Babies’ Stool Indicates Their Health

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Make sure to read the entire series!

Constipation is a common problem in children. It may also develop into a persisting problem for many months to years in children. A child is considered constipated when the child has fewer than three bowel movements in a week; has difficulty having a bowel movement; or when the stools are hard, dry and unusually large. Chronic constipation with fecal incontinence can be associated with significant physical morbidity and psychosocial stress. The successful treatment of constipation requires a precise well-organized plan for evaluation and a team approach involving the patient, family and health care provider.

Stool Appearance

Bristol Stool Chart

  • Type 1-3: constipation
  • Type 4-5: normal
  • Type 6-7: diarrhea
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Questions about your pregnancy, child birth or life with an infant? Ask the Doctor!

Causes of constipation

The major causes of constipation in children can be divided broadly into two categories: functional and organic. Approximately 95% of childhood constipation is functional in nature without any cause.

Organic causes are responsible for fewer than 5% of children with constipation include.

  • Anatomical malformation: Imperforated anus, Anal stenosis
  • Metabolic and gastrointestinal cause: Hypothyroid, Lead poisoning
  • Neuropathic conditions: Spinal cord lesion, cerebral palsy
  • Intestinal nerve and muscle disorder : Hirschsprung disease, Intestinal neuronal dysplasia
  • Abnormal abdominal musculature such as Prune-Belly, Down syndrome, Gastroschisis

Symptoms of constipation

An infant who is constipated that look hard or pellet-like. The infant may cry while trying to move his or her bowels. The infant may have bowel movements less frequently than before. You may be worried that your infant is constipated if your child looks like he or she is straining. Because infants have weak abdominal muscles, they often strain during a bowel movement, causing their face to appear red. The infant is unlikely to be constipated if he or she passes a soft bowel movement within a few minutes of straining.

If your child has fewer bowel movements than usual or complains of pain during a bowel movement, he or she may be constipated. For example, a child who normally has one to two bowel movements everyday may be constipated if he or she has not had a bowel movement in two days. Many children with constipation develop unusual habits when they feel the urge to have a bowel movement.

  • Infants may arch their back, tighten their buttocks, and cry
  • Toddlers may rock back and forth while stiffening their buttocks and legs, arch their back, stand on their tiptoes, and wriggle or fidget, or they may squat or get into other unusual positions
  • Children may hide in a corner or some other special place while doing this dance

Dealing with constipation

Constipation is treated somewhat differently in infants as compared to children. When constipation presents early in life, the parents should be particularly alert for evidence of organic disease, including Hirschsprung disease.

Give non digestible osmotically active carbohydrates such as sorbitol containing juices, prune, apple, or pear juice. You can give a total of two to four ounces of 100 percent fruit juice per day for chidren 4 to 8 months old. You can give up to six ounces of fruit juice per day to infants 8 and 12 months old.

  • Serve more fiber: Foods that are high in fiber. Food that are high in fiber, such as fruits, vegetables, and whole grain bread, can help prevent constipation. Fiber can’t be digested, so it helps clean out the intestines by moving the bowels along, while a diet full of fatty, sugary, or starchy foods can slow the bowels down. Fiber doesn’t have to be a turn off for kids. Try apples, oatmeal, oranges, bananas, baked potatoes, and popcorns
  • Develop a regular meal schedule: Since eating is a natural stimulant for the bowels, regular meals may help kids develop routine bowel habits. If necessary, schedule breakfast a little earlier to give your child a chance for a relaxed visit to the bathroom before school
  • Get kids into the habit of going: Try having a child who fights the urge to go to the bathroom sit on the toilet for at least10 minutes at about the same time each day. Preferably after a meal
  • Give medicine: Infants with recurrent constipation may need additional measures to address fecal impaction. Glycerin suppositories or rectal stimulation with a lubricated rectal thermometer can be used
  • Children: give osmotic laxative drugs: milk of magnesia or lactulose

Education for parents

Effective education of the parents and child with regard to constipation is crucial in changing chronic behavior patterns. Treatment requires a team approach involving the patient, family, and healthcare provider.

As noted above, parents should be apprised that this process can take as long as six months to several years. Regular follow up and ongoing support and encouragement to parents and child during periodic clinic visits or phone conversations are essential.

When to See Doctor

  • Poor weight gain
  • Abdominal pain
  • Blood in stool
  • Fecal incontinence (encopresis)

Samitivej, We Care!

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181

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