Constipation in a newborn baby: causes, treatment

Constipation in a newborn is a violation of the normal passage of stool or a decrease in the number of bowel movements in a child in the first month of life. This problem is one of the most common reasons for visiting a doctor, which indicates not only its widespread prevalence, but also the importance of the problem. Symptoms differ in children of different ages, but given the clinical manifestations, it is necessary to correctly conduct differential diagnostics.

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Epidemiology

The epidemiology of constipation in newborns indicates its high frequency in children of the first three months of life and its connection with physiological causes. More than 40% of mothers consult a doctor in the first three months of life precisely because of constipation, and more than 65% of such children are bottle-fed. This proves the advantages of breastfeeding in the development of functional disorders in the baby. Speaking about symptoms, the clinical manifestations of constipation bother the baby and mother less than colic, but in the case of a combination of constipation and colic, this becomes a serious problem for the baby's life.

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Causes constipation in a newborn

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

First of all, it is necessary to understand what exactly is constipation and what frequency of bowel movements should be in a healthy child depending on age. In newborns who are breastfed, the normal frequency of bowel movements is 6-7 times a day, and if the child is bottle-fed, then the frequency is 4-5 times a day. In children over six months old, with the beginning of the introduction of complementary foods, the stool should be at least 2-3 times, and in children aged 1-6 years - 1-2 times a day. As for a newborn child, the consistency of the stool is considered an important criterion, and not just its frequency. For such a baby, the feces should be mushy, unformed, without hard lumps. Therefore, it is possible to say that a newborn child has constipation if there has been no stool for more than 36 hours or if there is hard stool with straining and restlessness of the child before defecation, even with a normal frequency of the stool itself.

The problem of constipation can be present already 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, the baby's nutrition plays an important role. If the baby is exclusively bottle-fed, then the cause of constipation may be an unsuitable formula for the baby. Sometimes parents may have a tendency to constipation, so the baby inherits this tendency, and if the formula causes a violation of motility, then this can cause persistent constipation. Therefore, it is necessary to simply replace the formula with another series or a more adapted one. For example, constipation from Nestozhen in a newborn is very common, so it is necessary to simply change the formula to a special one or to another brand. If the baby is breastfed, then his digestion processes should be normal, because breast milk is the best means of nutrition. But often the cause of constipation in this case can be the improper organization of the mother's diet. If the mother has a lot of complex products in her diet, then this can slow down the intestinal motility of the child. Products that cause constipation in a newborn are rice and semolina porridge, grapes, pomegranate, quince, pear, crackers, white bread and bakery products, cocoa, caviar, slimy soups, jelly, boiled eggs, so they should be excluded from the diet. A nursing mother with constipation in a child should definitely introduce tannins into her diet - increase the amount of vegetables (beets, tomatoes) and fruits (plums, baked apple), cereals, liquid soups.

Risk factors

Risk factors for constipation in newborns increase if at least one of the parents has a tendency to constipation. Then, with functional immaturity of the digestive system, the child may have severe constipation even against the background of a simple tendency of the parents. Among other risk factors for constipation is a burdened family history of enzymopathies or food intolerance. Premature children or those born prematurely have a risk of developing intestinal obstruction and constipation, among other things.

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Pathogenesis

The pathogenesis of constipation symptoms in this case is functional in nature and is the least serious cause. Among other causes, organic diseases of the neonatal period can be distinguished - this is a group of food intolerance and organic pathology.

Among the intolerances of food pathologies that can cause constipation today are lactose intolerance, celiac disease, and cereal intolerance. Such pathologies often have alternating diarrhea with constipation, but sometimes they can be exclusively in the form of constipation.

One should not forget about a serious pathology such as congenital hypothyroidism. This is a congenital deficiency of thyroid hormones, which can manifest itself in the eyes of the mother as 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 symptoms appear.

A fairly common cause of constipation is the use of drugs. Sometimes, in order to treat intestinal colic, drugs that act on gas formation are used. But one of the properties of such drugs is the removal of these gas bubbles, but with a huge amount of them, the intestines may not cope with the load and this is accompanied by a short-term delay in stool. So constipation from Espumisan and Bobotik is associated precisely with the fact that the removal of stool and gas is disrupted due to the huge number of bubbles. In this case, a delay in stool for no more than a day against the background of such treatment is typical, but if we are talking about 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 in case of dysbiosis. It can cause constipation in the first day of use, until the intestinal flora is normalized.

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Symptoms constipation in a newborn

The first signs of constipation appear already during the first episode of delayed stool in a newborn for more than 36 hours. After this time, there may be stool, but the child cries and strains hard to have a bowel movement. This is considered one of the symptoms of constipation, even if the frequency of bowel movements is normal. The consistency of stool in the form of formed or hard 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 process of bowel movement itself.

