How To Relieve Infant Constipation


Beware of your baby’s cry. Though most of the time, your baby cries due to innocuous reasons but some of the cries may be triggered by pain in the abdomen arising from constipation. Candidly speaking, there is no hard or fast rule to what the frequency of bowel movements in infants should be. Some babies pass stool once a day, some once every three days, some once a week. On an average there should be one bowel movement by 3 days.


Since the baby cannot communicate it is up to the parent to diagnose his constipation and relieve it. Food as you know moves down the intestine with recurring waves of contraption called peristalsis. Though peristalsis is an automatic process requiring no stimulus but its intensity is dependent on how the intestine is stretched by food.  To understand what causes constipation we have to understand something of the ultra structure of the intestine and the physiology of nerve conduction and muscle contraction.


Physiology of Muscle Contraction


From inside outwards the intestine consists of the mucus membrane, lamina propria, the muscularis mucosae, the submucus coat, the muscularis externa and the serous coat. The layers that are of interest to us in understanding constipation are the submucus coat and the muscularis externa. The submucus coat contains two bundles of nerve fibers arranged in two plexuses, the Messner’s plexus and the Aurebach’s plexus.

These nerve fibers conduct electrochemical currents in the form of moving sodium and potassium ions. These impulses occur when the nerve fibers are stimulated by stretch receptor which as their name suggests are themselves stimulated by stretching of the intestine in whose walls they are situated.


Smooth Muscles in Muscularis Externa

The muscularis externa contains two layers of smooth muscle cells. These smooth muscles contract when a nerve impulse initiated by stretching of the intestinal walls reaches its cell surface forcing calcium ions into the cytoplasm and making its contractile protein actin and myosin to interdigitate. The contraction of these muscle cells forces the stool stored in the intestine through the rectum to the exterior. In constipation, the intestine is not stretched and these muscles do not contract. This is the basic patho-physiology of constipation.


Causes of Infant’s Constipation


Constipation in a baby occurs due to a number of reasons. One of the major causes is the introduction of solid foods.Breast fed babies are generally not constipated as breast milk is totally digested by the infant. It is when the infant is weaned to solid foods that the problems start. If the baby had been previously formula fed he stands a better chance of not being constipated. 

Besides weaning to solid foods there are other causes of constipation in infants.


Diets Low in Fiber fiber forms a gelatinous mass with water, thus increasing the total bulk of the food, stretching the intestine, making it contract thus aiding defecation.


Diets containing only dairy products like milk, cheese or yoghurt is likely to cause constipation


Foods such as bananas, bread or white potatoes are likely to cause constipation.


Tips to Fight With Constipation


The infant’s constipation may be relieved in a number of ways. Here are some of them


1. Changing the diet goes a long way towards relieving constipation. Diets should be changed to high fiber foods such as apricots, peaches, plums, peas and spinach.


2. Massaging the baby’s abdomen in a clockwise direction helps in relieving constipation.


3. Giving the baby a warm bath sometimes helps.


4. The baby is placed on his back with his legs in a half bent fashion. The legs are moved as if the baby is riding an imaginary bicycle. This is a very effective measure to relieve constipation.


5. For babies less than 4 months old giving one or two ounces of fruit juice relieve constipation.


6. If the baby is being formula fed try changing the formula.


7. Do some rectal stimulation with a rectal thermometer or ask your baby’s pediatrician to use a gloved finger for rectal stimulation.


8. There are baby laxatives, enemas and suppositories available in the market but consult a pediatrician before you use them.


9. Hirschsprung disease: Infant constipation may be caused by Hirschsprung’s disease or cystic fibrosis. In Hirschsprung’s disease the second relay neuron in the Aurebach’s plexus is congenitally absent. Nerve impulses cannot be conducted and hence the muscle cells do not contract. In cystic fibrosis the baby’s first stool or meconeum solidifies in the intestine leading to constipation consult your pediatrician.


10. Your baby may be suffering from imperforate anus i.e. the anal opening may be missing. The cure is surgical


Infant constipation is indeed troublesome for the baby but measures are at hand to alleviate it.

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