Breastfeeding is the best nutrition for healthy growth and development of babies. Good maternal nutrition helps sustain an adequate supply and quality of breast milk. Unnecessary introduction of bottle-feeding, partially or fully, or of other complementary foods and drinks may have a negative impact on breastfeeding, which may be irreversible. Consult your doctor and consider the social and financial implications before deciding to use breast milk substitutes or if you have difficulty breastfeeding. Follow usage, preparation and storage instructions of breast milk substitutes or of other complementary foods and drinks carefully as improper or unnecessary use may pose a health hazard.
Constipation is generally difficult to define, as there are no clear indications of what is ‘normal’ in terms of the frequency of bowl movements, and symptoms may vary from child to child. How then, does one tell if infrequent bathroom visits are normal for your child, or could be a sign of constipation? If you’re concerned that your child could be suffering from constipation, look out for these signs:
Difficult and infrequent bowel movements
Refusal to go to the toilet
Underwear is sometimes unknowingly soiled
Experiences anal pain, has uncontrolled bowel movements or blood in stool
Stool looks solid, lumpy or generally abnormal
Stool looks solid, lumpy or generally abnormal
Infant passes meconium after 48 hours or more at birth
As children under 5 years of age cannot control their faecal excretion reflux, it sometimes causes difficult bowel movements
Some children refuse to go to the toilet or have regular bowel movements, which could lead to constipation
Some children have a fear of sitting on the toilet or having regular bowel movements. As such, they choose to intentionally hold back their stool, a habit that could lead to constipation. This is how it could occur:
Your child refuses to go to the toilet
This causes anal muscle spasms and squeezed buttock muscles
As a result, faeces is pushed up to the rectum valve
In turn, this causes constipation in your child
Leading to colon dilation and decreased rectal sensitivity
That results in prolonged faecal accumulation, contributing to constipation
Insufficient water and fibre – A diet that includes an excessive intake of soft drinks, with insufficient drinking water, fruit and vegetables
Taking some medicines – Antipyretics, analgesics, cough medicine, diarrhoea medicines could be a cause of dry stools and difficult bowel movements
Anal fissure – Difficult and painful bowel movements
Emotional disorders – Being in a stressful home or family atmosphere, with divorced parents, a new baby, etc.
Diseases – Development of disorders related to the colon, rectum, nervous system, blood, etc.
Inactivity – That causes inactive peristalsis
Most children with constipation may not need treatment to remedy this condition, as this condition can generally be resolved with changes in diet or behaviour. However, if changes in diet or behaviour do not improve your child’s condition, do make a visit to your paediatrician for advice. Depending on the cause, duration and severity of constipation in your child, some medication or alternate forms of treatment might be required to treat the condition.
Mums and caregivers can also encourage their child to adopt good toileting habits that can ease their bowel movements, including:
Taking a deep breath, and holding their breath while straining to ease bowel movements
An average body takes about 18 to 72 hours to convert food ingested into faeces to pass it out, but regularity of bowel movements can differ individually. When the time is significantly shortened or lengthened, this results in diarrhoea or constipation due to the amount of water absorbed by the intestines.
The Bristol Stool Scale is a good indication of whether or not your child is suffering from constipation, as normal faeces should be passed out in the texture of Types 4 to 6, rather than dry, lumpy pieces in Types 1 to 3 that are hard to pass out.
In hard lumps or shaped like nuts
Sausage-shaped or lumpy stools
Like a sausage but with many cracks on the surface
Like a sausage or snake, smooth & soft
Soft blobs with clear cut edges
Fluffy pieces with ragged edges or mushy stools
Watery with no solid pieces or entirely liquid
If your child has experienced this condition for a prolonged period, it might be wise to call your doctor. Do seek medical attention especially if your child is suffering from any of these symptoms, including:
Colon dilation (where the colon is unnaturally extended)
Rectocele (or rectum prolapse)
Poor appetite of your child
Slow weight gain in your child
Persistent abdominal pain