you can use the infusion from the grass of the hay in the mother, because the child is difficult to predict the effect of grass. To do this, you need to steam the leaves of the hay in a glass of water and drink once a day. The effect of the baby can be already four hours after the mother's infusion.

Homeopathy can be used for a long time both in the child and in the mother.

1. Likopodium - a homeopathic remedy of inorganic origin. This tool works by increasing peristalsis and reducing gas production. Used in the treatment of constipation in children with the addition of a drug to a nursing mother. Dosage of the drug is two drops every four hours. Side effects are possible in the form of allergic reactions. Precautions - it is impossible to apply the drug to a suspected organic pathology in the baby.
2. Alumen is a homeopathic remedy of natural plant origin. The drug can be used for constipation for nervous and moody children who do not like wet weather and water. The method of application of the drug is for the mother for three weeks. Dosage - five grains three times a day. Side effects can be in the form of insomnia or stool disruption in the form of diarrhea, which requires a dose reduction of half.
3. Veratrum album is a complex six-component preparation of plant origin. It is used to treat constipation, which is accompanied by significant straining of the child and reddening it while doing so. Method of application of the drug in tablets. Dosage of the drug for the mother - on a tablet every six hours in an acute period. Side effects can only be in the form of allergic manifestations.
4. Nuks vomica is an organic homeopathic preparation, which includes herbs. Used to treat constipation in children with severe anxiety. The way of application of the preparation is oral in the form of grains for reception or in the form of drops for the mother. Dosage in case of taking drops - one drop twice a day, and grains - four times three times a day. Side effects are possible in the form of increased salivation and nausea. 

Operative treatment of constipation of a functional nature is not used, but if there is a confirmed diagnosis of intestinal obstruction, surgical intervention is carried out in urgent order. Surgical intervention involves the restoration of the passage of food through the intestines by restoring normal anatomy and intestinal topics. In the postoperative period, the first few days a child can be fed parenterally, and then switch to breast milk, which depends on the severity of the child's condition.

Massage with constipation in a child can very well affect the improvement of peristalsis. To do this, you need to carry out gentle massage movements along the belly clockwise, it is necessary that the hand was warm. After the massage you need to put a warm little buckwheat on your tummy and abuse the child for a while. This can provoke bowel movement.

[22], [23], [24], [25], [26], [27]

Prevention

Prevention of constipation in a newborn can be performed by moms if they are breastfed. To do this, you need to adjust your diet so that the food is right and rational, containing many products that stimulate peristalsis. Also it is necessary to feed the child in time, to observe the intervals between the feedings and to properly take care of the baby. It is very important the psychological condition of the nursing mother, because the constipations at this time are mostly functional. Therefore, nursing mother needs not only proper nutrition, but peace and a healthy sleep.

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Forecast

The prognosis of constipation in newborns is favorable, because most have a functional character and take place during the first three months after the maturation of the nervous regulation of digestion.

Constipation in a newborn is one of the most common causes of a child's anxiety in the first three months. More often such constipations have a functional character, but it is worth remembering about organic pathology. Therefore, you should carefully examine the child and exclude serious conditions. Treatment can be symptomatic, with mandatory correction of the diet of the mother.