When the baby doesn't poop: constipation

By Cristiano Antonino On Feb 19, 2023

By constipation we mean both a reduction in bowel frequency, both the difficult evacuation of hard stools and the daily evacuation of goat feces

In the majority of cases of constipation in children it is a functional constipation, therefore not associated with an organic disease (celiac disease, hypothyroidism, cystic fibrosis, intolerance to cow’s milk proteins, megacolon or spinal cord abnormalities).

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Functional constipation, symptoms

Functional constipation may be suspected when the following features are present:

normal meconium output;
onset of the transition from breast milk to formulated milk, abandonment of the diaper, insertion in kindergarten;
absence of vomiting and diarrhea;
absence of marked reduction in appetite (hyporexia);
presence of retentionistic attitudes;
auxological parameters normal;
non-distended abdomen;
presence of anal fissures;
involuntary loss of stools with a tendency to soil the panties (encopresis);
absence of signs of spina bifida occulta;
on rectal examination, presence of faeces in the ampoule;
response to medical treatment.

Children with functional constipation may have recurring abdominal pain, blood-streaked stools (hematochezia), anal fissures, and loss of appetite.

Constipation in children: what to do?

In case of functional constipation it is essential to perform rectal stimulation and in some cases it is necessary to resort to the use of faecal softeners (laxatives), which have the purpose of making the faeces softer and easier to evacuate.

The response to laxatives is individual, therefore it is necessary to tailor the doses.

It is essential not to interrupt the therapy abruptly but, once the habit has been regularized, gradually reduce the drug until it is completely suspended.

To evaluate the effectiveness of the therapy, it is advisable to compile a diary in which to record the evacuations, the characteristics of the faeces, the quantity of the drug and the possible use of enemas.

Obviously, a diet with an adequate supply of fiber and water, encouraging movement and performing appropriate “toilet training” are essential.

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