Tuesday, 18 November 2014

Has your child ever come out of the bathroom in tears, saying, “Mommy, it hurts when I poop?” The likely cause is constipation, a very common problem in children.How can you tell if your child is constipated? Besides the obvious painful bowel movements, look for these typical signs:  

ConstipationSymptoms, Stomach pain and bloating, bleeding with bowel movements, soiling accidents Sometimes is constipated child might actually appear to have diarrhea, which can be confused. What’s happening here is that a large formed stool has gotten stuck in your child’s rectum, and somewhat liquid stool gets passed around it. When a child is constipated, he has less frequent bowel movements, and when he does “go,” his stool is dry, hard, and painful to pass. There are many possible causes for constipation, including:  



Withholding stool, this means that your child is trying to hold his bowel movements in -- maybe because he’s stressed about potty training, maybe because he doesn’t want to use the toilet in certain places (like school), or maybe because he’s afraid of a painful bathroom experience. (Constipation can become a vicious cycle -- if it hurts to “poop” once, the child may be more fearful of going the next time.)A diet that’s low in fiber or doesn’t include enough liquids (or both), Side effects of certain medications

 

Constipation Treatments


There are three primary treatments for most cases of constipation, and they usually work hand-in-hand:

 A stool softener, also known as a laxative, to clear the bowels. These are safe in children, but should be used under the supervision of your pediatrician.Two common mistakes that parents make when giving their child a stool softener for constipation is not using a large enough dose, or stopping the laxative too soon. For example, you might think that you can stop giving a stool softener after your child’s first normal-looking bowel movement, but stopping too soon may just set your child up for another bout of constipation. Some children may need to stay on a stool softener for a few weeks. Your doctor can advise you on the right dosing schedule for your child.

A high-fiber diet with plenty of fluids: This means loading your child’s plate with plenty of fresh fruits and vegetables, high-fiber cereals, whole grain breads (look for at least 3-5 grams of fiber per serving), and a variety of beans and other legumes, like chickpeas and lentils. Two good sources of fiber that kids are often happy to eat are trail mix (let them make their own) and popcorn with minimal salt or butter. Foods containing proboscis, like yogurt, can also promote good digestive health. While focusing on fiber, don’t forget fluids. If your child is eating plenty of high-fiber food but not getting enough fluid to help flush it through his system, you can make matters worse. Your child should be drinking plenty of water throughout the day, along with some milk. Limit sugary drinks to 4 ounces a day in younger children and 6-8 ounces in school-aged kids.

Regular toilet time: Encourage your child to use the toilet first thing in the morning and after every meal or snack. Particularly for a younger child, you may get better results by telling, not asking. Instead of suggesting, “Do you need to go to the bathroom?” simply say, “Time to go to the bathroom now.”


You’ll get the best results if you combine all three of these approaches. A high-fiber diet isn’t likely to clear up a serious case of constipation on its own without the help of a stool softener; on the other hand, once your child stops taking a stool softener, if he stays on a low-fiber diet and doesn’t get enough healthy fluids, the problem is likely to happen again.

The average toddler (if there is such a thing) makes a bowel movement once a day. Usually, a child who has a bowel movement fewer than three times a week (or less often than he typically does), and whose stools are hard and difficult to pass, is constipated. Also, according to the American Academy of Pediatrics, any child with stools that are large, hard, dry, and accompanied by painful bowel movements, soiling between bowel movements, or blood on the outside of the stool may have constipation.

Don't be worried if your child has a bout of constipation -- it's perfectly normal once in awhile. But if your toddler's constipation lasts for two weeks or more it's called chronic constipation, and you should see your pediatrician.

Your doctor may ask you to keep track of your child's bowel movements -- how often they occur, how big and hard they are, and if there is any blood in your toddler's stool. You should also look for other symptoms that can occur along with constipation, such as: 

Stomachache, Bloating, Nausea, Loss of appetite, General crankiness, Crying or screaming during bowel movements, Avoiding the toilet (signs that your child is doing this include clenching the buttocks, crossing the legs, turning red, sweating, or crying),Smears or bits of liquid stool in the diaper or underwear (soiling)

Constipation is a very common problem among kids. A child is considered constipated when he or she 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.Constipation usually isn't a cause for concern — it's preventable and most cases can be remedied with healthy eating and exercise habits.

