home » Groups » Feces in newborns: norm and pathology. Loose stools in a breastfed baby - what to do? Constipation in a premature baby

Feces in newborns: norm and pathology. Loose stools in a breastfed baby - what to do? Constipation in a premature baby

Everything that can be with the nervous system of a premature baby can be divided into 2 large and unequal groups. First, even if nothing bad happened to the nerve cells and cerebral blood flow, the cells still nervous system are very immature and sometimes not "able" to carry out the correct regulation of all organs and systems. It takes time to develop these relationships. So, in the first days, the baby does not know how to suck independently, because the nerve impulse is not transmitted correctly to the muscles that are involved in sucking. The child is fed through a tube for a long time until the sucking reflex is formed. Very often such children, having already learned to suck, swallow badly. The child keeps food in the mouth in a small volume for a long time and only then swallows it. Feeding takes a lot of time, usually parents adapt to feed the baby from a pipette, in small portions. In addition, such a child has to be fed liquid food for a long time, sometimes up to 2-3 years, due to the fact that chewing muscles develop poorly. Due to the immaturity of the nervous system of the stomach and intestines, such children usually spit up profusely, intestinal colic sometimes continues up to 5-6 months of age. Often there are constipations, because the nervous regulation of the intestines is very imperfect.

Children whom doctors were forced to feed through a tube for a long time, and who were on artificial ventilation for a long time, usually start talking late, pronounce sounds incorrectly, because the reflexes that regulate muscle tone involved in the pronunciation of sounds take a very long time to form. Therefore, almost all very premature babies need the help of a speech therapist. Moreover, speech therapy classes are necessary even before the child begins to speak in order to normalize the tone of the muscles of the tongue, to form the correct development of speech muscles.

Due to the deep immaturity, premature babies are late in motor development, they begin to hold their heads, take a toy, and roll over late. After six months, immaturity is no longer so pronounced, and the child develops faster. Often, motor skills are “confused” in a premature baby: the child starts to get up first, then sit down, it may be too late to learn to crawl, perhaps he will walk on tiptoe for a long time. There are two cures for immaturity - time and your patience.

If your baby is less fortunate, then in addition to the deep immaturity of the cells of the nervous system, they can suffer from a lack of oxygen that a premature baby experiences during severe pregnancy and childbirth. If the oxygen starvation of the brain was not too severe and prolonged, then the changes that have occurred in the cells will be reversible and will not lead to serious consequences in the future. In the first months, such children may be more excitable, have sleep disturbances. In the future, they develop well and by 1.5-2 years do not differ in the level of development from full-term peers. But if, nevertheless, damage to the cells could not be avoided, then the result of this may be “ruptures” of the vessels of the brain and hemorrhages in the ventricles of the brain. At 1-2 months of life, the condition of such children is usually severe, and they need medical care and prolonged nursing.

With mild hemorrhages, the walls of small vessels “burst”, this can lead to an increase in intracranial pressure. Intracranial pressure rises due to excess formation of fluid in the ventricles of the brain, which presses on the surrounding tissues. With small hemorrhages, the condition in most cases is quickly compensated, the outflow of fluid from the ventricles normalizes, and the hemorrhages resolve without a trace. In other words, hemorrhages of 1 and 2 degrees can pass without a trace for the child, however, this does not mean that he does not need to be observed and treated at 1-2 years of age.

Severe hemorrhages, when large vessels “rupture”, blood fills all the cerebral ventricles, causes much more serious consequences, leads to convulsions, developmental delay, and motor disorders. Such children need the constant help of a neonatologist, neuropathologist and other specialists, in particular the control of neurosensory organs (hearing and vision), since these areas of the brain can be damaged. If the baby is greatly delayed in its development, you need to carefully observe if it has seizures. Seizures are very different and sometimes do not resemble convulsions at all. The child can look away and freeze for a few seconds, stick out his tongue, make unusual fanciful movements with his arms and legs. You should be especially alert if the child strongly bends or unbends how many times in a row in a series. With any suspicion of convulsive seizures, the baby needs to consult a neurologist, conduct an electroencephalogram. If possible, make a video recording so that the neurologist can see the attacks that alerted you.

In premature babies who have suffered a severe lack of oxygen, irreversible death of nerve cells directly in the brain tissue can occur. This is the most severe type of lesion, and it is called periventricular leukomalacia. With periventricular leukomalacia, cells of the white and sometimes gray matter of the brain are destroyed, and in their place are formed. This brain damage is established by ultrasound brain. Over time, these cysts "close", and after 6-8 months of age they are no longer visible on ultrasound. The outcome of such children can be different: from minimal motor disorders with motor awkwardness and normal development of the psyche, to the formation of paresis, paralysis with delayed psychomotor development.

The diagnosis of intracranial hemorrhage and periventricular leukomalacia is very serious, but not a final verdict. What will be the outcome in this case in the first months of life, no one knows. The brain cells of a premature baby continue to develop out of utero, the tissue is very plastic and it can partially take over the function of damaged cells. Again and again we want to say: do not lose hope, treat the child, try to help him, develop him, follow the doctor's prescription. And you will be able to get a fairly good result even in a very serious situation. Moreover, science is moving forward, and every day new knowledge and methods of providing assistance appear.

Digestive problems in a premature baby

The main concern of the parents of a premature baby is the problem of weight gain and, indeed, this is of paramount importance as the main indicator of the physical well-being of the baby. It should be noted that the growth rate physical indicators(body weight, length, head and chest circumference) in a premature baby will differ significantly from those of his full-term peers. At least up to 6-9 months, your baby will be “smaller”, and at this time obligatory weight control becomes of primary importance: in the first weeks and months of life, daily (at the same time, it is necessary to take into account the correct daily weighing of the child, which must be carried out at one and the same time). the same time, preferably before the first morning feeding or in the evening, before bathing), and then monthly. What should alert you in the first place is the drop in body weight or the lack of its increase (the baby "stands" in weight). The reasons can be both quite serious and due to feeding errors, insufficient breast milk in the mother. Naturally, in any case, you need to consult a pediatrician to clarify the causes and eliminate them.

The main problems of the digestive system in a premature baby, which almost all parents face, are intestinal colic. The word comes from the Greek "kolikos", which means "pain in the large intestine". Colic - paroxysmal pain in the abdomen, accompanied by severe anxiety of the child. The attack, as a rule, begins suddenly, the child screams loudly and more or less for a long time, reddening of the face or pallor of the nasolabial triangle may be noted. The abdomen is swollen and tense, the legs are pulled up to the stomach (they can immediately straighten up), the feet are often cold to the touch, the arms are pressed to the body. The attack sometimes ends only after the child is completely exhausted. Often noticeable relief comes after the passage of feces and gases.

Premature babies are particularly prone to colic, with some babies experiencing frequent and intense seizures that can be compared to labor pain in severity, and will certainly require medical intervention. Apparently, the immaturity of the neuromuscular apparatus and the enzymatic system of the intestine may be the main cause of these sufferings of the baby. And because of this, the tendency to increased gas formation, as a result of which pressure on the intestinal wall increases and muscle spasm occurs.

The cause of discomfort and bloating can also be irrational feeding. Some foods, especially those high in carbohydrates, can contribute to excessive fermentation in the intestines. Intestinal allergies also cause a baby to cry due to abdominal discomfort. But the causes of colic are not limited to these conditions. It is important to diagnose diseases requiring surgical intervention in a timely manner. Therefore, in the absence of the effect of the usual measures aimed at eliminating colic (special carminative herbal teas, simethicone preparations, cleansing enema, the use of a gas tube, abdominal massage, dry heat on the abdomen), the child should be carefully examined in a medical institution.

Dyspepsia (diarrhea, constipation) in a premature baby is a frequent and exciting phenomenon for parents and pediatricians. When breastfeeding, a child's stool can be after each feeding, along with gases (foamy) and quite liquid. In children receiving mixtures, stools are rarer - 3-4 times a day. The absence of a chair in a baby for more than 1 day can be considered constipation. The cause of dyspepsia is the immaturity of the neuromuscular apparatus of the intestine, a violation of the formation of the intestinal biocenosis, bacterial infections, long-term antibiotic therapy, treatment with iron preparations, anticonvulsants (what your child was prescribed for health reasons) can lead to a violation of intestinal innervation, as a result inflammation of its mucous membrane, changes in the trophism of the mucous membrane of the colon occur.

