Constipation in Children & New Born
Definition
Constipation in Children & New Born is defined as a delay or difficulty in defecation, present for 2 or more weeks and sufficient to cause significant distress to the patient.
Here are some synonyms for constipation in children and newborns:
- Bowel problems
- Difficulty having a bowel movement
- Infrequent bowel movements
- Straining during bowel movements
- Hard stools
These terms are all more general than constipation, but they can be used to describe the same problem.
It’s important to note that constipation in newborns and children can have different causes. If you are concerned about your child’s bowel habits, it is always best to talk to their doctor.
Overview
Epidemiology
Causes
Types
Risk Factors
Pathogenesis
Pathophysiology
Clinical Features
Sign & Symptoms
Clinical Examination
Diagnosis
Differential Diagnosis
Complications
Investigations
Treatment
Prevention
Prognosis
Homeopathic Treatment
Diet & Regimen
Do’s and Don'ts
Terminology
References
Also Search As
Overview
Overview of Constipation in Children & New Born
It is increasingly being recognized as a very common problem in children and is associated with both physical and psychological morbidity and a poor quality of life.
The normal stool frequency decreases from 4 or more per day during infancy to once per day at 4 years of age. A stool frequency of <2/week is considered abnormal for all ages. Constipation can be divided into two groups:
- Firstly, functional
- Secondly, organic.
The organic in a study of 135 Indian children with constipation, 85% had functional constipation and 15% had an organic etiology (most commonly, Hirschsprung disease, cerebral palsy and meningomyelocele).
Epidemiology
Epidemiology of Constipation in Indian Children & Newborns
Several studies have reported on the prevalence and characteristics of constipation in Indian children:
- Khanna, et al. (2010): In a study of 137 children with constipation, 85% had functional constipation, while the remaining 15% had an associated organic disorder. Hirschsprung’s disease accounted for 6% of all cases.[7]
- Poddar (2016): This review article highlights that the estimated prevalence of constipation is 3% among toddlers and pre-school children in India, with 95% of cases attributed to functional constipation.[8]
- Singh, et al. (2022): The prevalence of functional constipation was noted in 30.8% of children, with a higher incidence in females and in the 2-4 year age group.[9]
Key Points
- Functional constipation is the most common type of constipation in Indian children.
- Organic causes of constipation, such as Hirschsprung’s disease, are less common but important to identify.
- Prevalence rates vary across studies, but constipation is a significant issue in Indian children.
Note: These are just a few examples of studies on this topic. More research is needed to fully understand the epidemiology of constipation in Indian children, particularly in newborns.
Causes
Causes of Constipation in Children & New Born
Functional Constipation
The increase in intake of low residue diet and sedentary lifestyle is responsible for the increase in functional constipation in children.
Functional constipation is defined by the presence of at least 2 or more of the following criteria:
- Two or fewer defecations in the toilet per week
- At least 1 episode of fecal incontinence per week
- History of retentive posturing or excessive volitional stool retention
- History of painful or hard bowel movements
- Presence of a large fecal mass in the rectum
- History of passage of large diameter stools that may obstruct the toilet.
- Generally, Children with functional constipation pass large or hard stools and display stool withholding behavior, characterized by stiffening of whole body and screaming in infants, to walking on tiptoes or tightening of buttocks in older children. Additionally, This is often misunderstood by parents as if the child is trying to defecate.
- Moreover, Often an acute illness, change in diet, coercive toilet training or nonavailability of clean toilet leads to non-passage of stools. Besides this, The stools become hard and cause pain on passage which leads to association of defecation with pain and withholding.
- Lastly, These further increases stool size and hardness with more pain on defecation and a vicious cycle of constipation is initiated. Children with functional constipation often have abdominal pain (10-70%), anorexia (10-25%), enuresis or urinary tract infections (30%) also psychological problems (20%).
Organic Cause of Constipation
Intestinal nerve/muscle disorders e.g.:
- Hirschsprung disease
- Intestinal neuronal dysplasia
- Pseudo-obstruction
Spinal cord abnormalities e.g.
- Tethered cord
- Myelomeningocele
Anorectal e.g.
- Anteriorly placed anus
- Anal stenosis
- Rectal stricture
- Pelvic mass (in other words, sacral teratoma)
Systemic disease i.e.
- Hypothyroidism
- Celiac disease
- Diabetes insipidus
- Diabetes mellitus
- Hypercalcemia
- Cystic fibrosis
- Myotonic dystrophy
Developmental i.e.
Drugs i.e.
- Opiates
- Anticholinergic agents
- Phenobarbitone
- Vincristine
- Lead
Types
Types of Constipation in Children & New Born
Depending upon cause i.e.
