The famous pediatrician Dr. Komarovsky describes constipation in children as irregular, untimely or difficult bowel movements. In the latter case, the process of defecation gives the baby quite unpleasant, sometimes even painful sensations. And if a child does not poop on time, colic, gas, bloating and other troubles begin to bother him. The baby may not have a bowel movement every day. It is important to monitor his condition. If the child is breastfed and walks “largely” once every 1-3 days, and is cheerful, cheerful, and feels good, there is no need to panic. This means that mother’s milk is suitable for him and is completely digestible. But if you notice painful constipation in a baby, Komarovsky strongly advises taking action immediately.
Komarovsky video: Constipation
BE SURE TO WATCH THIS VIDEO IN FULL.
Komarovsky defines constipation in newborns as rare cases of bowel movements that cause poor health and discomfort.
Often inexperienced parents begin to sound the alarm if they don’t like the consistency, color, appearance baby chair. But the pediatrician insists that a breastfed baby may have completely different indicators. And this is not a problem if he is gaining weight and developing normally. Komarovsky comments on constipation in the video in this way: constipation cannot be the only symptom of the disease; if it is present, it will be expressed in other signs. You should definitely be alert to a bloated stomach, behavioral disturbances, and difficulty swallowing. You should start fussing when the child does not poop and feels unwell. In other cases, wait patiently until everything happens by itself.
If your baby still has constipation, Komarovsky advises, first of all, to review the diet of the mother if she is breastfeeding, and of the child if he is already receiving complementary foods. Some foods may be poorly absorbed by the child's body. The child needs to get enough fluid, it stimulates peristalsis and helps remove everything unnecessary from the intestines. Due to lack of water, feces become dense, move through the intestines with difficulty, scratch the walls, thereby causing a lot of trouble for the baby. If a child receives complementary foods, his diet should contain a sufficient amount of fiber: vegetables, fruits, wholemeal bread, cereals.
Komarovsky recommends under no circumstances stimulating the intestines with soap, a thermometer or other improvised means. Komarovsky allows children to treat constipation independently using two medications: lactulose syrup and glycerin suppositories. The syrup helps to increase the volume of feces and their excretion, and also stimulates the proliferation of beneficial microflora in the intestines. And candles with glycerin are much safer and softer than, say, a bar of soap shoved up a child’s butt. If the two methods mentioned above do not help, then you should urgently go to the doctor.
And once again, the pediatrician reminds that constipation can be treated without consulting a doctor only when it is the only symptom.
Komarovsky interview: Constipation
We strongly recommend that you watch the entire video online, which is located on this same page. It goes into more detail about the problem of constipation. The article displays the main points that Evgeniy Olegovich highlights, which parents should know first of all. In addition, you can read books by Dr. Komarovsky, where you can highlight a lot of new and useful things for yourself. The problem of constipation is described in detail in the book “The Health of the Child and the Common Sense of His Relatives” in the chapter “Constipation”.
Let's start with a definition taken from the Encyclopedic Dictionary of Medical Terms. So, " CONSTIPATION
- slow, difficult or systematic insufficient bowel movement
"Having decided, we will try to understand the essence of the problem, which is very relevant for thousands of people of all ages.
Attitudes towards constipation - their danger to health and the intensity of treatment methods - are largely determined by a person’s age. Of fundamental importance is the fact that serious causes - congenital disorders of the intestinal structure or metabolism, are usually detected in the early childhood. If a person is over three years old and, at least outwardly, looks healthy - he is not dystrophic, is not severely obese, is appropriate for his age mental development- the likelihood that the cause of constipation is associated with any congenital anomalies is extremely low.
The main takeaway from the previous paragraph is that constipation in early childhood should be taken much more seriously than throughout the rest of childhood. human life, since it is during this time period that one should ensure that there are no serious causes for concern.