Digestive disorders due to the increased fat content of breast milk or its substitutes; immaturity of enzymatic function. In all these cases, there are special corrective mixtures - therapeutic breast milk substitutes, preventive drugs that can help your child, but it is very important to coordinate their use with your pediatrician.

The regurgitation syndrome can also bother the parents of a premature baby. The most common cause of this is the immaturity and temporary (passing) smooth muscles of the stomach - the so-called "duodeno-gastric reflux". Most often it occurs in premature babies who have been fed for a long time through a tube. Aerophagia (when a baby greedily swallows air along with food) can also be a possible cause of regurgitation. Masses during regurgitation look plentiful due to their binding with air and usually do not change the baby's well-being in any way. In this case, you need to be patient and wait until the baby's stomach "ripens", while observing the recommendations for proper feeding, holding the baby vertically after feeding for 10-15 minutes. Quite quickly, improvement also occurs with the introduction of mixtures - thickeners (Frisov, Nutrilon-antireflux) into the diet. Medicines are best given to the child before feeding. However, there are situations in which urgent consultation with a specialist is necessary. If there are streaks of blood in the regurgitation masses, if they are so abundant that the child is not gaining weight well, if the baby’s health is disturbed during regurgitation - do not hesitate, consult a doctor!

Condition of the skeletal system and joints

The phenomena of morphological and functional immaturity in a premature baby often extend to the musculoskeletal system. Imperfection of the neuromuscular regulation, weakness of the ligaments, excessive mobility of the joints can lead to changes in the correct position of the limbs, head and spine of the child.

Often the baby keeps his head in a fixed position on one side. The reason for this may be a congenital shortening of the neck muscles on one side, a traumatic injury to the spine or cervical muscles during the removal of the head during childbirth, or just a “usual” position of the head, that is, the child “lyed” in this position most of the time in the uterus. The doctor always establishes the correct diagnosis, and the sooner this happens, the more effective the treatment will be.

Prematurity, especially in combination with an incorrect intrauterine position of the fetus, is usually accompanied by underdevelopment of the hip joints or "dysplasia". The most severe variant of this pathology is a dislocation of the hip joint. Diagnosis is established shortly after birth and requires early treatment based on hip abduction. Currently, an effective method in detecting abnormalities in the development of the joints is ultrasound scanning, which is mandatory for all children at 1 and 3 months of age, or more often if a disease is detected.

Considering that the described problems are especially common in premature babies, every baby should be examined by an orthopedist several times in the first year of life. As a rule, children receive the first consultation at 1 month of life, then at 3 and at 12 months. If pathology is detected, there may be more consultations. Timely detection of deviations will help to quickly begin treatment and raise a healthy child.

We tried to tell in an accessible form about the most common problems of the 1st year of a premature baby's life. All of them require attention, observation and timely treatment. We strongly recommend that you contact specialists who purposefully deal with the health and development of such children - this will help to avoid mistakes and unnecessary worries.

We wish happiness and health to you and your kids!

Skripets Petr Petrovich,
pediatric ophthalmic surgeon, candidate of medical sciences

Comment on the article "A premature baby is not a sentence for the family at all! Part 2"

The Ministry of Health of the Russian Federation will expand the risk group during vaccination. It will be supplemented by premature and underweight children, who will also need to receive a vaccination against Haemophilus influenzae. Thus, the Ministry of Health of the Russian Federation will change the National calendar of preventive vaccinations. The draft order provides for an increase in the number of children who are at risk - namely, with an anomaly in the development of the intestine, oncological diseases, premature and underweight children. For this...

An amazing story happened to the pregnant Alena Avdeeva in the Miass maternity hospital. Miass doctors during the operation caesarean section found in her instead multiple pregnancy cyst, which surprised both parties. During the operation, the cyst was removed by doctors, - a REGNUM correspondent says. This sad event destroyed the hope of the failed mother and she turned to the police. I wanted to find out if there really were no children or if something had happened to them. Alena was observed in ...

A premature baby is not a sentence for a family at all! Part 2. If the oxygen starvation of the brain was not too severe and prolonged, then the changes that occurred in the cells will be. Intracranial pressure rises ...

At present, the optimal mode of delivery for infected women has not been fully determined. To make a decision, the doctor needs to know the results of a comprehensive virological study. Natural childbirth includes a whole range of measures aimed at adequate pain relief, prevention of fetal hypoxia and early rupture amniotic fluid reduce injuries of the birth canal in the mother and skin of the baby. Only when all preventive measures are observed ...

The unborn child said: “I am afraid to come into this world. There are so many inhospitable, evil Eyes prickly, smiles crooked ... I will freeze, I will get lost there, I will get wet in heavy rain. Well, to whom I quietly snuggle up? With whom will I stay, left alone? The Lord answered him quietly: “Do not be sad, baby, do not be sad, the good angel, he will be with you, As long as you mature and grow. He will undead, rock you, Leaning down, sing lullabies, He will press you tightly to his chest, He will carefully warm his wings. First tooth...

Name of examination Expiry date 1. Blood group, Rh factor 2. General analysis blood count 14 days 3. Urinalysis 14 days 4. Glycosylated hemoglobin (only for patients with type I and type II diabetes) 3 months 5. Biochemical analysis blood: total protein -. Urea, creatinine. K, Na–Blood sugar – Bilirubin (by fractions) 14 days 6. Blood clotting time: (Duke or Sukharev) or coagulogram 14 days 7. HIV, RW, HbS, HCV (have a PASSPORT with you) 3 months 8. ECG 1 month 9...

Not only diarrhea can cause concern for mothers, but also fatty baby stools as a symptom of serious disorders in the body. In a healthy baby, stools are usually of a uniform consistency, yellowish in color, soft and free of blood and other fluids. The emptying process should be painless. Constipation and diarrhea are not good, but isolated cases do not indicate any abnormalities in the body of the crumbs. But fatty stools can signal serious violations in the work of the pancreas ...

What to do for the first 10 minutes after a fall: * Do not think that the child will forever remain disabled * Do not think that this is “nonsense”, that “all children fall” * Really assess the child’s condition: is there soft tissue swelling? Is the child behaving unusually? * Call a doctor. It is better to exclude a serious injury (after X-ray or tomography studies) than to miss it. Sound the alarm * Pallor of the skin and changes in the reactions of the baby. The child becomes lethargic and drowsy or excessively...

Three times we went to Turkey with children. Once we had a rotovirus. With a call for an ambulance to the youngest. Then I was taught prevention. The doctor of the highest category, the paid aunt came to the house. A few days before departure and on the day of departure, Arbidol and Viferon suppositories. Now the children are 8 and 13 years old with their grandmother in Bulgaria, the third week ends.In the residential complex 2...

The other day on the pages of livejournal magazine, a post was published “Supernanny - is it bad?” In search of a nanny, Nastya found exactly the one that would seem to be happy with any mother. ‘’ The nanny helped to overcome all the problems that scare young mothers so much - how to potty train, wean from a pacifier, teach them to fall asleep on their own. And by the child it was clear that the nanny was a treasure. But there was a climax in the nanny-family relationship, and the child demanded the presence of a nanny. The question arises: to be good ...

Nastya was born at 33-34 weeks. Prematurity, triple entanglement of the umbilical cord and difficult labor (stimulation, pressure on the abdomen, anhydrous period of about 14 hours) led to serious consequences: 2 weeks in intensive care (including 10 days on mechanical ventilation), a month in the neonatal pathology department and, as a result, in a month and a half the child and mother finally got home with the following diagnoses: subacute intracerebral hematoma of the left parietal region and subdural hematoma in the posteromedial surface of the left hemisphere...

A premature baby is not a sentence for a family at all! Part 2. Respond who brings up very premature babies born weighing less than 600 grams.

A premature baby is not a sentence for a family at all! Part 2. 7ya.ru - an information project on family issues: pregnancy and childbirth, parenting, education and career, home economics, recreation, beauty and health, family relationships.

A premature baby is not a sentence for a family at all! Part 2. If the oxygen starvation of the brain was not too severe and leukomalacia, cells of the white, and sometimes gray matter of the brain are destroyed, and cysts form in their place.