- Firstly, Functional Constipation
- Secondly, Organic Constipation
Risk Factors
Risk factor of Constipation in Children & New Born
- Low fiber diet.
- Psychological stress
- Cow’s milk protein allergy
- Familial predisposition
- Prematurity
- Living in urban areas.(1)
Pathogenesis
Pathogenesis of Constipation in Children & Newborns
Constipation in children and newborns can be classified as either organic (resulting from an underlying medical condition) or functional (without an identifiable cause). The pathogenesis of each type differs:
1. Organic Constipation
Organic constipation arises from structural abnormalities, neurological disorders, metabolic conditions, or intestinal disorders. Some common causes include:
- Hirschsprung’s disease: The absence of nerve cells in a segment of the colon leads to lack of peristalsis and stool accumulation.
- Anorectal malformations: Structural defects in the anus and rectum hinder the passage of stool.
- Metabolic disorders: Hypothyroidism, hypercalcemia, or other metabolic imbalances can slow down bowel movements.
- Spinal cord abnormalities: Neurological problems affecting the nerves that control bowel function can cause constipation.
2. Functional Constipation
Functional constipation is the most common type in children and newborns. It usually develops due to a combination of factors, including:
- Dietary factors: Low fiber intake, dehydration, and excessive consumption of cow’s milk or dairy products can contribute to constipation.
- Toilet training issues: Withholding stool due to fear of pain or discomfort can lead to a vicious cycle of constipation and pain.
- Psychological factors: Stress, anxiety, or emotional trauma can affect bowel function.
- Slow colonic transit: Reduced motility of the colon can cause delayed stool passage.
- Dysfunctional defecation: Difficulty coordinating the muscles needed for defecation can lead to stool retention.[10]
Pathophysiology
Pathophysiology of Constipation in Children & New Born:
The Pathophysiology of functional capacity in children remains unclear but is multifactorial. 3 most commonly discussed theories are
- Withholding behavior
- Slow transit
- Genetic factors.
The most common mechanism for developing FC,especially in younger age group, is withholding behavior.
Withholding behavior
- The psychology of functional constipation can be explained based on three events.
- Initial events.
- Cycles of fecal stasis
- Stool-withholding maneuver
- Events/causes that lead to initial painful defecation and later develop as functional constipation.
- Change in routine look the timing of defecation or diet, starting of school.
- Stressful events like physical or sexual abuse
- Inter-current illness.
- Non availability of toilets such as long and frequent travels.
- Child’s postponing defecation because child is too busy.
- Forceful toilet training.
All these events give rise to large, hard stool and the passage of such stools leads to stretching of the pain sensitive anal canal. As a results of this child decides to avoid defecation.
2. Cycle of fecal statis
- Withholding of feces leads to prolonged fecal stasis in the rectum, with the resultant absorption of fluids and harder stools.
- Successive retention of stools in the rectum makes them larger.
- As the cycle is repeated, successively greater amounts of larger and harder stools are built up in the rectum and passed with even greater pain accompanied by sever " stool withholding maneuvers".
3. Genetic factors
- Many children with functional constipation have a positive family history.
- In this subgroup genetic factors may play a role.
- Neurodevelopmental disorders such as autism spectrum disorders can be associated with functional constipation resulting from lack of adequate behavioral response to a defecation sensation.(2)
Clinical Features
Clinical Features of Constipation in Children & Newborns
The clinical presentation of constipation varies depending on the age of the child and the underlying cause. However, some common features include:
Infants and Newborns:
- Infrequent bowel movements: Less than three bowel movements per week.
- Straining and crying during defecation.
- Hard, pellet-like stools.
- Abdominal distension and discomfort.
- Poor feeding and weight gain.
Older Children:
- History of infrequent and/or painful bowel movements.
- Stool withholding behavior.
- Abdominal pain and discomfort.
- Soiling or fecal incontinence (leakage of stool).
- Presence of large, hard stools in the rectum.
Additional Features (Both Age Groups):
- Anal fissures (small tears in the anus) or hemorrhoids (swollen blood vessels around the anus) due to straining.
- Blood on the surface of the stool due to anal fissures.
- Behavioral changes such as irritability, decreased appetite, or lethargy.