By and large, in children of the first year of life, only one disease is serious and dangerous cause constipation is Hirschsprung's disease (H. Hirschsprung, 1830-1916, Danish physician who described this disease). The essence of the disease is that nerve cells in one of the intestinal areas are not developed. The reason is a violation of the development of embryonic tissue, and no one knows for sure why this happens. It is clear that if nerve cells in a certain area of the intestine do not function correctly, then this area itself does not function correctly. With Hirschsprung's disease, the “irregularity” is manifested in the fact that the affected area of the intestine is in a constant state of contraction - feces accumulate over it and, quite naturally, constipation occurs. Treatment of Hirschsprung's disease is only surgical. The purpose of the operation is to remove a non-functioning section of the intestine, and the complexity of the intervention is obvious, especially taking into account the fact that children in the first year of life have to be operated on. But without surgery a person is doomed.
Fortunately, Hirschsprung's disease does not occur very often (one case in 2 - 5 thousand newborns). That's why 99% of childhood constipation and almost 100% of adult constipation are not life-threatening, although they can really darken this very life.
It should always be remembered that through individual labor activity, i.e., without the help of a doctor, it is quite difficult to establish the cause of constipation. In the end, constipation is often not an independent disease, but only a symptom of another disease - peptic ulcer, hemorrhoids, pancreatitis, cholecystitis, thyroid dysfunction, etc. At the same time, and this happens quite often, the most profound examination does not reveal the cause of constipation. By the way, this is the one the cause is much more often undetected than discovered. But making therapeutic attempts to eliminate constipation - be it special diet, enemas or laxatives - you should always be sure that there is nothing more serious. From here it is a completely logical conclusion: contacting a specialist doctor (gastroenterologist) will always be useful.
It is quite obvious that if the examination reveals a specific disease, then the main therapeutic efforts should be aimed not at saving from constipation, but at treating the specific disease. But if you haven’t found anything, then this article may well be useful to you - if you decide to self-medicate, then at least try not to do anything stupid and know, as the great proletarian poet used to say, “what is good and what is bad” .
1. Constipation is bad. No problem, no tragedy. Trouble. You can help yourself or your child. But how?
2. There are two most important conditions for the normal functioning of the intestines. Providing the body, firstly, with a sufficient amount of fluid and, secondly, with a sufficient level of potassium. If a person loses a lot of fluid, the functioning of intestinal juices is disrupted. This may be, for example, at high body temperature due to some infectious disease or due to dryness and high temperature ambient air. Plus, the habit of drinking boiled water, generated by the fear of becoming infected and poisoned. Nobody argues that boiled water is better than water from a tap, but we must not forget that boiled water does not contain mineral salts. Potassium for the intestines is like gasoline for a car. With a lack of potassium, intestinal contractions (the so-called peristalsis) sharply weaken, and this may well be the cause of constipation. The most potassium is found in raisins, dried apricots, prunes, and figs. If you already drink boiled water, eat the indicated foods, or even better, cook compote and drink for your health. Parents, remember: overheating and boiled water are the main causes of constipation in infants. The best drink for infants is raisin decoction. One tablespoon of raisins per glass of boiling water is best steamed in a thermos.
3. Principles of diet therapy
are as follows. Foods rich in protein are undesirable - chocolate, cottage cheese, nuts. Desirable - yoghurts, one-day kefir and yogurt. Brown bread is better than white bread. Apple juice better than a whole apple. In general, when constipation vegetarianism is very good. By the way, drinking one glass of yogurt + 20 steamed prunes at night allows you to get rid of constipation in 25% of cases without any other medications. In any case, remember: does not happen with constipation, it is absolutely possible and absolutely impossible. It is always advisable to solve the problem and not spoil yourself or your child’s life with eternal diets.
Therefore, if you really want to, then you can.