Ekaterina Rakitina

Dr. Dietrich Bonhoeffer Klinikum, Germany

Reading time: 5 minutes

A A

Article last updated: 02/05/2019

When changing a baby diaper, parents should always pay attention to its contents. After all, this is an important indicator that can tell a lot about the health of your baby, especially if the child is bottle-fed. In this case, the functioning of the intestine changes in the child, and, consequently, there are noticeable changes in the feces.

You need to pay attention to the following parameters:

stool consistency;
regularity of bowel movements;
chair color.

In the event that the color of the bowel movements is unnaturally yellow or orange, this may indicate problems with the liver. Green stool is an indicator of a different type of dysbacteriosis. Therefore, noticing any changes in the baby's feces, you should immediately contact a specialist.

Can the green stool of the baby be the norm with artificial feeding

There is a certain period when the green stool of a formula-fed baby should not cause any concern. This period is a natural process and lasts about five days after birth.

The initial bowel movements of a newborn are always characterized in green. This is due to the fact that the body tends to get rid of swallowed epithelial tissues, amniotic fluid, etc. in the first days after birth. This is how the intestines are cleansed.

Gradually, around the fifth day, the baby's stool should undergo noticeable changes:

stools may contain white curd pieces of undigested milk mixture;
the color of the stool changes to yellow-green, which should gradually become completely yellow or mustard.

However, there are exceptions to all rules. There are cases when a baby has a green stool with the presence of mucus, which indicates that the digestive system is not yet fully formed and there are not enough enzymes for the proper processing of food.

Sometimes dark green stools can cause bilirubin to be flushed out of the body. This is also a fairly common process, which can be characterized by these changes.

In a formula-fed newborn, green stools may be a common reaction to formula intake. This is especially facilitated by a diet with a high content of iron in its composition.

In a five-month-old child, a greenish tint of stools may be a consequence of the introduction of the first complementary foods or the beginning of teething.

Symptoms of an unhealthy condition of the baby with a green stool

Having noticed a green stool in a baby, it is necessary to constantly monitor his condition. If the behavior of the newborn has changed dramatically, he has become more whiny, capricious, began to refuse food, then you should immediately seek the advice of a doctor.

Green stools that cause anxiety and fear should look like this:

green stool foams and has a sharp unpleasant odor;
frequent green stools that have a liquid consistency;
green stools with black patches, having a rotten smell;
slimy green stools in combination with a sharp deterioration in the baby's well-being;
green stools with bloody discharge or inclusions (usually observed with constipation).

When the stool is frothy and green in color, it may indicate a lack of nutrients or vitamins in the newborn. Breastfed babies are often deficient in the so-called colostrum. This can cause a deficiency of the elements necessary for the body. In the presence of such a chair, testing is necessary, with its help it is possible to identify various infections that adversely affect the well-being of the baby.

The unpleasant smell of green feces can be a herald of the beginning inflammatory process. And stools with blood blotches indicate either a serious problem with the digestive system, or a violation of the integrity of the intestinal lining. With these symptoms, contacting a qualified specialist is considered necessary.

It is worth being attentive to other signs of an unhealthy condition of the baby:

increased weakness and drowsiness;
tearfulness;
refusal to eat;
constant tightening of the legs to the abdomen;
sudden weight loss;
nausea and gag reflex;
colic and pain;
temperature;
diarrhea;
difficulty with defecation;
rash;
allergic reactions on the skin;
flatulence.

Reasons for the presence of green stool in infants with artificial feeding

The reasons for the green stool of a child can be quite natural, not cause for concern, or they can pose a huge threat to the health of the newborn.

The most common reason is food. Digestive system baby not yet able to work one hundred percent. Therefore, there are often problems with the digestion of food. In this case, green stools may be accompanied by mucus. To normalize the bowel movements of a newborn, it is often sufficient to simply change the mixture.

Also, every baby at the beginning of his life is faced with such a problem as dysbacteriosis. It occurs at the time of the formation of the necessary microflora in the intestine. This period is characterized by an increase in the development of pathogenic bacteria that can change the color and consistency of the baby's stool. The bowel movements will return to normal when the microflora is fully formed.

Serious causes of green stools during artificial feeding of a child can be:

rotavirus or fungal infections;
congenital disorders associated with the gastrointestinal tract;
weak immunity;
lactose deficiency;
allergic reactions;
enterocolitis;
diarrhea, etc.

Necessary measures to combat green stools in an infant

In order to facilitate the well-being of your child, it is necessary to take certain measures in the presence of green stools.

Secondly, it is necessary to submit bakposev. This analysis will characterize the state of the intestinal microflora.

Thanks to the diagnosis, the doctor prescribes the right method of treatment that is necessary for your child. Often, infants are prescribed nutritional supplements that contain probiotics and prebiotics. They help the growth of beneficial bacteria in the body. These drugs include:

linox
acipol
lactobacterin, etc.

The most important thing in this situation is not to self-medicate. Otherwise, you can worsen the health of your child. You should also monitor the nutrition of the newborn and his reaction after each meal.

For many years working at the Center for the Correction of the Development of Premature Infants of the Research Clinical Institute of Pediatrics and engaged in scientific research on the growth and development of these children, they are currently consulting at the Chaika Clinic. Elena Solomonovna released a guide for parents about what the family of a premature baby has to go through and how to maintain love and friendship. We publish its continuation.

Physical development of a premature baby (weight and height gain)

The first concern of the parents of a premature baby is the problem of weight gain. And indeed it is of paramount importance as the main indicator of the physical well-being of the baby.

It should be noted that the growth rate of physical parameters (body weight, length, head and chest circumference) in a premature baby will differ significantly from those of his full-term peers. At least up to 6-9 months your baby will be “smaller”, and at this time obligatory weight control becomes of primary importance: in the first weeks and months of life, daily (at the same time, it is necessary to take into account the correct daily weighing of the child, which must be carried out in the same time, preferably before the first morning feed or in the evening before bathing), and then monthly.

What should be your first concern? This is a drop in body weight or the absence of its increase (the baby "stands" in weight).

The reasons can be both quite serious and due to feeding errors, insufficient breast milk in the mother. Naturally, in any case, you need to consult with the child's leading doctor to clarify the causes and eliminate them. I repeat, with a one-time consultation of a pediatrician, the condition of a child born prematurely and very different from full-term peers can be assessed as more severe than it actually is.

Digestive problems in a premature baby

The main problems of the digestive system in a premature baby, which almost all parents face, are:

Intestinal colic

Colic is derived from the Greek kolikos, which means "colon pain". Colic - paroxysmal pain in the abdomen, accompanied by severe anxiety of the child. The attack, as a rule, begins suddenly, the child screams loudly and more or less continuously, reddening of the face or pallor of the nasolabial triangle may be noted. The abdomen is swollen and tense, the legs are pulled up to the stomach and can instantly straighten up, the feet are often cold to the touch, the arms are pressed to the body. The attack sometimes ends only after the child is completely exhausted. Often noticeable relief comes after the passage of feces and gases.

Premature babies are particularly prone to colic, with some babies experiencing frequent and intense seizures that can be compared to labor pain in severity, and will certainly require medical intervention. Apparently, the main cause of these sufferings of the baby is the immaturity of the neuromuscular apparatus and the enzymatic system of the intestine and, therefore, the tendency to increased gas formation. As a result, pressure on the intestinal wall increases and muscle spasm occurs.

But the causes of colic are not limited to these conditions. It is important to diagnose diseases requiring surgical intervention in a timely manner. Therefore, in the absence of the effect of the usual measures aimed at eliminating colic (special carminative herbal teas, preparations of simethicone Sub / Simplex, Espumizan, cleansing enema, use of a gas vent tube, abdominal massage, dry heat on the abdomen), the child should be carefully examined in a medical institution.

regurgitation syndrome

The regurgitation syndrome can also bother the parents of a premature baby. The most common cause of this is immaturity and temporary (transient) hypotension of the smooth muscles of the stomach - the so-called "duodeno-gastric reflux". Most often this occurs in premature babies who have been fed for a long time through a tube. Aerophagia (when a baby greedily swallows air along with food) can also be a possible cause of regurgitation. Masses during regurgitation look plentiful due to their binding with air and usually do not change the baby's well-being in any way. In this case, you need to be patient and wait until the baby's stomach "ripens", while observing the recommendations for proper feeding, holding the baby vertically after feeding for 10-15 minutes. Medicines are best given to the child before feeding. However, there are situations in which an urgent consultation of a specialist is necessary: if there are streaks of blood in the regurgitation masses, if the regurgitation is so abundant that the child does not gain weight well, if the baby’s health is disturbed when regurgitation occurs - do not hesitate, consult a doctor!