Red Flags (Possible Indicators of Organic Constipation):
Sign & Symptoms
Sign & Symptoms of Constipation in Children & New Born:
Symptoms of constipation in children may include your child
- Having fewer than two bowel movements a week
- Passing stools that are hard, dry, or lumpy
- Having stools that are difficult or painful to pass
- Telling you that he feels that not all stool has passed
- Changing positions to avoid or delay having a bowel movement, including
- standing on tiptoes and then rocking back on his heels
- clenching his buttocks
- doing unusual, dancelike movements
- Having a swollen abdomen, or bloating
- Having daytime or nighttime wetting
- Having stool in underwear that looks like diarrhea
If your child avoids or delays having a bowel movement, child may develop a fecal impaction. (3)
Clinical Examination
Clinical Examination of Constipation in Children & New Born:
A thorough clinical examination is essential to evaluate constipation in children and newborns, differentiate functional constipation from organic causes, and identify any underlying conditions. The examination typically includes the following components:
History:
- Detailed history of bowel habits: Onset and duration of constipation, stool frequency and consistency, presence of pain or straining during defecation, associated symptoms (e.g., abdominal pain, vomiting, poor weight gain), dietary history, and toilet training history.
- Past medical history: Birth history (especially timing of first meconium passage), previous episodes of constipation, underlying medical conditions, and medications.
- Family history: History of constipation or other gastrointestinal disorders in family members.
Physical Examination:
- Growth parameters: Assessment of weight, height, and head circumference to evaluate growth patterns.
- Abdominal examination: Inspection for distension, auscultation for bowel sounds, palpation for tenderness or masses, and percussion for tympany or dullness.
- Rectal examination: Digital rectal examination to assess rectal tone, presence of stool in the rectum, and presence of anal fissures.
- Neurological examination: Assessment of lower extremity reflexes and tone to rule out neurological causes of constipation (e.g., spinal cord abnormalities).
Additional Tests:
- Abdominal X-ray: To evaluate the extent of stool burden and rule out bowel obstruction.
- Barium enema: May be indicated in cases of suspected Hirschsprung’s disease or other structural abnormalities.
- Anorectal manometry: To assess anorectal function and coordination in cases of suspected functional constipation.[12]
Important Considerations:
- Age-specific variations: The clinical examination should be tailored to the child’s age and developmental stage. For example, a newborn with delayed passage of meconium may require different tests than an older child with chronic constipation.
- Red flags: Be alert for "red flags" that may suggest an organic cause of constipation, such as delayed passage of meconium, failure to thrive, bloody stools, abdominal distension, or neurological abnormalities.
Diagnosis
Diagnosis of Constipation in Children & New Born:
- Approach a detailed history and physical examination is the most useful tool for making a diagnosis of constipation. The details about pattern of stooling, time of first passage of meconium, presence of blood in stools, diet, stressful life events, drug intake and previous surgeries should be known.
- A predominantly liquid and low fiber diet (milk based) is common and contributes to constipation. A complete physical and neurological examination is essential. Examination for features of spina bifida (pigmentation or tuft of hair on lower back), power in lower limbs, perianal sensation, voluntary contraction and tone of anal sphincter and amount and consistency of stool in rectum on per rectal examination are extremely useful for diagnosis.
- Presence of ‘red flags’ like failure to thrive, blood in stools, recurrent fever with loose stools (enterocohhs), recurrent vomiting, lump in abdomen, recurrent chest infections and features of hypothyroidism should alert the physician to suspect organic etiology.
- No investigations are required for diagnosis in the majority of children with functional constipation. However, an X-ray abdomen may be done to document impaction in select situations, e.g. a child higher in weight who is not willing for a per rectal examination.
Differential Diagnosis
Differential diagnosis of Constipation in Children & New Born:
- Anorectal anomaly
- Hirschsprung disease
- Group A streptococcal perianal skin infection
- Anal fissure
- Lichen sclerosis et atrophicus
- Anal sexual abuse
- Myotonic dystrophy
- Crohn disease
- Gluten enteropathy
- Hypothyroidism
- Neurofibromatosis
- Genetic diseases (6)
Complications
Complications of Constipation in Children and Newborns
While often a benign and transient issue, untreated or persistent constipation in children and newborns can lead to several complications:
Anal Fissures: Straining during defecation can cause small tears in the skin around the anus. These fissures can be painful, leading to fear of defecation and exacerbating constipation.
Rectal Prolapse: Chronic straining may cause the rectum to protrude through the anus. This can be alarming and may require manual reduction or even surgery.
Hemorrhoids: Increased pressure in the veins around the anus due to straining can lead to swollen and inflamed blood vessels (hemorrhoids).
Encopresis: Chronic constipation can lead to impaction of stool in the rectum. This can cause involuntary leakage of liquid stool around the impacted mass, leading to soiling and embarrassment.
Urinary Tract Infections: Severe constipation can compress the bladder and interfere with normal emptying, increasing the risk of urinary tract infections.
Behavioral Problems: Chronic pain, discomfort, and embarrassment associated with constipation can lead to behavioral issues such as anxiety, withdrawal, and school refusal.
