Constipation in Children

Constipation in Children
Constipation in Children
Constipation in Children

Constipation is one of the problems that pediatricians face quite often. Constipation is a hard and sparse defecation due to the inability or failure of normal defecation. Constipation is either short-term and temporary or chronic. Constipation lasting more than a month is considered chronic constipation.


  • If the child is under the age of 4, having at least two of the following criteria will diagnose constipation;

  • If it feces 2 or less per week,

  • If there is a history of excessive stool accumulation,

  • If it is painful and stiff stool,

  • If there is a large scale stool

  • If there is a large stool mass in the rectum

  • After acquiring the toilet skill;

  • A history of stool incontinence at least once a week,

  • If there is a large history of defecation enough to block the toilet


 Features of Normal Stool

"Meconium", the first poop of the newborn, is greenish black in color, odorless, has a dense and sticky appearance. The transition poop may be greenish brown, less dense, with a stench and a cut-fermented milk appearance. In this period, bowel movements may be absent in relation to the food the baby receives or may occur 12-14 times a day. Therefore, not only the number of feces, but also its appearance is important in order to call it constipation or diarrhea. Milk poop appears after the first week. The baby's poop, which is fed with breast milk, has a homogeneous, slightly sour-smelling, light yellow color, sticky, dish-like appearance. In this period, babies can feces after each feeding. It can rarely be light green and mucus. Babies fed with cow's milk have a tight-hard, pale-yellow color. In contact with air, it turns green-brown.

The average frequency of defecation of infants fed with breast milk is as follows:
0-6 weeks: Bowel movements are observed that may cause defecation after each breastfeeding. However, how many of them result in defecation shows individual differences (average number of defections 4-5 / day).
> 6 weeks - 6 months: It can vary from 7-10 days to 3-5 times a day.
6 - 60 months: <4 times / day

 Causes of Constipation

Constipation is for structural or functional reasons. The onset of constipation in young children often happens during toilet training. The most common reasons for this are the use of high toilets that do not allow proper foot support, the oppressive attitude of the child caregiver, and the early start of the toilet training process. In a very small proportion of children, constipation depends on structural causes in the body. The most common cause of constipation (90-95%) after the neonatal period is functional constipation. Often, if constipation is not treated well or improperly treated, it may be the cause of chronic constipation.


Education

It is very important for the family to learn the cause of constipation, pay attention to the child's diet and comply with the treatment. The ideal target for the family and child is to prevent negative thoughts and attitudes. Families should be willing and supportive for the continuation of the treatment. Constipation and toilet training should be maintained.


Regulation of Behavior

Regular toilet training is at the top of the behavior change. It is recommended to go to the toilet after meals without rushing. An important part of constipation treatment is to motivate the child. This includes some kind of reward system. For example, going to the toilet 3-4 times a day should be made into habit, for 5-10 minutes after each meal and before going to bed at night. Children going to school should do this at least 2 times a day. For children with motivation or behavioral problems, child psychiatry may be asked for help.
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