By Clare Namanya
For two weeks, Cerinah Kenema’s nine-month-old baby held onto his mother and screamed as he passed stool. “I didn’t take it seriously until I saw blood in his stool, I suspected my son was constipated because the housemaid does not often give him enough to drink,” Kenema says.
According to Dr. Michael Juma, a paediatrician at Baylor College of Medicine, Mulago, when a bowel movement happens less frequently than usual and is characterised by hard stool, which is uncomfortable to pass, this is referred to as constipation.
Constipation, he says, is common in babies who are being weaned (introduced to semi-solid foods, in addition to breast and/or formula milk). This happens because the baby’s digestive system that had been accustomed to processing the easily and highly digestible milk, now has to gradually adjust to digesting solid foods.
Chandiru says according to Mulago Hospital statistics, six out of 10 babies of first time mothers present with constipation because the mothers are not familiar with a baby’s nutrition requirements. They may also take it lightly and rely on advice from other mothers.
What causes constipation?
Dr. Grace Chandiru, a paediatric at Mulago Hospital, explains that when a child has been breastfeeding exclusively and is started on semi-solid foods, it takes the digestive system sometime to adjust to the food because it was accustomed to milk which is easily digestible.
Constipation is a symptom and not a disease. A poor diet for instance can cause constipation. Chandiru says some foods, especially when consumed in large quantities can result in constipation. These include milk, bananas, cheese, yoghurt, rice and sweet potatoes.
Formula milk, especially the soya-based type is not intestine-friendly for babies, especially those who are just being introduced to solid foods, as it tends to harden the stool.
According to Chandiru, dehydration (lack of adequate fluids in the body) also causes constipation. “The constipation can be mild, moderate or severe, depending on how much fluids have been lost and not replenished. When a child is not drinking enough fluids, such as water, the body responds by absorbing the fluids from wherever it can and that includes the bowl. This hardens the stool, resulting in constipation.
She also explains that a child who eats less or nothing most of the time is also likely to get constipated because the little that is taken in is digested, but does not make waste enough to dispose of. It would have to wait for more waste to accumulate and make it bulky enough to excrete. But the longer stool stays in the body, the harder it becomes.
Withholding of stool can result in constipation. When a child is stressed, embarrassed to use a public toilet, or is scared to interrupt his playtime because of a painful bowel movement and sometimes poor potty training can cause constipation.
Symptoms of constipation
These include passing of hard stool, the child crying as he passes stool due to pain and abdominal pain.
According to Juma, when hard stool forces its way through the baby’s narrow rectum, it tears the rectal wall, resulting in bloody stool.
How to ease constipation
According to Juma, one can relieve a child of constipation by feeding him right. “Lots of fluids like water and juice, when given more frequently, keep the body hydrated and prevent stool from hardening,” he says.
Fruits, such as pawpaws and tomatoes can also help relieve a child from constipation. Parents should, however, avoid giving a child a lot of bananas as these may only make the constipation worse.
Juma recommends foods rich in fibre. These include vegetables, cereals and whole grains.
He says when diet fails to sort out the constipation, seek medical help. A doctor may prescribe anal medication to relieve the child of constipation.
Enema (an application of a liquid through the anus to stimulate evacuation of stool) may be done as a last resort.
Some parents push soap into the baby’s rectum, but this may only cause temporary relief and may irritate the baby’s rectum and anus.