Psychosocial Impact: Chronic constipation can significantly impact a child’s quality of life, leading to reduced self-esteem, social isolation, and anxiety.
Rare Complications: In severe cases, complications such as fecal impaction, bowel obstruction, or volvulus (twisting of the intestine) can occur. These are medical emergencies and require immediate intervention.[13]
Important Considerations:
- Early Identification and Treatment: Early recognition and appropriate treatment of constipation can help prevent complications and improve outcomes.
- Multidisciplinary Approach: Managing complications often requires a multidisciplinary approach involving pediatricians, gastroenterologists, dieticians, and behavioral therapists.
- Parental Education: Educating parents and caregivers about the potential complications of constipation is crucial for early detection and prompt intervention.
Investigations
Investigation of Constipation in Children & New Born:
- Abdominal X-ray. This standard X-ray test allows your child’s doctor to see if there are any blockages in your child’s abdomen.
- Anorectal manometry or motility test. In this test, a thin tube called a catheter is placed in the rectum to measure the coordination of the muscles your child uses to pass stool.
- Barium enema X-ray. In this test, the lining of the bowel is coated with a contrast dye (barium) so that the rectum, colon and sometimes part of the small intestine can be clearly seen on an X-ray.
- Rectal biopsy. In this test, a small sample of tissue is taken from the lining of the rectum to see if nerve cells are normal.
- Transit study or marker study. In this test, your child will swallow a capsule containing markers that show up on X-rays taken over several days. Your child’s doctor will analyze the way the markers move through your child’s digestive tract. (4)
- Blood tests. Occasionally, blood tests are performed, such as a thyroid panel.
Treatment
Treatment of Constipation in Children & New Born
- In detail, Two main steps in the management are disimpaction and maintenance therapy.
- Disimpaction require in patients who have a rectal impaction, i.e. presence of a large hard mass of feces on per rectal examination. Rectal impaction is responsible for progressive dilatation of the rectum over time also increased threshold volume for rectal sensation and defecation.
- This ‘clean out’ is essential if maintenance therapy is to be effective.
- The oral route prefer over rectal as it is less invasive. Additionally, total bowel wash is done to clean the entire colon using polyethylene glycol (in other words, PEG) in a dose of 1.5 g/kg/ day for 3-4 days at home. Alternatively, PEG electrolyte solution can give in the dose of 15-40 ml/kg/hr till the rectal output is clear and devoid of solid fecal material. In young children, this should done using a nasogastric tube and in hospital under supervision. The child should fast for PEG administration.
- Intravenous fluids may require in small children during this period to maintain adequate hydration.
- An alternative to oral administration of PEG is the use of phosphate enema or sodium dioctyl sulfosuccinate enema, 30-60 ml/10 kg body weight to a maximum of 120 ml, once or twice daily for 1-2 days. Repeated rectal enemas should avoid in children. The aim of the maintenance phase is to promote regular stooling and prevent reimpaction.
- Success of this therapy define as passage of 1-2 soft stools per day and no soiling. It includes the following components:
- Behavioral training involves establishing a positive routine of sitting on toilet for passing stools after meals regularly (specifically, 2-3 times per day for 5-10 min) and documenting all stool passage. Embarrassment or punishment should avoid.
Dietary changes
- Dietary changes. Furthermore, A nutritious diet with fruit/vegetables and adequate fluids give. A short trial of milk and milk product free diet may done in cases suspected to have milk allergy.
- Regular and tailor-made (as per response) laxative use is the key to success and this should explain to the family. Osmotic laxatives like lactulose (1-3 ml/kg/day) and PEG (0.8-1.0 g/kg/ day) are the first line agents.
- Stimulant laxatives like Senna or Bisacodyl are to use only intermittently as a rescue therapy to avoid impaction. Prokinetics like cisapride are not recommend. In infants, mineral oil also stimulant laxatives should not use.
- Glycerin suppository prefer over enema for impaction in infants. Besides this, Premature withdrawal of medications is a very common cause of relapse.
Prevention
Prevention of Constipation in Children & New Born
- Increasing your fiber intake: Fiber-rich foods, such as fruits, vegetables and whole grains, all help improve gut function. If you have bowel sensitivity, you’ll want to avoid high-fructose fruits, such as apples, pears and watermelon, which can cause gas.
- Getting more exercise: Regular exercise can help keep stool moving through the colon.
- Drinking more water: Aim for eight glasses daily, and avoid caffeine, as it can be dehydrating.
- Go when you feel like it: When you feel the urge to go, don’t wait.(6)
Prognosis
Prognosis of Constipation in Children & New Born
- Most of the children need maintenance therapy for 6-24 months. About 50-60% patients achieve success Diseases of Gastrointestinal System and Liver at 1 yr and 70-80% in the long-term.