4. From laxatives, permissible for use without the advice of a doctor, we note two groups of medications. Firstly, liquid oils (castor, almond, olive, vaseline) and, secondly, mild laxatives containing senna (senna leaves, senadexin, senade, glacsena, regulax). The essence and rules for using these drugs are as follows:
it is necessary to ensure that there is a bowel movement at least once a day and at a certain time. It's best in the morning, before breakfast and before everything else. In short, it’s better to start the day with this - get out of bed and sit on the potty (an option is to visit the toilet);
Before going to bed you take 1/2 tablet, for example, Senadexine. It is quite possible that this dose will be enough for you. If the usual problems arise in the morning, increase the dose. The task is to find the minimum dose at which going to the toilet in the morning will not be a challenge for you. Let’s make a reservation right away: if you follow the principles of diet therapy described above, do not overheat and consume a sufficient amount of potassium-containing foods, and taking two tablets of Senadexin at night for three days does not eliminate constipation, all attempts at self-medication must be stopped immediately and, if you want, or you don’t want to, but go to the doctor. In any case, do not exceed a dose of two tablets at night;
Having selected the dose, maintain it for about 10-14 days. It is important not only to achieve regular bowel movements, but also to form a reflex in the body to empty the bowel at a strictly defined time. Then, slowly, begin to slowly reduce the dose (a quarter of a tablet every 3-4 days), in no case stopping immediately. If problems arise when reducing the dose, return to the previous amount of the drug.
5. We should not forget that the treatment of constipation, as well as the treatment of any disease, must be comprehensive. They don't teach this in newspapers, they teach this in medical school. The arsenal of remedies that a doctor can prescribe for constipation goes far beyond just taking laxatives - these include drugs that reduce intestinal tone, enzyme agents, so-called eubiotics, and much more.
6. A common cause of constipation is hemorrhoids and fissures in the anus, when you are ready to go to the toilet at least three times a day, but it’s so scary that you endure until the last. In this situation, in addition to specific treatment, it is very good effect provide suppositories with glycerin And candles with sea buckthorn oil
. By the way, suppositories with glycerin
- one of the most accessible and safe ways to combat constipation in children of the first year of life. At the very least, these suppositories should be used before giving your child an enema.
7. In addition to the problems with the process itself, mentioned in paragraph 6, problems often arise with the place where this process takes place. The toilet itself - its location, temperature, presence of a queue, sanitary conditions, odors and much more - may well be the cause of constipation, but not at the level of the intestines, but at the level of the head. Of course, we don’t always have at hand, or rather under our buttocks, a warm toilet in an isolated apartment, but at least we simply must take this fact into account before rushing to the pharmacy for castor oil.
The essence of this article is as follows. Constipation is very common pathological condition, most often caused not by serious disorders in the body, but by a simple misunderstanding that not going to the toilet for three days is wrong and that the frequency of bowel movements must be monitored. Constipation is a disease of civilization, its components are stress, lack of rough food in the diet, boiled water, unattractive-looking toilets. But, unlike many other diseases, constipation in the vast majority of cases is quite treatable, and the remedies used for this are quite safe. So maybe try?
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I think that every mother, over the course of months... or even years, will receive a colossal amount of knowledge about what size, weight, color, smell, volume a child's poop should be and how many times he should go to the toilet. But at the beginning of this journey, young mothers know nothing about this and the absence of poop in diapers or a diaper for a day or (Horror!) several days leads them to horror and panic. But is it worth worrying in all cases?
I think Dr. Komarovsky’s explanations about constipation in infants will be very useful to them.
Komarovsky about constipation in infants
In each of his communications with the parents of infants, Dr. Komarovsky repeats over and over again - the absence of stool in a baby for even a few days is not a reason to worry. This only indicates that mom's milk is completely digestible the baby's body.
So, once again, stool frequency, how often a child has bowel movements, is not an indicator of constipation. Rare bowel movements are not a cause for concern. With one caveat - the absence of stool is not considered constipation if the child does not show anxiety, does not refuse to eat and as long as bowel movements occur calmly - without pain and crying of the baby.
According to Komarovsky, the absence of bowel movements for up to 5 days, if the child does not have any other behavioral abnormalities or other symptoms, is not constipation. And even the absence of stool for up to 8 days for newborns and infants not receiving complementary foods or artificial nutrition, can also be normal.
What then is considered constipation in a baby?