If the baby does not poop for a long time, then the stool retention increases the fermentation processes in the intestines and increases gas formation. Therefore, bloating, gases and constipation in newborns are often combined symptoms. The child begins to be capricious, cry and the feeding process is disrupted. Although the child wants to eat, the bloating in the stomach does not allow him to eat the amount he wants. Thus, the child is hungry and even more capricious. His tummy swells due to the increased amount of gases that cannot pass against the background of an increase in fecal masses. This can be accompanied by colic in the abdomen. The symptoms then become more expressive - the child cries, nothing can calm him down, except for rocking in your arms for a long time or the process of defecation.

Constipation in a newborn with breastfeeding can occur if the mother ate something from the products that hinder intestinal peristalsis. Therefore, if such constipation in the child for the first time, the mother can monitor her diet and include products with a prokinetic effect. This will allow the symptoms of constipation in the child to pass already against the background of correction of the mother's diet. Constipation in a newborn with artificial and mixed feeding can manifest itself already at the first introduction of the mixture - then this may indicate an incorrectly selected mixture.

Hunger constipation in a newborn can be caused by an untimely and incorrect feeding regimen. Sometimes the mother may not know the frequency with which the baby needs to be fed - and this is an arbitrary regimen at the request of the baby himself, which should be no less than eight times a day or no less than every three hours. When feedings are insufficient, the child will cry and will be constipated precisely because there is not enough food in the intestines to stimulate peristalsis. Then symptoms of hypotrophy will appear - that is, the child will stop gaining enough weight, he will be capricious and lethargic. In this case, you must definitely consult a doctor to assess the feeding regimen and weigh the child.

Speaking about congenital intestinal obstruction, the symptoms appear from the first days of life. The child does not pass meconium or its passage is delayed. During examination, asymmetry of the abdomen is noted, it can be swollen on 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 also the passage of gases. These symptoms are dangerous and require immediate action.

Congenital hypothyroidism manifests itself already in the first month of life, but such symptoms can only be noticed by a doctor. The symptoms that a mother can see are limited to constipation. This occurs due to a lack of thyroid hormones, which play an important role in the child's body, since they ensure the differentiation of all cells in the body. They stimulate intestinal peristalsis, provide energy processes, and participate in the division of nerve cells. Therefore, with hypothyroidism, in addition to constipation, symptoms of developmental delay and decreased energy potential of the child's body appear. When examining such a child, it can be noted that he is heavier than he should be, he is calm and does not cause concern to the mother. He has a large fontanelle and sometimes the lateral ones may not be closed due to the fetus being overdue. Such a baby has a weak voice, he is lethargic and slightly behind in development. But only a doctor can notice such features at such a young age, and the mother may only be bothered by constipation.

During the neonatal period, the child should eat, sleep and poop well - this is the key to his excellent condition. If the child is constipated, 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

Constipation in a newborn baby often results in a violation of the microflora, which is already imperfect in such a small child. This subsequently leads to increased food fermentation processes, which increases the processes of gas formation. And all this threatens the appearance of colic already against the background of diarrhea. Long-term delay in stool leads to the absorption of all harmful products and the child's condition is disturbed.

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

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Diagnostics constipation in a newborn

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

When examining a child, abdominal distension and straining just before defecation can help diagnose constipation. When palpating, the abdomen is soft but swollen, indicating an increased amount of gas or feces. It is imperative to weigh the baby and measure his height to rule out organic causes of bloating.

The tests that can be performed for constipation in newborns should exclude congenital enzymopathies or intestinal dysbiosis. Therefore, you need to start with the simplest test - stool analysis and coprogram. In a child with a functional constipation, the coprogram will be within the normal range, there may be changes only in the form of mild intestinal dysbiosis, which can cause the functional nature of constipation. If the coprogram shows neutral fats, undigested particles, connective fibers, then it is necessary to exclude pancreatic pathology, lactase intolerance, cystic fibrosis, congenital hypothyroidism.

Tests for congenital hypothyroidism should be performed as soon as possible to start treatment immediately. In this case, a blood test to determine thyroid hormones is mandatory. An increase in thyroid-stimulating hormone and a decrease in T3 and T4 indicate a high probability of congenital hypothyroidism.

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Differential diagnosis

Differential diagnostics plays an important role in establishing the diagnosis of constipation. First of all, anxiety and bloating can be caused by colic in a child. In this case, if we are talking only about colic, then you need to ask the mother about the details of the child's condition. With colic, as a rule, the child begins to cry in the evening, and this continues for a long time. The child is slightly calmed by rocking in your arms while on the tummy or a warm heating pad on the tummy. If the child has constipation, then he can cry and worry throughout the day. His condition improves precisely after defecation, and is in no way associated with other methods. In addition, you can note errors in the mother's diet, characteristic of the formation of constipation.