- Nearly 50% patients will have a relapse after successful therapy. In nearly one-third patients, constipation persists even after puberty.
Homeopathic Treatment
Homeopathic Treatment of Constipation in Children & New Born:
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.
Which includes
- The medical history of the patient,
- Physical and mental constitution,
- Family history,
- Presenting symptoms,
- Underlying pathology,
- Possible causative factors etc.
A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.
What Homoeopathic doctors do in Constipation in Children & New Born?
A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?
The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.
Homeopathic Medicines for Constipation in Children & New Born
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.
So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).
Medicines for Constipation in Children & New Born:
Nux Vomica – For Ineffectual Urging and Scanty Stool
- Nux Vomica is one of the most effective medicines for constipation cases of insufficient stool with ineffectual urging.
- Child brought up too early on animal food or the nurse takes too much coffee.
- A person who needs prescribing Nux Vomica passes scanty stool, very frequently.
- The stool is unsatisfactory and insufficient.
- Even after passing stool many times a day, there is a never “got done” feeling.
- Abdomen pain may arise along with constipation.
- More importantly, it also effectively treats piles from constipation.
Bryonia Alba – For Dry, Hard, Stool in Lump Form
- For constipation with hard, dry stool that passes in lump form, Bryonia Alba is considered one of the best medicines for constipation.
- The stool is dry, as if burnt, and pass with much difficulty.
- Abdominal distension also note in some cases.
- Headache from constipation may also effectively treat with Bryonia Alba.
- Faeces hard, dry as if burnt and of a dark color, so large as to give great pain in passing; dry lips and mouth.
Alumina – For Constipation with No urge to Pass Stool for Days
- Alumina is another well-known name on the long list of medicines for constipation.
- A guiding feature for the use of Alumina is the absence of the urge to pass stool for days together.
- Inertia of rectum; long-standing cases which resisted other drugs; abuse of farinaceous food; child has to make great effort to pass even a soft stool.
- The person needing Alumina will go days without passing stool.
- The intestine action is extremely sluggish.
- The stool pass only when there is a large accumulation of fecal matter in the intestine.
- Another important symptom for using Alumina is excessive straining to pass stool even when the stool is soft.
- Alumina also one of the majorly indicate medicine for constipation in children, infants, bottle-fed babies and among old age persons.
Lycopodium Clavatum – For Flatulence and Bloating
- Lycopodium Clavatum works wonders in cases where constipation attend with flatulence and a bloated abdomen.
- Lycopodium Clavatum is also the most helpful medicine for constipation in older people.
- It is very useful in irritable bowel syndrome as well.
Silicea – For Constipation where Stool Recedes after being Partially Expelled
- In some constipation cases, the stool known to recede after being partially expelled.
- In such cases, Silicea is the most useful medicine for constipation.
- The stool is soft, needs straining to pass out, but recedes back into the rectum after being partially expelled.
- There is constriction of anus. Exhaustion attends straining efforts to pass stool.
- Burning, smarting pain at the anus may also arise.
- Stools with difficulty force to the very verge of the anus, when they slip back again.
- Rectum inactive; spine weak.
- Child’s head and face perspire copiously directly upon its falling asleep.
Antimonium Crudum- For constipation alternating with diarrhea
- Antimonium Crudum is an effective medicine for constipation which treats soreness of rectum, anal itching, and mucus piles.
- It is extremely useful for alternating constipation and diarrhea.
Podophyllum– Alternating constipation and diarrhea
- Gurgling in bowels, prolapse of the rectum with stool.
- Clay-coloured stool or greenish stool and highly offensive stool.
- Alternating constipation and diarrhea.
- Obstinate constipation following diarrhoea in artificially brought-up children.
- Rolling of head, with moaning during sleep; eyes half open.
Natrum Mur – For Constipation when Stool is passed on Alternate Days
- In cases where stool is passed on alternative days, Natrum Mur is to regular rise bowel movements.
- The attending features are constriction in the rectum, smarting, burning or tearing pain at the anus.
Opium– For Dry, Hard Stool in Ball Form
- Opium work well in cases of constipation where the stool is hard, dry and passed in ball-like form.
- In addition, Opium is also the medicine for constipation where the has been taking laxatives to pass stool for a long time.
Calcarea carb – for Constipation in Children & New Born
- Hard, undigested, chalky stools of a light color.
- Poorly developed bones.
- Dry scald head.
Chamomilla
- Constipation during dentition.
- Excessive dryness of faeces.
- Crumbling during stool, from inactivity of anus.