Diarrhea and constipation

Dyspepsia (diarrhea and constipation), changes in the structure of the stool, the appearance of mucus and impurities in a premature baby is a frequent and exciting phenomenon for parents and pediatricians. It is necessary to determine what should not cause concern to parents.

When breastfeeding, a child's stool can be after each feeding, along with gases (foamy) and quite liquid. In children receiving mixtures, stools are rarer - 3-4 times a day. A change in the quality and color of the stool also occurs with the late formation of intestinal enzymes in a premature baby, the difficulty in digesting fats or carbohydrates.

The most common problem in a premature baby is the temporary absence of stool or delayed stool evacuation. There is no stool for several days, the child strains to no avail. When defecation occurs, the stool as a whole is not changed in consistency, which does not allow us to call it constipation in the generally accepted sense of the word.

It will take some time to make it easier for the child to defecate, there is nothing wrong with that if you do it with the knowledge and under the supervision of a doctor.

The cause of all violations of the functional state of the gastrointestinal tract is immaturity.

However, proper feeding is the best and natural cure. Breast milk is perhaps the best thing a mother can give to her baby. At the birth of a premature baby, milk, as it were, adapts to the immature intestines, so that the hormones necessary and coming from the mother, and active metabolites, protective substances and enzymes contribute to the faster maturation of all organs.

Therefore, breast milk and the possibility of natural feeding must be tried to preserve with all our might. However, if there is still not enough milk, and you were forced to replace it with formula, then it is most advisable to use special mixtures for premature babies. In any case, it is important to coordinate the use of mixtures with your pediatrician.

The main criterion for the fact that all the changes you observe in the gastrointestinal tract are not diseases that require urgent therapeutic measures is a sufficient increase in the child's body weight and the absence of a pronounced pain syndrome in the child

Anemia of prematurity

Almost all premature babies have a drop in hemoglobin, which is called anemia. The cause of anemia is the same immaturity. In premature babies, the so-called “fruit” hemoglobin is determined for a longer time, which is destroyed faster, and the ability to form a new one is reduced. At the same time, hemoglobin carries oxygen, which is necessary for the functioning of all cells and their maturation. Controlling hemoglobin levels is very important.

A premature baby needs to be prevented from anemia and treated in time if hemoglobin drops to 100g/l.

Rickets of prematurity

Rickets is a deficiency in the formation of vitamin D in the body and the entry of calcium into the cells, which is necessary for the growth of bone tissue and the formation of neuromuscular regulation.

Deficiencies in vitamin D formation and calcium absorption are associated with immaturity. This slows down the development of the child. The baby becomes more irritable, sweaty, sleep is disturbed, hair falls out, growth and weight gain slow down. The bones become "weak" and may twist. A premature baby requires mandatory prophylactic use of vitamin D preparations, and with clinically obvious manifestations of rickets, treatment with vitamin D and calcium preparations.

Condition of the skeletal system and joints

The phenomena of morphofunctional immaturity in a premature baby often extend to the musculoskeletal system. Imperfection of the neuromuscular regulation, weakness of the ligaments, excessive mobility of the joints can lead to changes in the correct position of the limbs, head and spine of the child.

Prematurity, especially in combination with an abnormal intrauterine position of the fetus, is usually accompanied by underdevelopment of the hip joints or "dysplasia". The most severe variant of this pathology is a dislocation of the hip joint. Diagnosis is established shortly after birth and requires early treatment based on hip abduction. Currently, an effective method in identifying abnormalities in the development of the joints is ultrasound scanning, which is mandatory for all children in the first months of life.

For premature babies, the most diagnostically reliable period is 3-4 months of the corrected age for assessing the condition of the hip joints. In more early dates the risk of error is very high due to their natural immaturity.

Premature eye disease

Retinopathy of prematurity (RP) is an eye disease of premature babies that can even lead to permanent loss of visual function.

The possibility of developing ROP is associated with the term and body weight at birth, the presence of severe changes in the respiratory, circulatory and nervous systems, as well as the adequacy of the measures taken to nurse the baby.

This disease was first identified in a premature baby in 1942. Then it was called retrolental fibroplasia. Until now, the causes of the onset, progression and spontaneous regression of the disease are not completely clear and are only being studied.

At this stage in the development of ophthalmology, it is indisputable that the development of retinopathy occurs precisely in an immature infant, as a violation of the normal formation of retinal vessels (which is completed by the 40th week of intrauterine development, i.e. by the time a full-term baby is born). It is known that up to 16 weeks of intrauterine development, the fetal retina does not have blood vessels. Their growth into the retina starts from the point of exit of the optic nerve towards the periphery. By the 34th week, the formation of the vasculature in the nasal part of the retina is completed (the optic disc, from which the vessels grow, is closer to the nasal side). In the temporal part, the growth of blood vessels continues up to 40 weeks. Based on the foregoing, it becomes clear that the earlier the child was born, the smaller the area of the retina covered with vessels, i.e. an ophthalmological examination reveals more extensive avascular, or avascular, zones (if the child was born before the 34th week, then, accordingly, the avascular zones of the retina are detected on the periphery from the temporal and nasal sides). After the birth of a premature baby, various pathological factors act on the process of vascular formation: external environment, light, oxygen - which can lead to the development of retinopathy.

The main manifestation of RH is the stoppage of the normal formation of blood vessels, their germination directly into the eye into the vitreous body. The growth of the vascular and, after it, the young connective tissue causes tension and detachment of the retina.

As mentioned earlier, the presence of avascular zones on the periphery of the fundus is not a disease. This is only evidence of underdevelopment of retinal vessels, and, accordingly, the possibility of developing retinopathy in the future. Therefore, from the 34th week of development (or from the 3rd week of life) of the child, it is necessary that your child is examined by an ophthalmologist, a specialist in retinopathy of prematurity, who has special equipment for examining the retina. Such monitoring is necessary for all children born before 35 weeks and with birth weight less than 2000 g.

If signs of ROP are detected, examinations are carried out every week (with the so-called "plus" stage of the disease - every 3 days) until the threshold stage develops (at this stage, the issue of preventive surgical treatment is decided) or the disease completely regresses. With the regression of the pathological process, the examination can be carried out 1 time in 2 weeks. The examination is carried out with the obligatory expansion of the pupil, using special children's eyelid dilators, so as not to put pressure on the eye with fingers.

Most often, the threshold stage of ROP develops by the 36-42nd week of development (1-4 months of life), so the parents of a premature baby should know that during this period he should be examined by a specialist (an ophthalmologist who has special equipment and is aware of the signs of active retinopathy ).

Active retinopathy is a staged pathological process that can end in regression with the complete disappearance of the manifestations of the disease or cicatricial changes.

According to the international classification, active retinopathy is divided into stages of the process, its localization and extent:

1 stage. The appearance of a dividing line at the border of the vascular and avascular retina.

2 stage. The appearance of a shaft (solid line) at the place of separation.

It should be emphasized that in 70-80% of cases with 1-2 stages of ROP, a spontaneous cure of the disease is possible with minimal residual changes in the fundus.

Stage 3 is characterized by the appearance of growth of retinal vessels into the vitreous body in the area of the shaft. With a short duration of the process, as in the first two stages, spontaneous regression is possible, but the residual changes are more pronounced.

When the growth of vessels inside the eye has spread over a fairly large area, this condition is considered to be the threshold stage of ROP, when the progression of ROP becomes almost irreversible and requires urgent preventive treatment.

The effectiveness of prophylactic laser and cryocoagulation of the avascular retina ranges from 50-80%. Timely treatment can significantly reduce the number of adverse outcomes of the disease. If the operation is not performed within 1-2 days after the diagnosis of the threshold stage of retinopathy, then the risk of developing retinal detachment increases dramatically. It should be noted that with the development of retinal detachment, cryo-, laser coagulation is not possible. The further prognosis for the development of vision in such an eye is extremely unfavorable.

The operation is often performed under anesthesia (local anesthesia is less often used) in order to avoid oculocardial and oculopulmonary reactions. Evaluation of the results of treatment is carried out after a few days to decide whether to repeat the procedure. The effectiveness of preventive treatment can be judged 2-3 weeks after the formation of scars at the site of the shaft. If the treatment was not carried out or the effect was not achieved after the treatment (severe ROP), terminal stages develop.