Video - Why does a breastfed baby rarely poop - Komarovsky
You can easily tell if your baby is constipated because your baby will feel pain or discomfort during bowel movements. They will strain and strain, even cry. And the poop will be drier and tougher than usual, often like small dry balls or pellets. Sometimes you can see small drops of blood or small cracks in the delicate skin - due to damage to the anus during the passage of hard feces. And it hurts so much.
If this happens, you can very carefully lubricate the anus with sea buckthorn oil or aloe juice.
The only laxatives that Dr. Komarovsky recommends in case of actual constipation in a baby are Glycerin suppositories (choose in the form for children) and Lactose - a probiotic with lactobacilli. These drugs are sold in pharmacies without prescriptions and are recommended infants doctors from all countries.
In the video below, Dr. Komarovsky talks about constipation in infants and the norms of bowel movements for babies.
At birth, the baby's organs and systems are in the process of formation; they continue to develop throughout the first year of life. The imperfection of the gastrointestinal tract makes it vulnerable to various disorders. What to do if the baby cannot go big?
To find out whether the baby really has problems with bowel movements, it is necessary to monitor the frequency of stool, the consistency and color of the stool.
- Defecation should not cause discomfort to the child. Anxiety, severe straining and crying signal constipation, the treatment of which cannot be delayed;
- For infants, the norm is 4-10 bowel movements per day. This number is decreasing every month, one year old child I have bowel movements once a day now. But even if the baby does not have daily bowel movements, this may not indicate the presence of pathologies;
- The consistency of stool in infants in the first month of life is soft and mushy. With age, it gradually approaches the “sausage” shape;
- The color of feces is influenced by the baby's diet. Before the introduction of complementary foods, the stool is yellow in color, and after it is brown.
So, the following signs indicate constipation: stool less than once a day, while the baby shows anxiety, refuses to eat, cries, and sleeps poorly.
Vomiting and bloating may occur. IN in this case The act of defecation is hampered by the high density of feces.
Possible causes of colic and constipation in newborns
What to do for constipation in newborns
- First of all, it is necessary to eliminate the most obvious reasons digestive disorders: adjust the mother’s diet if breastfeeding or replace formula milk with artificial milk. It is important to maintain a drinking regime. A negative reaction of the body can also be caused by too early or incorrect introduction of complementary foods;
- If the situation does not change in better side, to exclude diseases, you need to be examined by a gastroenterologist, endocrinologist, or neurologist. If pathologies are detected, the doctor will give the necessary recommendations that should be followed;
- Place your baby on his tummy more often. You can apply a slightly warmed diaper to your stomach. The warmth of the mother's body also has a positive effect;
- The problem of constipation in children 6-8 months old can be solved with the help of fruit puree from plums, apricots, peaches, apples, as well as freshly squeezed juices diluted with water, a decoction of a mixture of dried fruits. Start with a teaspoon and, based on the result, determine the optimal dose.
How to give an enema to a newborn baby with constipation
Before you begin the procedure, prepare everything you need:
- a small pear-shaped can with a soft tip. As a rule, pharmacies offer the following types of devices: No. 1 for newborn babies and No. 2 for infants;
- boiled water 24-25 degrees. Too cold a liquid can cause a spasm, and a warm liquid will not have the desired effect. You can add a spoonful of chamomile infusion;
- baby cream or Vaseline, hemp oil for lubricating the anus and the tip of the balloon;
- oilcloth and clean diaper;
- For convenience, you can use a diaper.
How to give your baby an enema? Here are the detailed instructions:
How to give a tummy massage to a newborn with constipation
The massage procedure should be carried out several times a day; one-time manipulations will not give the desired effect.
Preparation:
- so as not to damage delicate skin baby, cut your legs short, keep your hands clean;
- the room should have a comfortable temperature;
- Apply a little oil or cream to your palms and rub to distribute it evenly;
- so that excess air comes out of the stomach, hold the baby in a “column”;
- after feeding, at least an hour should pass so as not to provoke vomiting;
- The surface on which the child lies should be moderately hard and provide back support.