If a child is suspected of having congenital intestinal obstruction, then instrumental diagnostics are mandatory - X-ray examination with contrast. In case of intestinal obstruction, the X-ray of the abdominal organs will show a delay of the contrast agent in the intestinal loops according to the type of Kloiber cups.

If the doctor's examination rules out any organic pathologies, then no invasive examinations are performed on the child; this is not justified by such a young age.

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

Treatment constipation in a newborn

Treatment of constipation in a newborn can be complex, medicinal methods are used as a means of choice if the mother's diet has already been corrected. Therefore, first of all, the mother needs to be warned about the correctness of nutrition and the inclusion of foods in the diet that are rich in fiber and stimulate peristalsis. Such products include fermented milk products in a volume of up to 500 milliliters per day, black bread, honey, sour fruits, mineral waters, foods rich in plant fibers, vegetables. But do not forget that some products can cause allergies in the baby, so you need to approach the diet of a nursing mother wisely.

If there are no results from diet correction within a week and constipation continues, then drug treatment is used.

1. Plantex is a drug used in children to treat functional digestive disorders. The main active ingredient of the drug is fennel extract, which has the ability to reduce gas formation against the background of constipation and relieve symptoms of abdominal pain. In the treatment of constipation, the drug can be used if the child also has colic. The dosage of the drug is one or two sachets per day. How to use - one sachet of granules should be dissolved in 100 milliliters of warm water, without adding any sweeteners. Give the child warm after each feeding. You can also use the drug for mothers two or three sachets per day. Side effects are most often only in the form of allergic reactions, respiratory failure.
2. Espumisan is a drug whose main active ingredient is simethicone. This substance is a surface-active molecule that helps inactivate air bubbles in the intestines and easily remove them. Simethicone does not affect the peristalsis process itself, so in case of constipation, Espumisan can be used in combination treatment for bloating in a child. The dosage of the drug depends on the content of the active substance. If simethicone is 40 mg, then you need to give 25 drops to the child, and if the content of the active substance is 100 mg, then you need to dose 5-10 drops. Method of application - after each breastfeeding, you need to give the medicine, and if the child is on formula, then you need to add it to the bottle before each feeding. Side effects - drowsiness, as well as addiction.
3. Bobotik is also a simethicone-based medicine, which is used in combination therapy on the principle of espumisan. The dosage of the drug is 16 drops for each feeding.
4. Bifidumbacterin for constipation in a newborn can be used only after examining the state of the intestines and determining the state of the biocenosis. If the child has dysbiosis, which can be the cause of constipation, then drugs containing beneficial bacteria are prescribed. Bifidumbacterin contains lyophilized bifidobacteria, which, when entering the intestines, replenish the deficiency of beneficial flora. The method of using the drug in the form of powder dissolved in water. The dosage is one or two doses per day for a child under six months. Side effects may be in the form of diarrhea. Also, for complex treatment, you can add lactobacterin, which also contains lactobacilli.
5. Dufalac for constipation in newborns is the most selective specialized remedy that facilitates the process of defecation. The active substance of the drug is lactulose, which promotes the removal of feces due to the volume mechanism. The dosage of the drug is up to 5 milliliters per day. The daily dose can be used once or twice. Side effects can be - abdominal pain, flatulence, vomiting, diarrhea, imbalance of basic electrolytes.
6. Microlax is a remedy used to treat constipation by enema. The drug contains active substances that act by fermenting fecal matter and then removing it. How to use the drug: open the tube with the drug, then insert it halfway into the newborn's rectum and squeeze out the contents into a volume of 5 milliliters. This dosage is allowed for small children. The use of such a drug by enema is limited to one or two times, since it is traumatic for such a baby and cracks can form. Therefore, the drug is not used for long-term treatment of constipation. Side effects can be in the form of local irritation and abdominal pain.
7. Baby Calm is a herbal remedy that includes fennel, mint, and anise extract. They have anti-inflammatory and vitrogonic properties, so the drug can be used in the complex treatment of constipation in children. Dosage is 10 drops for each feeding. Side effects may be allergic reactions.
8. It is not advisable to use Linex for constipation in newborns, since the drug has the opposite effect and, in addition to the fact that it contains lactobacilli, it helps to strengthen the stool. Smecta is also not used for constipation in newborns due to age restrictions.
9. Suppositories for constipation in newborns are used very widely, since in addition to the local effect, the drug has a softening effect on the rectum and an antibacterial effect. Glycerin suppositories are used for this. Method of application - one suppository should be inserted into the rectum once a day, preferably in the morning, which promotes bowel movement. Side effects can be nausea, vomiting, abdominal pain, allergic reaction.