Causticum – for Constipation in Children & New Born
- Timid children afraid to go to bed alone.
- Abdomen swollen.
- Hard; knotty stool, like sheep’s dung, with red face from straining; nocturnal enuresis.
Diet & Regimen
Diet and Regimen
Regimen and diet for constipation in children
Diet for Constipation in Children:
- Fiber Power:
- Older children: Increase their intake of age-appropriate high-fiber foods like fruits (pears, berries, prunes), vegetables (broccoli, peas), and whole grains (whole-wheat bread, brown rice).
- Babies (over 6 months): Offer pureed fruits and vegetables rich in fiber, such as prunes, pears, and sweet potatoes.
- Hydration Heroes: Ensure your child drinks plenty of fluids. Water is best, but diluted prune juice can also be helpful for older babies and children.
- Limit Constipating Foods: Reduce or avoid foods that can contribute to constipation, like processed foods, dairy products (cheese, yogurt), and bananas.
Diet for Constipation in Newborns:
- Breastfeeding: For exclusively breastfed babies, constipation is less common. Ensure the mother stays well-hydrated.
- Formula-fed babies: Sometimes, the type of formula can contribute to constipation. Your pediatrician may recommend switching formulas.
Regimen for Constipation in Children:
- Potty Training Power: If your child is potty training, encourage regular bathroom breaks and a relaxed approach to avoid withholding.
- Tummy Time: For babies, encourage tummy time to help with digestion and bowel movements.
- Movement and Exercise: Encourage physical activity and play to help stimulate bowel movements.
- Massage: Gentle tummy massages can help relieve discomfort and encourage bowel movements in babies.
Regimen for Constipation in Newborns:
- Bicycle Legs: Gently move your baby’s legs in a bicycling motion to help stimulate their bowels.
- Warm Bath: A warm bath can help relax your baby’s abdominal muscles.
Do’s and Don'ts
The Do’s and Don’ts
Constipation in children and newborns is a common issue, but it can be uncomfortable and distressing for both the child and parents. Understanding the do’s and don’ts can help manage and prevent constipation effectively.
Do’s:
- Increase Fiber Intake: Offer high-fiber foods like fruits (prunes, pears, apples), vegetables (broccoli, peas, beans), and whole grains (whole-wheat bread, oatmeal).
- Ensure Adequate Hydration: Offer plenty of fluids like water, clear broth, and diluted fruit juices (prune juice can be helpful).
- Establish a Toilet Routine: Encourage your child to sit on the toilet for a few minutes after meals, even if they don’t feel the urge to go.
- Encourage Physical Activity: Regular exercise can help stimulate bowel movements.
- Respond Promptly to Urges: Teach your child not to hold in their stool when they feel the need to go.
- Create a Relaxed Toilet Environment: Make sure the bathroom is comfortable and inviting for your child.
- Offer Positive Reinforcement: Praise your child for using the toilet and trying to have a bowel movement.
- Consult a Doctor: If constipation persists or is severe, seek medical advice for further evaluation and treatment.
Don’ts:
- Avoid Force Bowel Movements: Don’t pressure or punish your child for not having a bowel movement.
- Do not Overuse Laxatives without consulting a doctor: Laxatives should only be used under medical supervision, as they can have side effects and may not be appropriate for all children.
- Don’t Ignore the Problem: If constipation is persistent or accompanied by other symptoms, seek medical help.
- Avoid Restrict Fluids: Adequate hydration is essential for preventing and managing constipation.
- Do not Offer Excessive Dairy: Too much dairy can contribute to constipation in some children.
- Don’t Discourage Toilet Use: Make sure your child feels comfortable and safe using the toilet.
Additional Tips for Newborns:
- Massage: Gently massage your baby’s tummy in a clockwise direction to stimulate bowel movements.
- Bicycle Legs: Gently move your baby’s legs in a bicycling motion to help relieve gas and promote bowel movements.
- Warm Bath: A warm bath can help relax the muscles and encourage bowel movements.
Remember: It’s important to consult with your pediatrician or healthcare provider for personalized advice and treatment options, especially for newborns and young children. They can assess your child’s specific needs and recommend the best course of action.
Disclaimer: This information is not intended to be a substitute for professional medical advice. Always consult with a qualified healthcare provider for any questions you may have regarding constipation or any other health concern.
Terminology
Terminologies:
- Constipation: Infrequent or difficult bowel movements, often characterized by hard, dry stools.
- Functional Constipation: Constipation without an identifiable underlying medical cause.
- Organic Constipation: Constipation caused by an underlying medical condition (e.g., Hirschsprung’s disease, hypothyroidism).
- Encopresis: Repeated soiling of underwear with stool, often associated with chronic constipation.