Perform the massage when the baby is relaxed and in good mood, in this case, his abdominal wall remains relaxed and the impact will be most effective.
Correct massage technique
Simple manipulations can enhance the ability of the smooth muscles of the gastrointestinal tract to contract and facilitate the elimination of gases and feces. The duration of the session should not exceed ten minutes.
Follow the following sequence of actions:
- place the baby on his back;
- lightly stroke the tummy clockwise 10 times;
- place your wrist on the navel area, use the other palm to make spiral movements, applying light pressure;
- left and right side Massage the abdominal wall a little more intensely;
- in the lower abdomen, where the large intestine is located, work with your fingertips, repeating the outline of the letter “P”;
- make soft vibrating movements and light thrusts;
- Turn the baby over onto his tummy and stroke him along the back, starting from the shoulder blades and ending with the sacral area.
Important nuances
Having decided to fight constipation with the help of massage, you need to consider in what cases it is prohibited to do so as not to harm your health.
You should refuse massage if:
- the child is lethargic, his face is pale;
- there are rashes or lesions on the skin;
- blood is visible in the feces;
- constipation is accompanied by hyperthermia;
- the stomach is very tense, swollen on one side;
- When you touch the belly, the baby begins to cry.
Medicines
For systematic stool retention, medications are prescribed. Therapy will be the same for both breastfeeding and artificial feeding.
- For children under one year of age, products containing lactulose, such as Duphalac syrup, are suitable. The drug is not addictive, the maximum single dose is five milliliters;
- Babies older than six months can be given the mild laxative Forlax;
- You can also use glycerin suppositories to promote bowel movements;
- Irritating laxatives and salt osmotic agents for children less than a year old contraindicated.
It is important to remember that the use of medications for constipation should not become regular. It is necessary to identify the cause of intestinal dysfunction and eliminate it.
What does Komarovsky recommend if a newborn has constipation?
Dr. Komarovsky gives several tips to help alleviate the baby's condition. If these measures do not help, you should contact a specialist.
What to do if your baby is constipated?
- do the “bicycle” exercise: take turns bending the child’s legs 10 times;
- place the baby in a warm bath;
- massage the baby's tummy, cover with a warm diaper.
Prevention
- The main method of prevention is proper nutrition nursing mother and child. If there is a predisposition to stool retention, the mother should regularly eat beets, prunes, and apricots. But baked goods, flour and fatty foods will have to be limited;
- If constipation recurs frequently, use a special formula for feeding;
- The baby must move, spend enough time on fresh air;
- The emptying procedure should take place in a calm environment, preferably at the same time.
Eliminating constipation requires an integrated approach. It is necessary to follow your doctor's recommendations and give your child medications only under the supervision of a specialist. It is important to monitor your diet and sufficient fluid intake to prevent bowel dysfunction.
And some more information about constipation in newborns is in the next video.
All parents have encountered. At such moments, it is necessary to understand what type of problem the child has and what provoked it. To do this, you need to consult a doctor and read information about constipation in infants from Komarovsky.
Is an incomplete or irregular act of defecation. Most often this problem occurs in children in the first year of life.. This is due to poor functioning of the intestinal tract and causes discomfort to the baby and his parents.
Difficulty in defecation can be determined by several signs.
These include:
The main thing is to clearly understand what to do for constipation in a child under one year old according to Komarovsky, as well as according to the recommendations of the local pediatrician. You should not self-medicate.
Reasons for its development
Dr. Komarovsky says the following about constipation in children: “The main reasons for difficult passage of feces is the lack of fluid and potassium in the growing body.”
During dehydration, stool becomes dry and makes bowel movements difficult.. Lack of potassium in a growing body (especially in the first years of life) negatively affects the wave-like contraction of hollow tubular organs and prevents the movement of their contents into the outlet openings. This phenomenon makes it difficult to pass feces.
What the doctor says about constipation in children
Dr. Komarovsky tells what to do for constipation in a baby during breastfeeding and artificial feeding as follows.