4 stage. Partial retinal detachment.

5 stage. Complete retinal detachment.

Even if the process has reached stages 4 and 5, it is necessary to carry out a whole range of therapeutic and surgical measures aimed at preventing severe cicatricial changes.

Separately, the “plus” disease is singled out as the most unfavorable form of active retinopathy. The disease begins early, has no clearly defined stages, progresses rapidly and leads to retinal detachment before reaching the threshold stage. The pathological process is characterized by a sharp dilation of the retinal vessels, pronounced edema of the vitreous body, hemorrhages along the vessels, dilation of the vessels of the iris, often with the inability to expand the pupil. The effectiveness of treatment for "plus" disease is still low.

If the active process has reached 3 or more stages in its development, then after its completion (with or without preventive treatment), cicatricial changes of varying severity form on the fundus.

1 degree - minimal changes in the periphery of the fundus;

Grade 2 - dystrophic changes in the center and on the periphery, remnants of scar tissue;

Grade 3 - deformation of the optic disc, with displacement of the central parts of the retina;

4 degree - the presence of retinal folds, combined with changes characteristic of the 3rd stage;

Grade 5 - complete, often funnel-shaped, retinal detachment.

With the first and second degrees, a sufficiently high visual acuity can be maintained, with the development of third or more degrees, a sharp, often irreversible decrease in visual acuity occurs.

Indications for surgical treatment of cicatricial stages of ROP are strictly individual, determined by the degree and localization of retinal detachment, as well as the general somatic condition of the child. In any case, the functional and anatomical effectiveness of operations is noticeable only up to 1 year of life, when it is possible to improve visual acuity and create conditions for eye growth.

However, upon reaching the 5th stage of cicatricial ROP, the pathological process can continue and lead to the development of complications in the form of corneal clouding and secondary glaucoma. Therefore, with the development of contact between the cornea and the iris, urgent surgical treatment is necessary in order to save the eye (in this case, we are not talking about increasing visual acuity).

It should be noted that if a child has undergone even mild stages of active ROP or has unexpressed cicatricial changes, then it is considered that such children do not form a full-fledged retina. In the future, these children have a high risk of developing myopia, dystrophy and secondary retinal detachments. Based on this, children who have had ROP should be observed by an ophthalmologist at least 2 times a year until they reach the age of 18.

Successful nursing and subsequent development of premature babies, including the preservation of visual functions, is a difficult but quite feasible task, although it is difficult. Achieving a good rehabilitation result is the envy of the joint efforts of neonatologists, ophthalmologists and psychologists.

Formation of hearing and speech

There is no evidence that premature infants are more likely than full-term infants to have severe forms of hearing loss. However, in many of them, the formation of auditory function is slow. Hearing can be assessed by a hardware technique, which is now widely used and is called otoacoustic emission or an audio test. Taking into account the characteristics of a premature baby, it is possible to reliably judge the passing of the test only at the age of 4 months of the corrected age. Until that time, there will be many false negative results, which are explained by the same immaturity of the child, but cause a huge number of unnecessary worries. Late formation of auditory function leads to more late start cooing, difficulty with the child's speech in the future. Complex features lead to the fact that the child begins to speak later and many sounds are pronounced incorrectly (perhaps the child hears them that way). All this gradually normalizes, but most premature babies will need the help of a speech therapist and it is advisable to start classes earlier than recommended for full-term babies, for example, at 2.5-3 years, depending on the overall development of the child.

What happens to the immune system of a premature baby?

Will he often get sick with colds?

Numerous studies in our country and abroad dispelled the prejudice about the "weakness" of the immune system of a premature baby. Just like in full-term children, it is formed in the first three years of life and differs slightly in terms of indicators. Just like full-term babies, when breastfeeding breast milk, the formation of the immune system is faster and its activity is higher, but not so much as to say that without breast milk your child is not at all protected.

Why do premature babies get sick more often and more severely? There are several explanations for this: Premature babies are more likely to visit healthcare facilities where the risk of infection is high. Premature babies are very guarded by their parents, they often overheat and this inhibits the development of the immune system. Premature babies with illnesses often develop bronchospasm, respiratory failure, they are more often hospitalized and more often prescribed antibiotics, which also weakens the formation of immune defenses. All this determines the approaches and tactics that parents of a premature baby should follow, and this should be taught by a doctor who knows the characteristics of the child and, most importantly, is not afraid that he was born prematurely.

Should premature babies be vaccinated?

Must and must! Actually, vaccinations are for them. Because strong and strong child, most likely, will easily transfer any infection, but for an “immature” and poorly protected premature baby, any severe infection can be fatal.

Previously, neonatologists made a tap for a premature baby up to a year old. Today, this concept is being revised around the world. It has been proven that the immune system is more ready to produce antibodies in the first months of life. Judge for yourself: any child is born completely “sterile” and from the very first seconds is faced with many viruses that are common around us, and with bacteria that inhabit surfaces and our bodies. However, he defends himself with sufficient ease, except for the situation of super-massive impacts (intensive care unit, significant concentrations of sick children and adults).

However, there are still limitations - these are acute conditions, which are temporary, but absolute contraindications to vaccination, and some chronic conditions: and this is, first of all, damage to the central nervous system. These include absolute contraindications - decompensated hydrocephalus and convulsions.

And yet, only the attending physician can tell if your child is ready for vaccinations, explain in detail to you what vaccinations and against what diseases your baby is required, whether any examinations are needed, for example, an ECG or EEG. This is a very important decision that requires great knowledge of the doctor, self-confidence and your child. On the other hand, the importance of this decision is to protect your baby as much as possible from possible severe infections, which, unfortunately, abound in any society, realizing how difficult it will be for a premature baby to endure these diseases.

What is the prevention of respiratory syncytial virus infection and why should it be carried out?

One of the most serious diseases of a premature baby in the 1st year of life is RSV infection. This is a very common disease. In fact, almost all children under 2 years of age at least once suffer this viral infection.

This infection proceeds like a cold, but its peculiarity is the defeat of the lower respiratory tract, like pneumonia or, terminologically, alveolitis. Alveolitis is an inflammation of the most terminal parts of the respiratory tract - the alveoli, where gas exchange occurs. Thus, if the alveoli become inflamed, then the person begins to suffocate from a lack of oxygen and the accumulation of carbon dioxide in the body. This infection is especially severe in premature infants, who already have a very immature broncho-alveolar tree, many have signs of broncho-pulmonary dysplasia. In severe cases, children require hospitalization, resuscitation, mechanical ventilation, antibiotic therapy, etc., not to mention severe psychological trauma for the baby and the whole family.

Over time, when faced with this virus, the child develops antibodies and after 2-3 years the virus becomes practically not dangerous and the disease proceeds like a normal ARVI.

But! These 2 years must be lived. IN last years A preparation was developed, created and widely distributed, which is a purified antibody to the respiratory syncytial virus. The introduction of these antibodies protects the child from the disease, not only with this virus, but also with other similar viruses, and the child as a whole begins to get sick less.

Today, the country has the drug SINAGIS, which is very expensive in price, as it is an ultra-purified monoclonal antibody. Effective protection against the virus requires 3-4 injections with an interval of 30 days during the most dangerous epidemiological period - approximately from November to March. The introduction of the drug is not a vaccination, but a passive immunization: when it is not the child's body that produces antibodies, but they are already administered. Therefore, repeated administration is required during the first year with strictly observed intervals.

In the near future, it is possible that there will be other drugs of similar action in the country, most likely cheaper and more affordable. But this still needs to be verified.

We tried to tell in an accessible form about the most common problems of the first year of a premature baby's life. All of them require attention, observation and timely treatment.