- Fecal Impaction: A large, hard mass of stool that gets stuck in the rectum and cannot be passed.
- Disimpaction: The process of removing a fecal impaction, often involving enemas or manual removal.
- Laxatives: Medications that help to soften stools and promote bowel movements.
- Enemas: Liquid solutions introduced into the rectum to soften stools and stimulate bowel movements.
- Bowel Retraining: A therapy that teaches children how to recognize and respond to the urge to defecate.
General Terminologies:
- Stool: Another word for feces or bowel movement.
- Bowel Movement: The act of passing stool.
- Straining: The effort involved in trying to pass stool.
- Painful Defecation: Discomfort or pain experienced during bowel movements.
- Bristol Stool Chart: A visual guide that classifies stool types based on their shape and consistency.
- Dietary Fiber: A type of carbohydrate found in plant-based foods that helps to add bulk to stools and promote regularity.
- Hydration: The process of drinking enough fluids to maintain proper bodily functions, including bowel movements.
- Toilet Training: The process of teaching a child to use the toilet for bowel movements.
Additional Terms:
- Neonatal Constipation: Constipation in newborns, often due to immaturity of the digestive system.
- Infant Dyschezia: Straining and crying during bowel movements in infants, even though the stool is soft.
- Idiopathic Constipation: Constipation with no known cause.
- Chronic Constipation: Constipation lasting for several weeks or months.:
Homeopathic Terminologies:
- Similia Similibus Curentur: This Latin phrase, meaning "like cures like," is the fundamental principle of homeopathy. It indicates that a substance that can cause symptoms in a healthy person can cure similar symptoms in a sick person when administered in a highly diluted form.
- Repertory: A comprehensive index of symptoms and the corresponding homeopathic remedies known to address those symptoms. Homeopaths use repertories to identify potential remedies based on the specific symptom picture of the individual.
- Materia Medica: A collection of detailed descriptions of the therapeutic properties, symptom pictures, and potential applications of homeopathic remedies. Homeopaths consult materia medica to understand the characteristics of various remedies and their suitability for specific cases.
- Potency: The strength or dilution of a homeopathic remedy. Homeopathic remedies are prepared through a process of serial dilution and succussion (vigorous shaking). The potency indicates the number of dilutions and succussions the remedy has undergone.
- Constitutional Remedy: A homeopathic remedy chosen based on the individual’s overall physical, mental, and emotional characteristics, rather than solely on the specific symptoms of constipation. Constitutional remedies aim to address the root cause of the imbalance and promote overall well-being.
- Acute Remedy: A homeopathic remedy selected to address the immediate symptoms of constipation. Acute remedies are typically chosen based on the specific presenting symptoms and may be used in conjunction with a constitutional remedy.
- Aggravation: A temporary worsening of symptoms after taking a homeopathic remedy. Homeopaths often view a slight aggravation as a positive sign, indicating that the remedy is stimulating the body’s healing response.
- Amelioration: An improvement in symptoms after taking a homeopathic remedy. Homeopaths monitor the amelioration of symptoms to assess the effectiveness of the chosen remedy.
Remedy-Related Terminologies:
- Alumina: A homeopathic remedy often indicated for chronic constipation with dry, hard stools that are difficult to expel.
- Bryonia Alba: A remedy for constipation with hard, dry stools, thirst, and a tendency to worsen with movement.
- Nux Vomica: A remedy for constipation with frequent, ineffectual urges to defecate, irritability, and a feeling of incomplete evacuation.
- Opium: A remedy for constipation with a lack of urge to defecate, a feeling of paralytic inaction in the intestines, and abdominal distension.
- Lycopodium Clavatum: A remedy for constipation with abdominal bloating, gas, and a craving for sweets.
References
Reference
- Causes and Risk Factors of Constipation in Children | Download Scientific Diagram (researchgate.net)
- Pathophysiology of functional constipation in children – DNB Pediatrics
- Symptoms & Causes of Constipation in Children | NIDDK (nih.gov)
- Constipation in children – Diagnosis and treatment – Mayo Clinic
- Constipation in children – Differential Diagnosis (epocrates.com)
- Constipation: Causes and Prevention Tips | Johns Hopkins Medicine
- Khanna, P., et al. (2010). Etiology and Clinical Spectrum of Constipation in Indian Children. Indian Pediatrics, 47(12), 1025-1029.
- Poddar, U. (2016). Approach to Constipation in Children. Indian Journal of Pediatrics, 83(4), 319-327.
- Singh, P., et al. (2022). Constipation in children: incidence, causes in relation to diet pattern and psychosocial aspects. International Journal of Contemporary Pediatrics, 9(9), 1676-1680.