In infants
First of all, it is necessary to avoid dehydration of a small, fragile child.. To do this, it is enough to feed him at the allotted time and, if necessary, supplement with warm raisin water (this must be done especially when artificial form feeding). Plain boiled water is not suitable for soldering, since after heat treatment there are few minerals left in it that are useful for a growing organism.
Important! To maintain the required amount of potassium (with the permission of the pediatrician), compotes of raisins, prunes and figs should be introduced. This drink will help your baby cope with constipation.
You also need monitor the humidity and temperature in the room, because this directly affects the baby’s stool.
For supporting necessary conditions You need to wet clean the room more often and ventilate it.
Try not to overheat your baby by dressing him too warmly.. In small children, body thermoregulation is poorly adjusted, and therefore children cannot control it on their own.
To do this, dress children in accordance with the air temperature and let them take air baths more often (the child must be completely undressed).
For proper fecal exit, you should to walk outside(at least 2 times a day for 30 minutes) and do gymnastics in the morning.
The main thing is to know what to do if a one-year-old child has constipation. Komarovsky recommends not to panic and follow the instructions.
In older children
Older babies are also susceptible to constipation. Some of their causes are similar (dehydration or lack of potassium). However, during this period the reasons become more numerous.
Dr. Komarovsky believes that constipation in children 2 years old may arise due to psychological factors. This happens when the baby feels pain or discomfort when going to the toilet and subsequently tries to restrain the waste of feces. So he tries to avoid discomfort related to going to the toilet.
This is how psychological constipation manifests itself in a 2-year-old child. Komarovsky recommends that in such situations, try to explain to the baby that going to the toilet can cause great inconvenience. If you cannot solve the problem on your own, then you need to consult a psychologist.
Irregular and unhealthy diet may cause constipation. Nutrition should be complete and combine the daily intake of fats, proteins and carbohydrates. If the problem arose for this reason, then the child’s nutrition should be normalized and provided required quantity liquids.
Some medications can cause constipation.
To prevent this from happening, it is necessary to give children drugs during treatment that restore intestinal function (Lactofiltrum, Linex, etc.).
They can also make it difficult to pass stool. congenital or acquired diseases autoimmune, neurological and endocrine systems.
For treatment, you will first need to cure the disease, and only then treat constipation. Therapy should be carried out under the supervision of a physician.
Important! Komarovsky calls for entrusting the treatment of constipation in children 2 years of age and older to specialists after passing all necessary tests. This is due to the fact that constipation can be caused by various factors, which a person without a medical education cannot determine on his own.
Preventive measures during pregnancy
During pregnancy, many women do not realize that they can solve the problem of constipation in themselves and their unborn baby in advance. For this you need to eat healthy and fresh food.
- The expectant mother needs to drink a sufficient amount of fluid (in the absence of swelling of the extremities).
- Eating all types of nuts is encouraged, with the only exception being walnuts.
- In the morning you should definitely eat porridge with dried fruits (prunes, dried apricots, raisins).
- Vegetables can be eaten in any form.
- Meat must be present in the diet, boiled eggs, cereals.
- You should eat fresh fruit every day.
Komarovsky also believes that constipation in a baby with mixed feeding can be avoided by proper nutrition of the woman during pregnancy.
Treatment of a child 1-5 years old according to Komarovsky
If your child becomes constipated, the first thing you should do is adjust lifestyle and nutrition. If you reach desired result If it doesn’t work out, you will have to use medications.
The most effective and well-known drugs are considered "Dufalak", "Normaze" and "Lazilak". These medicines can be used in young children.
Elimination of constipation occurs in courses and in stages. Dr. Komarovsky recommends starting with 2 ml and gradually increasing the dose to 5 ml.
Peculiarities! If, due to difficulty in passing feces, the baby has cracks near the anus, then it is better to use glycerin or sea buckthorn suppositories. This will reduce pain during bowel movements.
Prevention of constipation in children
It is no secret that it is better to avoid a problem than to deal with it in the future. That's why performing simple rules, parents can relieve their baby from constipation.