Let us repeat once again why you need to monitor a premature baby in the first year of life:

The development of the child, the formation of his psycho-motor functions requires a monthly assessment by one specialist. You should carefully observe the baby in order to tell the doctor about the child's behavior as truthfully and objectively as possible.
Weight gain, which indicates the sufficiency of absorption and assimilation of nutrients. Premature babies tend to have reduced appetite, and sometimes it is a big problem to feed such a child. The more premature the child is, the more pronounced the violation of the absorption of nutrients and the worse the weight gain. In this case, the use of special preparations that improve the energy state of the cells can help to cope with this.
Prevention or, if necessary, treatment of rickets.
Prevention and, if necessary, treatment of anemia.
Relief for the child of "intestinal colic", control of the state of the gastrointestinal tract, correction of regurgitation. Rational feeding. Mandatory consultation to resolve the issue of the timeliness of the introduction of complementary foods.
Control of the state of the nervous system, timely conduct of special examinations to determine the maturation of brain structures, to control the manifestation of hypoxic-ischemic encephalopathy (if your baby had a hemorrhage or periventricular leukomalacia, if he had meningitis or encephalitis).
Monitoring the state of the respiratory system, especially if the child has been on a ventilator for more than 3 days. Remember that in the case of the formation of bronchopulmonary dysplasia in a child, it is necessary to carefully monitor the color of the child's skin and his breathing (the child begins to breathe "heavy" and often), since periods of exacerbations are possible (in case of any doubt, it is better to contact the doctor observing your baby) . If such a baby gets sick, he often develops an "obstructive syndrome", which requires urgent treatment.
Control of the state of the heart, especially in children with bronchopulmonary dysplasia. It is especially important for such children to control physical activity, prescribe massage and physical rehabilitation methods in a dosed manner.
Monitoring the condition of the musculoskeletal system, in particular the hip joints, as a violation of the development of these joints will not allow the child to sit down, stand up and walk properly.
Monitoring the state of the organs of vision
Hearing control.

Thus, there are a lot of problems. It is almost impossible to treat everything at the same time - the baby simply cannot withstand such a load. Therefore, when assessing the child's condition, it is necessary to determine the primary task, which to a greater extent disrupts the normal development of the baby and requires urgent correction. Only a specialist can decide this.

Happiness, health and good luck to you and your kids!

Judging by how actively the topic of constipation in babies is being actively discussed at various forums, this problem is acute in many families. Since these tops often catch the eye of mothers, many begin to closely monitor their children. On the one hand, of course, it is good that the health of babies is under vigilant supervision. But on the other hand, mothers are increasingly inventing illnesses for their babies precisely because of the excess of information, among which there are tips, following which can worsen the situation.

Interesting

According to statistics, only 10% of children have real constipation. And it almost never happens in babies who are breastfed.

In order not to get into a situation where you have to correct the mistakes of self-treatment, you must first decide what should be considered constipation.

Everyone knows that this is the absence of a chair for any time. The greatest problems are caused just by the limitation of the period after which we can already talk about stool retention.

Doctors do not have a single opinion on this matter. Traditionally, it is believed that breastfed children need to walk “in a big way” at least 2 times a day, and artificial ones - once. However, even Spock pointed out that for some babies who are breastfed, the norm is a chair up to once a week and even once every 2 weeks. This is due to the high digestibility of milk, that is, the child’s intestines simply do not fill up.

Still, it is more important to pay attention not to the number of bowel movements, but to the consistency of the stool. Before the introduction of complementary foods, feces should not be formed, and after 6 months it can be both mushy and “sausage”, but still soft.

The behavior of the child before defecation is of great importance: the baby is relaxed, does not show negative emotions. Children who are just learning to control their body can grunt and push at the same time.

Thus, we can talk about constipation if, for example, the number of times is normal, but at the same time the baby cries and behaves restlessly. And do not worry if it seems to you that the child’s stool is rare, but at the same time its consistency corresponds to age, and the baby is cheerful and does not get sick.

Why is constipation bad?

Through the intestines, the body removes those substances that it could not digest, some of them are toxic. Therefore, if feces are retained in the body, the substances contained in it are absorbed, enter the bloodstream and spread throughout the body, clogging and poisoning it.

Persistent and chronic constipation makes a person lethargic, irritable. Added to this is a decrease in appetite.

Constipation is often the cause of dysbiosis and iron deficiency anemia. In advanced cases, inflammation develops.

Causes of constipation

The predisposition to constipation is inherited.

But most of the time it's the wrong diet. If we talk about babies, then stool retention can be provoked by too early weaning or early introduction of complementary foods, a sharp transition from one mixture to another, not enough food. Older children have problems with stools if their food lacks fiber and dietary fiber (only mashed potatoes and porridges are given), and vice versa, if the food is replete with fats, proteins, sugar. According to some reports, constipation can occur against the background of too much spitting up.

It happens that milk intolerance is to blame.

Important

Fixing products: strong coffee and tea, cocoa, jelly, white flour products, chocolate and other sweets, semolina and rice cereals, cottage cheese, pomegranate, pear, quince.

The lack of liquid in the diet of the child and mother (if she is breastfeeding) makes the stool hard, which makes it difficult to remove it from the body.

Dysbiosis is another common cause of constipation in children. Violation of the composition of the intestinal microflora can occur both as a result of the illness of the mother during pregnancy, and after taking antibiotics and some other drugs. Dysbiosis is quite common in premature babies. You can disrupt the microflora by frequent use of enemas and laxatives.

The underdevelopment of the neuromuscular apparatus leads to the fact that the child does not know how to relax the muscles in time and correctly, which means that he cannot go to the toilet. It is not always a disease. It is important to understand that the immaturity of this system is normal for children in the first months of life.

In impressionable and modest children, constipation may occur due to punishment, under strong impression, after fright, due to stress of any kind. For toddlers, a change in routine can be stressful.

For the timely development of the muscles of the abdominal cavity, regular exercise stress. If the child does not move much, if he has general muscle weakness, he is likely to suffer from constipation.

Rickets can also cause persistent stool retention.

Sometimes there are malformations (defects) in the development of the intestine that affect its work. Constipation often accompanies diabetes mellitus and various diseases of the gastrointestinal tract.

The use of drugs is also not always safe for the intestines. In addition to antibiotics, violations in its work can cause too frequent use of enzymes, bifidobacteria, antispasmodics, diuretics, anticonvulsants and psychotropic drugs.

Treatment

It is often necessary to correct the stool for a very long time, up to a year. Treatment is always based on adherence to the regimen and diet.

It is nutrition that is being reviewed in the first place. Often diet is the only thing needed to treat constipation. Basic principles of nutrition, correct in terms of intestinal health:

breastfeeding until at least 6 months of age;
timely introduction of complementary foods, but not earlier than 5-6 months;
slow (within 7-10 days) introduction of new food, including a new mixture;
a large number of raw vegetables and fruits;
crumbly cereals from whole grain cereals;
dishes in which food is cut into pieces, but not ground;
inclusion in the diet of kefir, curdled milk or natural yogurt (but produced no later than a day ago!);
only black or gray bread, it is possible with bran, yesterday's baking;
exclusion of fatty foods and sweets.

With constipation, foods that increase gas formation can cause trouble: apples, legumes, sweets, whole milk.

For breastfed children, the problem is solved using the same principles. proper nutrition applied to mother.

To fuel the muscles, it is useful to eat foods high in potassium: these are various dried fruits and baked potatoes.

Important

Relaxing products: fermented milk drinks, juice, raw fruits and vegetables (carrots, beets, cauliflower and Brussels sprouts, pumpkin, zucchini, squash), stone fruits (plum, cherry, apricot), banana, gourds (watermelon, melon), oatmeal, buckwheat, corn and barley porridge, rye bread, wheat bran, honey, vegetable oil, seaweed.

Make sure your child has enough to drink. This does not mean that it is necessary to pour a certain amount of liquid into the child. Just offer him a variety of drinks (except carbonated) and vegetable soups - more often than usual. Fresh, not boiled water drunk in the morning on an empty stomach helps to get rid of constipation.

Physical exercise will increase muscle tone. To do this, you can go to physiotherapy exercises or at least do exercises every morning, starting from infancy. Some exercises can help get out the accumulated gas. For example, you can lift the baby's legs and lightly press them to the tummy. However, do not overdo it, because physical overload can worsen the condition.

Massage also has a therapeutic effect as a general strengthening procedure. Babies suffering from constipation can stroke the tummy clockwise before eating. This will ease the pain and relax the muscles, as well as help the baby suffering from excess gas.

Sometimes, if the child suffers from the fact that he cannot go "in a big way", the use of enemas with water at room temperature is acceptable. This procedure should not be done more than once every 2 days. The abuse of enemas depresses the reflexes of the child and causes even more problems, since water washes away the intestinal microflora.

If intestinal dysbiosis is detected, the doctor may recommend taking probiotics and other biological products that stimulate the growth of normal microflora. For infants, there are special therapeutic mixtures, which should also be prescribed by a doctor.

