Coping with constipation in babies and toddlers
A healthy stool pattern can be a sign of nutritional and developmental health, and many new parents find themselves anxiously monitoring their baby’s bowel movements quite closely! Constipation is a fairly common complaint in babies and toddlers, and makes life uncomfortable for your little one and stressful for you.
How common is constipation?
Be careful of comparing your child’s stool patterns with other children’s, as “normal” bowel movements can range from anywhere between 5-40 times a week for an infant, and 4-21 times a week for a toddler. The best way to pinpoint constipation is a significant change in your child’s own stool pattern, along with symptoms such as hard or painful bowel movements, soiled pants, and distended bellies. Childhood constipation is a common complaint, with an estimated 20-30% of South African children struggling with it at least once in their lives. This is much higher than the international figure (about 12%).
Causes of childhood constipation can be organic (resulting from an underlying illness or anatomical malformation) or functional/non-organic (resulting from lifestyle and psychological causes). Don’t forget that medications can also cause constipation – if your little one is on a course of opiates, phenobarbital, sucralfate, or antacids, rule these out before investigating other causes.
Organic causes of childhood constipation
Organic causes only account for about 5% of childhood constipation, and include anatomic malformations (such as an anal mass), metabolic disorders, neuropathic conditions (such as Hirschprung’s), muscle disorders, and connective tissue disorders (such as scleroderma). Constipation is seldom the only symptom of these illnesses, so if there are additional worrying signs such as fever, explosive diarrhoea, bloody stools, nausea or vomiting, drastic weight changes or failure to thrive, seek out advice from a health professional.
Inorganic causes of childhood constipation
Functional causes of constipation are much more common. It could be related to diet, an allergy, or inactivity (even in babies!). Some little ones simply have an inert colon or genetic predisposition to constipation, while constipation can also occur as a result of developmental delays or attention deficit disorder. An extremely common cause of constipation in children is voluntary stool retention, which often results from an unpleasant, traumatic, or embarrassing experience with toilet training or defecation.
Read part 2 of coping with constipation in babies and toddlers
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