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

Physiotherapy treatment is not used in newborn babies in physiological conditions; in the postoperative period it can be used to improve peristalsis.

Traditional treatment of constipation in newborns

Traditional treatment of constipation is widely used by mothers, but it should be noted that such methods are not always safe. Sometimes more complications may arise during treatment than just because of constipation in a child. Therefore, it is necessary to understand all traditional methods and discuss their safety for the baby's health.

1. An enema for constipation in a newborn is often used. You can use water for this, but it is better to use special enemas with medicinal products that are sold in pharmacies. Therefore, an enema can be used once or twice symptomatically. It is not recommended to use an enema more often in a newborn, since there may be local complications.
2. Soap for constipation is also often mentioned in some recommendations, but it should be noted that this is a very old method, which is dangerous in terms of severe allergic reactions. Therefore, this method cannot be used in newborns, regardless of whether it is household or cosmetic soap.
3. A cotton swab is used to stimulate contractions of the distal rectum, which leads to increased peristalsis. But such irritation of the delicate mucous membrane can cause cracks, so it should not be used for treatment.
4. Vaseline oil is used for constipation, as it softens the mucous membrane and speeds up defecation. But in children, Vaseline oil can cause allergies due to the high concentration of essential substances, so it is also not recommended for use in newborns.

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

1. Dill water for constipation can be used by the mother, which reduces bloating in the child, improves digestion. When using a high concentration of dill water, the child may have allergic reactions, so it is better to use such a herb for the mother. To do this, ten grams of dill are needed per glass of boiled water, drink for ten minutes. You need to drink such grass no more than three times a day.
2. Chamomile for constipation can also be used in children, but only if there is no allergic history 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. Senna is a herbal remedy with a very strong diarrhea effect. Therefore, to treat constipation in a baby, you can use an infusion of senna grass from the mother, since it is difficult to predict the effect of the herb on a child. To do this, you need to steam senna leaves in a glass of water and drink once a day. The effect in the baby can be as early as four hours after the mother takes the infusion.

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

1. Lycopodium is a homeopathic remedy of inorganic origin. This remedy works by increasing peristalsis and reducing gas formation. It is used to treat constipation in children when adding the medicine to a nursing mother. The dosage of the drug is two drops every four hours. Side effects are possible in the form of allergic reactions. Precautions - do not use the drug if there is a suspicion of organic pathology in the baby.
2. Alumena is a homeopathic remedy of natural plant origin. The drug can be used for constipation in nervous and capricious children who do not like wet weather and water. The method of using the drug is for the mother for three weeks. Dosage - five grains three times a day. Side effects can be insomnia or stool disorders in the form of diarrhea, which requires halving the dose.
3. Veratrum album is a complex six-component herbal preparation. It is used to treat constipation, which is accompanied by significant straining of the child and his redness at the same time. Method of application of the preparation in tablets. The dosage of the preparation for the mother is one tablet every six hours in the acute period. Side effects can only be in the form of allergic reactions.
4. Nux vomica is an organic homeopathic preparation, which includes herbs. It is used to treat constipation in children with severe anxiety. The method of administration of the drug is oral in the form of granules for taking or in the form of drops for the mother. The dosage in case of taking drops is one drop twice a day, and granules - four three times a day. Side effects are possible in the form of increased salivation and nausea.

Surgical treatment of functional constipation is not used, but if there is a confirmed diagnosis of intestinal obstruction, then surgical intervention is performed urgently. Surgical intervention involves restoring the passage of food through the intestine by restoring normal anatomy and topic of the intestine. In the postoperative period, the child can be fed parenterally for the first few days, and then they switch to breast milk, which depends on the severity of the child's condition.

Massage for constipation in a child can have a very good effect on improving peristalsis. To do this, you need to make light massage movements on the tummy clockwise, the hand needs to be warm. After the massage, you need to put a warm heating pad on the tummy and wear the child for some time. This can provoke bowel movement.

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Prevention

Prevention of constipation in a newborn can be carried out by mothers if they are breastfeeding. To do this, you need to adjust your diet so that the food is correct and rational, containing many products that stimulate peristalsis. You also need to feed the child on time, observe the intervals between feedings and properly care for the baby. The psychological state of the nursing mother is very important, because constipation at this time is mainly functional. Therefore, a nursing mother needs not only proper nutrition, but also rest and healthy sleep.

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Forecast

The prognosis for constipation in newborns is favorable, since most of them are functional in nature and disappear within 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 anxiety in a child during the first three months. Most often, such constipation is functional in nature, but it is also 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 mother's diet.