I have many anxious parents who come into the clinic and tell me that their child is constipated. The child had soft stools the day before but no stools today. Before we get carried away with treating constipation, let's understand when we call constipation constipation.
When is constipation, CONSTIPATION?
- Less then 3 bowel movement a week, or not having bowel movement for 3 - 4 days
- If the stools are very hard and the child has difficulty passing the stools
- Give lots of fluids. Water and naturally sweetened fruit juices are best. Avoid soft drinks and fruit juices which are artificially sweetened
- Give the child lots of fibre in the form of cereals and bran. Fruits such as papaya and even dried fruits like prunes and raisins are excellent for promoting bowel motion. Make sure they get their vegetables which are a good source of fibre
- Getting the child to be active and excercising. Bring the child to the playground and let them run around and jump up and down!
- Always make sure that the constipation is not due to other causes. The Doctor will help you determine that
- Use a bit of lubrication like wiping a bit of petroleum jelly on the anus
- Make sure the formula is prepared according to instructions. Some overenthusiastic parents and grandparents put more powder or compact the milk powder to help the child grow fat fat faster!
A real life example
I saw a 5 year old child who had been having chronic constipation for almost a year. The passage of stools is very hard and she usually goes to the toilet only twice a week. It all started with simple constipation, but after a while, the stools were so hard that the skin of the anus was stretched so much that it started to tear, resulting in an anal fissure. Because it was now more painful to pass motion, the child controls the motion to avoid the pain. This results in the stools getting harder and drier and more difficult to pass. And the cycle goes around and around...
A word on toilet training
It is important that you do not let the child start to develop this problem. So in addition to the measures outlined above, you should also:
- Put the Toddler on the Toilet Bowl at the same time daily, usually after a meal and leave him there for 10 minutes. Make sure that the feet are rested on the floor or a stool. Encourage him to Pang Sai (Pass Motion), but if there is no motion, don't worry too much about it. Just do the same routine everyday.
- See your doctor once the constipation is more than 2 weeks. The doctor may prescribe some medication to help soften the stools. He will also check for other problems that may cause the constipation
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