In extreme cases, medications are prescribed. It can be not only laxatives, but also drugs, the action of which is aimed at normalizing the motor function of the intestine. It is highly undesirable to give laxatives to children, because, as mentioned above, they depress reflexes, wash away the microorganisms necessary for digestion, in addition, they have a number of serious side effects.

Moms can help their constipated babies by teaching them how to relax during bowel movements. To do this, the baby is enough just to give the breast. Over time, he will have an understanding that at some point it is necessary to relax the muscles.

As for the regime, it is important to teach the child to relieve his need regularly and at a certain time. Better - in the morning. If the child gets used to going to the toilet immediately after sleep, it will be easier for him to relax.

Trying to save the child from torment, it is important not to overdo it and not bring him suffering with your actions.

Despite the fact that constipation is a common phenomenon, it should not be treated on its own. Specialists will help to understand the causes of stool delays and select the appropriate treatment. In some cases, consultations of other specialists will have to be added to visits to a gastroenterologist: a neurologist, an endocrinologist, a surgeon, and even a psychologist.

A common cause of sleepless nights for young parents is a disruption in the child's emerging intestinal tract: colic, flatulence, and constipation. According to statistics, every fifth baby suffers from the latter. Usually artificial people or infants are susceptible to an unpleasant illness. mixed feeding, but infants are also at risk. What is the cause of constipation and babies, how to avoid it, what emergency measures can be taken and how to ensure comfortable digestion for the baby are tasks of paramount importance. The frivolous attitude of parents to this problem or the use of drugs and methods of treatment that are not agreed with the pediatrician is fraught with a lot of complications for the crumbs at an older age.

What can be considered constipation in a baby?

From a medical point of view, constipation in a child under one year old is considered to be difficulty in defecation or lack of bowel movement over the past 24 hours. This concept is rather vague, since it is closely related to the specific age of the child: in a bottle-fed baby and in an infant, the frequency and consistency of the stool will vary significantly. For example, for newborns under the age of one month, the norm is to empty the intestines in as much quantity as there were meals. This is with breastfeeding. For an artificial child, the norm is only 2 - 3 bowel movements per day.

Of great importance is the instability of the intestines of the baby. Without the help of a specialist, it is quite difficult to determine when the baby is suffering from constipation, and when a decrease in stool frequency is just physiological feature development of a small organism. Therefore, it is important to control not only the number of "adventures", but also the consistency, smell, density and color of feces, the behavior of the child before and during defecation.

Feces of babies up to six months old have a semi-liquid consistency. He yellow color, without bad smell, may contain particles of undigested breast milk in the form of cheesy inclusions. The artificial feces are denser, may have a characteristic specific smell.

Signs and symptoms of constipation

The main thing to pay attention to is the general condition of the child and the consistency of feces. Symptoms that indicate constipation include:

a child with constipation is naughty, crying;
restless behavior of the child during defecation: but straining does not lead to any result, expression of pain on the face, attempts, crying;
any attempt to empty the intestines is accompanied by cries and restless movements of the baby;
feces with constipation in infants are hard: either it looks like peas, or its first portion looks like a “cork”, followed by a mushy mass;
incomplete bowel movement;
regular stool retention for 1 - 2 days;
restless sleep;
refusal to eat;
lack of gases;
causeless crying;
bloating;
pulling the knees to the chest;
vomit.

The manifestation of one or two of these signs does not yet mean that the baby has constipation, but if there are several symptoms, you can be quite sure of the diagnosis and begin treatment. First of all, be sure to contact the pediatrician observing the child. It is necessary to exclude the possibility of an intestinal reaction to medications taken, new foods, the start of complementary foods, and other factors that provoke difficulties in the gastrointestinal tract. Be sure to diagnose dysbacteriosis, allergic reactions and other digestive pathologies. A nursing mother should urgently introduce into the diet products that activate the motility of the smooth muscles of the intestine: boiled prunes, beets, pumpkin. For children after six months, in the absence of allergies, these products can also be used as complementary foods.

If the child is calm, does not refuse the breast or bottle, and bowel movements do not cause him discomfort, then this is definitely not constipation. In newborns, mother's milk or formula can be absorbed so well that they simply have nothing to go to the toilet with.

If the listed problems are still present, then before treating constipation, it is necessary to find out the causes.

Causes of constipation

In the early stages of constipation, it is quite easy to deal with it, simply by eliminating the causes that provoked constipation. These include:

Lack of liquid

This is an extremely relevant cause of constipation for formula-fed babies, especially in hot summers or winters when the air in the room is dry due to heating appliances. Be sure to increase the amount of water your child consumes. The popular pediatrician Komarovsky strongly recommends supplementing even breastfed newborns.

Irrational nutrition of a nursing mother, an adapted mixture that is not suitable for a child, a lack of products that stimulate the digestive tract (beets, pumpkin, dried apricots, figs, apples, peach, apricot, prunes and others)

Taking certain medications by an infant or breastfeeding mother

Constipation is possible when taking antidepressants, antispasmodics. antibiotics, bismuth and iron preparations, NSAIDs, anticonvulsants, muscle relaxants. Acceptance and cancellation of any medication, both by the mother and the baby, must be pre-agreed with the pediatrician.

Breast milk deficiency

Causes the so-called "hungry constipation" in an infant. In this case, all the food consumed is absorbed into the walls internal organs and blood, and the intestines simply have nothing to process.

The introduction of complementary foods

More often, the introduction of complementary foods contributes to the normalization of the digestive tract, but it can also cause difficulties with the stool. You should carefully monitor the reaction of the intestines to new dishes. Also early can contribute to constipation.

Sudden change in diet

This is possible with a sharp loss of milk from the mother, replacing one adapted mixture with another, or an incorrect transition from one type of feeding to another. Usually constipation disappears after adaptation to a new food.

Psychological constipation

This is by no means a myth, as some people think. The body of a child, finding himself in unusual or uncomfortable conditions (for example, when a baby breaks up with his mother), responds to stress in this way. Also, the child may be afraid to recover because of the pain that occurs at this moment. In this case, it is necessary to try to return the normal mushy consistency to the baby's stool, adhering to the diet.

There is another reason for psychological constipation - a child can manipulate adults in this way. If any signs of constipation in a baby cause his parents to panic and the parents begin to constantly regret, comfort and fuss around the child, then the baby may deliberately delay the stool. The only way to treat this situation is to be calm about the problem.

Colds or infections

An increase in body temperature can provoke a significant compaction of feces and lead to constipation.

It is extremely important that constipation itself can be one of the signs of serious diseases and pathologies, so it is important not to self-treat, but to consult a doctor. These diseases include:

genetic predisposition.
Anatomical defects of the gastrointestinal tract.
Diabetes.
Disorders in the digestive tract.
Rickets.
Diseases of the nervous system.
Myasthenia.
Violation of the functions of the spinal cord.
Liver diseases.
lactose deficiency.
Allergic reaction to protein in cow's milk.
food allergy.
Hypothyroidism.

Diseases that lead to constipation. Fortunately, these diseases are rare. These include dolichosigma, Hirschsprung disease and lactase deficiency.

Dolichosigma is an extension of the sigmoid colon. Bowel emptying is slowed down due to kinks and excessive pressure of the sigmoid colon on itself and the rectum;
Hirschsprung's disease occurs due to a violation of the innervation of the intestine. This leads to the fact that some parts of the intestine do not work and are in a spasmodic state;
Lactase deficiency appears due to the absence or small amount of an enzyme that breaks down milk sugar (lactase). In this case, constipation in the baby will be replaced by diarrhea.

Only a doctor can identify such constipation in a baby, and only a doctor decides what to do in this situation.

constipation treatment

The first task in the treatment of constipation is to determine its cause and eliminate it. To establish the normal functioning of the intestines of a newborn, you need:

Medical examination.
When breastfeeding, more frequent breastfeeding.
For a child on artificial nutrition - supplementing with special baby water (not boiled) between meals, while the volume of liquid should be equal to the volume of one serving.
For a baby older than 6 months - the introduction of apples and vegetables into the diet.
For a child after a year - soup, as a mandatory dish in the daily diet.

TO general recommendations in the fight against constipation also include: correction of the nutrition of the mother and baby, increasing the amount of fluid consumed, changing the nature of complementary foods or changing the adapted mixture to one that contains more lactobacilli.