Causes of Constipation

Most of the time, constipation is due to a diet that doesn't include enough water and dietary fiber, which both help the bowels move properly. Kids who eat a typical fast-food diet  rich in fats (burgers, fries, milkshakes) and processed sugars (candy, cookies, sugary soft drinks) — may find that they're constipated more often.

Sometimes, medications like antidepressants and medications used to treat iron deficiencies can lead to constipation. In babies, constipation can occur as they transition from breast milk to baby formula or from baby food to solid food.

Keep in mind that some kids tend to avoid going to the bathroom, even when they really have the urge to go. They might ignore internal urges because they don't want to stop playing a fun game, use a restroom away from home, or have to ask an adult to be excused to go to the bathroom. When they ignore the urge to go, it's harder to go later on.
Stress can also lead to constipation. Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Research has shown that emotional upsets can affect how well the gut functions and can cause constipation, as well as other conditions, like diarrhea.

Some kids get constipated because of a condition called irritable bowel syndrome (IBS), which can occur when they're stressed or eat certain trigger foods, which often are fatty or spicy. A child with IBS may have constipation or diarrhea as well as stomach pain and gas. In rare cases, constipation is a sign of other medical illnesses, so keep your doctor informed if your child continues to have problems, or if the constipation lasts for 2 to 3 weeks.

Parents often get very worried about their child's bowel habit. This anxiety can start when the child is a baby, with concern over the number of dirty nappies. The main thing to realize is that every child is different. Normal can vary quite a bit. It is a change in what is normal for your child that suggests a problem. Babies will open their bowels anything from several times per day, to once every few days. The frequency of bowel movements is not very important. What is important is that the poor (faces, stools or motions) is soft and easily passed.
Breast-fed babies tend to pass runnier, mustard yellow-colored stools. This is because breast milk is better digested than infant formula (bottle feeds). Newborn breast-fed babies may open their bowels with every feed. However, it is also normal for a breast-fed baby to go up to a week without a bowel movement.Bottle-fed babies often need to open their bowels daily, as the stools are bulkier. Bottle-fed baby stools smell worse (more like an adult's).
It is not uncommon for your baby's stools to vary in color and consistency from day to day. Any prolonged change to harder, less frequent stools might mean constipation.
As babies are weaned to solid foods, their stools will change in color and smell. The frequency may again change. Generally, the stools become thicker, darker and a lot smellier. You will notice that your baby's stools will alter depending upon what you have fed him or her. Some high-fiber foods, such as raisins, may even pass through your baby's bowels virtually unchanged, appearing in the nappy at the next change.

As your baby grows up, into a toddler and then a young child, you may see further changes in their stool frequency and consistency, often dependent on what they are eating. If your toddler is constipated, it will be painful for her to do a poo. This pain means that she might hold back even more and a vicious circle begins. If she is very constipated, she may lose the sensation of wanting to open her bowels altogether. 

Boosting your child’s fiber intake will make her bowel movements easier. Offer foods such as whole meal bread and cereal, and fruits and vegetables such as prunes, figs, apricots, plums, peas, broccoli, sweet corn, potatoes and baked beans. 


Prunes can be mashed and disguised in your toddler’s food, and she may find fig rolls tastier than plain figs. Give her fruit with the peel left on, and leave jacket potatoes and chips in their skins. However, don’t overload your toddler with high-fibre foods – they shouldn’t form the bulk of her diet until she is at least five.


Give your child plenty of fluids to help moisten her poo. Water is best, although you can offer well-diluted fruit juice too (at least one part juice to 10 parts water). 

Constipation may make your toddler sluggish and low in energy. But being active will help to ease her constipation. Encourage her to get out and walk alongside the buggy for a short while when you’re out and about. If your child is constipated while you are potty training her, think about whether she is too young or too anxious to use the potty. Also think about whether you’re pushing her too soon – maybe you’re anxious to get her potty trained because you’re worried about accidents. Your child can pick up on this and refuse to go to the toilet, making the problem much worse. You may need to put potty training on hold until you see the signs that she’s ready. Talk to your health visitor too, who can offer practical advice about potty training. If your child’s constipation still doesn’t improve, your doctor may prescribe a mild laxative, probably lacunose, until your child’s constipation clears up she may be angry, irritable and lacking in energy and a source of worry for you and your partner. But with your attention and treatment, she’ll soon establish regular.


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