- "Nelson Textbook of Pediatrics," 21st Edition (2020), edited by Robert M. Kliegman, et al., and published by Elsevier. This renowned textbook provides a comprehensive overview of pediatric health and diseases, including the pathogenesis of constipation in children and newborns.
- Nelson Textbook of Pediatrics, 21st Edition (2020), edited by Robert M. Kliegman, et al., and published by Elsevier. This textbook provides a detailed discussion of the clinical features of constipation in children and newborns, including the red flags that may indicate an underlying organic cause.
Wyllie, R., Hyams, J. S., Kay, M. (Eds.). (2016). Pediatric Gastrointestinal and Liver Disease (5th ed.). Elsevier.
Nurko, S., & Rudolph, C. D. (Eds.). (2016). Rudolph’s Pediatrics (23rd ed.). McGraw Hill.
Also Search As
Also Search As
Online Resources:
- Search Engines: Use search engines like Google, Bing, or DuckDuckGo with keywords such as "constipation in children," "infant constipation," or "newborn constipation."
- Reputable Health Websites: Look for information on websites of well-known medical organizations like the Mayo Clinic, Nationwide Children’s Hospital, or HealthyChildren.org (from the American Academy of Pediatrics).
- Medical Databases: If you have access, you can search medical databases like PubMed for scholarly articles on constipation in children and newborns.
Books and Publications:
- Pediatric Textbooks: Look for information in standard pediatric textbooks like "Rudolph’s Pediatrics" or "Nelson Textbook of Pediatrics."
- Parenting Books: Many parenting books have sections on infant and child health, including constipation.
Healthcare Professionals:
- Pediatrician: The best source of information and treatment for constipation in children and newborns is their pediatrician. Don’t hesitate to consult with them for accurate diagnosis and personalized guidance.
- Other Specialists: Depending on the suspected cause of constipation, you may be referred to a pediatric gastroenterologist or other specialists.
Additional Tips for Searching:
- Be Specific: Use specific keywords to narrow down your search results. For example, search for "constipation in breastfed newborns" if that’s your specific concern.
- Check Credibility: Ensure the information you find comes from reputable sources like medical organizations, hospitals, or academic institutions.
- Ask for Help: If you’re having trouble finding information or are unsure about what you’ve found, don’t hesitate to ask your pediatrician for guidance.
Frequently Asked Questions (FAQ)
What causes constipation in children?
Causes
Constipation in children can be caused by dietary factors (low fiber, dehydration), toilet training issues, psychological factors, slow colonic transit, and dysfunctional defecation. In some cases, it may be due to an underlying medical condition.
How is constipation treated in children?
Treatment for constipation in children often involves increasing fiber and fluid intake, establishing a toilet routine, encouraging physical activity, and addressing any underlying medical conditions. Laxatives may be recommended under medical supervision.
Can constipation be prevented in children?
constipation can often be prevented by ensuring a diet rich in fiber and fluids, encouraging regular physical activity, and promoting healthy toilet habits.
When should I see a doctor for my child’s constipation?
If your child’s constipation is persistent, severe, or accompanied by other symptoms like abdominal pain, blood in the stool, or vomiting, consult a doctor promptly.
Is homeopathic treatment safe for newborns and infants?
Yes, homeopathic remedies are generally safe for newborns and infants when prescribed and administered by a qualified homeopathic practitioner. The remedies are highly diluted and do not cause any side effects.
What are the signs of constipation in children and New borns?
Signs of constipation in babies include infrequent bowel movements (less than three per week), straining and crying during defecation, hard pellet-like stools, abdominal distension, and poor feeding
Can homeopathy help with constipation in babies and children?
Yes, homeopathy offers gentle and effective remedies for constipation in babies and children. Homeopathic remedies aim to address the root cause of constipation, whether it’s due to dietary factors, emotional stress, or underlying health conditions.
How long does it take for homeopathic remedies to work for constipation?
The response time to homeopathic treatment varies depending on the individual and the severity of constipation. Some children may experience relief within a few days, while others may require longer-term treatment.
Which homeopathic remedies are commonly used for constipation in children?
Homoeopathic Medicines
Several homeopathic remedies are known to be effective for constipation in children, including Alumina, Bryonia, Nux Vomica, Opium, and Lycopodium. The choice of remedy depends on the specific symptoms and individual characteristics of the child
How does homeopathic treatment for constipation differ from conventional treatment?
Homeopathic treatment focuses on stimulating the body’s natural healing abilities and addressing the underlying cause of constipation. Unlike conventional laxatives, which may have side effects, homeopathic remedies are gentle and aim to restore balance in the digestive system.