Moms take note!

Hello girls) I didn’t think that the problem of stretch marks would affect me, but I’ll write about it))) But I have nowhere to go, so I’m writing here: How did I get rid of stretch marks after childbirth? I will be very glad if my method helps you too ...

Separately, we should dwell on the issue of complementary foods. Independent experts have long proven that store-bought juices, purees and other "jars for children", regardless of the manufacturer, are made with the addition of quite harmful substances and preservatives and are the strongest allergens for a child. Try to find some time to prepare really healthy complementary foods. From an ordinary carrot or apple, you will get many times more healthy and fortified puree or juice. The money saved on the purchase of the dangerous Agushi can be spent on a convenient blender or juicer, which will facilitate the preparation of complementary foods.

Enemas and laxatives should only be used as a last resort. They wash out beneficial microflora from the intestines: potassium, vitamins, protein, microelements; contribute to a decrease in the tone of the intestinal muscles, lead to a violation of the natural bowel cleansing reflex, and prevent the absorption of nutrients. Before resorting to these emergency measures in a panic, you should try milder and more harmless methods, which in most cases give a positive result. These methods include:

Tummy massage

It is aimed at relieving spasm, increasing intestinal tone and activating its peristalsis. It is performed with soft strokes with a slight pressure on the baby's stomach. Movements must be performed clockwise. You can additionally put a towel or a diaper ironed with an iron on the tummy of the crumbs. Just make sure that it is not hot, but warm. Warm baths and the warmth of the mother's body also help well: just lightly press the baby's tummy to your own stomach.

Abdominal massage for constipation:

Mechanical stimulation of the intestine

It is performed by irritating the anus. Can be done using cotton swab richly lubricated with baby cream. The stick is inserted shallowly into the anus and gently rotated several times. Usually after a few minutes there is a bowel movement.

During the procedure, there is a risk of scratching the epithelium of the anus with a stick, so you need to act extremely carefully, with light movements, do not abuse this method.

For similar purposes, a special gas outlet tube is provided. It is also gently inserted into the rectum, which allows you to activate the process of defecation.

Glycerin suppositories

You can use special rectal suppositories for newborns. They quickly soften the feces and help cleanse the intestines. For a newborn, 1/3 of the suppository is enough. It must be carefully cut and, smoothing the sharp ends with your finger, slowly and gently insert into the anus.

If an hour after the introduction of the suppository, the child has not emptied the intestines, you should call a doctor. Sometimes suppositories can cause discomfort: burning, itching, allergic reactions, so glycerin suppositories also apply to emergency measures.

There is an old and allegedly effective "grandmother's" method of treating constipation, in which a bar of soap is used instead of a glycerin suppository. You need to know that this is a very dangerous method: soap contains alkali and other harmful substances that can cause rectal burns. Even when using baby soap it is difficult to guarantee that it is made without hazardous components.

Enema

An enema is considered an emergency remedy for constipation. A syringe (20 - 30 ml) with a cooled boiled water or a decoction of medicinal chamomile, injected to a depth of no more than 1.5 cm into the anus of the baby and slowly inject all the liquid. The required liquid temperature is about 37 °C. It is advisable to dissolve a pinch of salt in the enema water and add a couple of drops of pharmaceutical glycerin. When buying a syringe, opt not for a plastic one, but for a rubber or silicone tip, they are less traumatic. Pre-syringe tip should be generously lubricated with baby cream or oil. Too warm water should not be used: it will simply be absorbed into the intestinal walls, and desired result will not be reached.

A modern analogue of an enema with a milder effect - designed specifically for newborns. It is a microclyster based on a water-salt solution with the addition of glycerin. The effect of Microlax occurs a quarter of an hour after application. You must first read the instructions for use, and do not insert the tip into the rectum further than the drawn line.

These methods can be used as emergency measures, especially with regular constipation. Frequent use of an enema disrupts the functioning and favorable microflora of the intestinal tract and causes dysbacteriosis, which will have to be treated with probiotics.

Laxatives

Taking laxatives is only necessary when nothing else helps. To a baby up to a year, most laxatives are contraindicated. The exception is Dufalac syrup and similar preparations based on lactulose. To call a bowel movement, Duphalac must be given to the crumbs in a volume of 5 ml. If the baby is breastfed, then the remedy can also be used by a nursing mother.

A six-month-old child can take the drug Forlax. Its great advantage is the duration of use up to three months.

Before using any remedy, remember that medications can only be prescribed by the attending physician, and emergency measures are allowed to be applied only when absolutely necessary: when all methods of treating constipation have been ineffective.

Often in young children, the tummy hurts. How to help a child? What are the best treatments for constipation in an infant? Do I need to use drugs or can I do without folk remedies? All these questions are answered by the pediatrician of the "Home Doctor" with extensive experience Orlova Galina Viktorovna:

Preventive measures

The simplest and effective method treatment is the prevention of disease. The health of children under the age of one year requires constant monitoring and attention. Do not wait for the first signs of constipation, immediately begin preventive measures.

A simple but effective way is very useful: before feeding, after eating, wear the crumbs for several minutes in a column;
Do gymnastics regularly. To do this, lay the baby on its back, gently and smoothly lift its legs bent at the knees and lightly press it against the tummy. Repeat several times, avoiding sudden movements. It is also useful to do the exercise "bike";
Provide the crumbs with the necessary amount of liquid. Instead of tea and juices, it is better to drink special bottled baby water. You don't need to boil it. When introducing complementary foods, juices must be diluted with water;
If the baby is more than 4 months old, prune juice is excellent for constipation. Two teaspoons is enough. After six months, you can use mashed prunes. Equally effective as fresh fruits and dried fruits. You can add prunes to compotes;
Don't wrap your baby. Overheating, along with dehydration, is one of the main causes of constipation. This is also true for colds and infectious diseases: if the baby has a temperature, drink it as often as possible, otherwise constipation after the illness cannot be avoided;
Effective drinks for constipation - dried fruit compote with dried apricots and prunes, raisin water. To prepare it, it is enough to pour a spoonful of pure raisins with boiling water and insist in a thermos;
Give preference to vegetables with a "laxative effect" and a high content of coarse fiber, fruits rich in potassium. These are figs, green apples, prunes, dried apricots, beets, carrots, peaches, apricots, pumpkins. The same products should be introduced into the diet of a nursing mother;
Extremely useful for the intestinal microflora are preparations with bifidobacteria and lactobacilli, fermented milk products, natural yoghurts. They are shown to both the child and the mother;
Try to breastfeed your baby for as long as possible, the first six months are especially important. If this is not possible, give preference to sour-milk adapted mixtures;
If necessary, antibiotic treatment, at the same time as taking them, begin to give funds for the prevention of dysbacteriosis.

There is no need to panic if the baby has constipation. The first step to recovery is to identify and eliminate the causes of the disease. But do not self-medicate and do not use grandmother's treatment methods without consulting a doctor. Most often, it is enough to improve nutrition, drink more fluids and do not forget about massage and gymnastics so that the ailment recedes. In emergency situations, Dufalac, glycerin suppositories or an enema will help. Pay maximum attention to the treatment of constipation. The formation and normalization of the gastrointestinal tract in the first year of life is the key to the future health of the child.

On the subject of newborn stools:

telegram channel

Digestive problems in a premature baby

Condition of the skeletal system and joints

Can the green stool of the baby be the norm with artificial feeding

Symptoms of an unhealthy condition of the baby with a green stool

Reasons for the presence of green stool in infants with artificial feeding

Necessary measures to combat green stools in an infant

Physical development of a premature baby (weight and height gain)

Digestive problems in a premature baby

Intestinal colic

regurgitation syndrome

Diarrhea and constipation

Anemia of prematurity

Rickets of prematurity

Condition of the skeletal system and joints

Premature eye disease

Formation of hearing and speech

What happens to the immune system of a premature baby?

Should premature babies be vaccinated?

What is the prevention of respiratory syncytial virus infection and why should it be carried out?

Let us repeat once again why you need to monitor a premature baby in the first year of life:

Why is constipation bad?

Causes of constipation

Treatment

What can be considered constipation in a baby?

Signs and symptoms of constipation

Causes of constipation

constipation treatment

Tummy massage

Mechanical stimulation of the intestine

Glycerin suppositories

Enema

Laxatives

Preventive measures

Similar articles