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Q: My daughter is 3 years old. Last month I saw a pipe-like thing coming out of her anus and when I consulted a doctor, he said that my child's anus was collapsing and that I would have to show her to a surgeon. But the surgeon said that surgery was not required and I just have to see that she doesn't have constipation. But now it has become a daily issue. Whenever she passes motion her anus comes out. I am quite worried. Is a surgery required? She is a very active child. Why does her anus come out? Please help me!
A: Your daughter has something called as prolapse. There are many reasons for this including pin worms, severe constipation and dysentery. Severe straining at stools is also one of the reasons. What the child needs is dietary advice and may be a ring reinforcement of the anal sphincter. Get in touch with a paediatric surgeon.
Q: I have a 2 and a half year old son. He had been constipated for a week. Our doctor prescribed a medication which works as long as he is on it. The minute he stops the medicines, the constipation continues. We tried changing his milk formula. He has Soya milk as he is allergic to cow milk. (We thus mix an equal amount of cow and soya milk and give it to him.) He seemed to be fine, till he developed constipation. We then tried giving him more of cow milk, a bit of honey and a lot of water and fluids. And now he has developed loose stools. What is happening? The doctor feels nothing is wrong.
A: Stop all forms of milk.
Q: My two year old daughter passes hard, painful stools. She drinks milk and has lots of fruit, prune juice, black beans and Nestle Cereal. She has had this problem ever since she started taking formula milk.
A: Children on formula feeds have tight stools. The ideal solution would be to stop formula and start the child on regular pasteurised milk.
Q: My daughter who is 2 years old has rice twice a day and in the evenings she has Ragi and oats. She also has bread, prune juice and bananas regularly. For the past two weeks she has been passing very hard stools. What should I do?
A: Please give your child syrup Cremoffin 5 ml everyday for 15 days and report back to me.
Q: My son has been constipated ever since he was born. I regularly give him fibrous fruits, rotis etc. to ease his bowels. I have also tried giving him homeopathic medicines and Isabgol, which he doesn't like so I force him to have it! I don't like applying pressure. Any suggestions?
A: Are your son's stools very hard? Does he pass blood with his stools? If the answer to both these questions is negative, there is no need to worry. If the answer is positive, give him Cremoffin liquid 5 ml at bedtime for 2 weeks. If it still persists, consult your pediatrician.
Q: My daughter is three months old. She gets constipated every couple of days. The doctor prescribed Karo syrup in her formula or water. She does not like this and screams terribly whenever it is given to her. Is there any alternative?
A: Your daughter is not suffering from constipation. It is normal for a 3 month old to pass infrequent stools. There is no need for any treatment. Other babies pass stools around 5-6 times a day. That is normal as well.
Q: I have a two year old son. He has had severe constipation for the past year. Though he passes stools everyday, he struggles a lot and his stool is very tight. We have been giving him a lot of water, apple juice, vegetable juice and even prune, but his constipation has not improved. This problem started when we shifted residence. He now eats bread, egg, milk or rice cereal, milk for breakfast. For lunch he has rice with dal and apple/banana or strawberry. In the evening he has a glass of milk. At night, he has noodles or rice with vegetables and a glass of milk. He takes vegetable soup almost every day. This is his general diet. He takes fish once in a while. He is not yet potty trained. Could you please let me know whether his diet needs to be changed to overcome this problem? If so what can we add/delete? If he is potty trained, will she get better? Since the stool is very hard and he struggles a lot, will she develop any problems like piles etc. as he grows up?
A: Constipation should be taken seriously because it can lead to complications. Toilet training for your child should be undertaken only after the motions are better. We suggest below the diet in general in case of constipation in children. Eating sufficient fruits, vegetables, sprouts whole grains and fluids helps in the prevention as well as the treatment of constipation. Regular bowel habits and relaxed pace for morning routines also helps to avoid constipation A glass of water on getting up in the morning is helpful. Many children may get a normal urge to pass a motion after that. Others may get used to passing the motion after drinking milk or after breakfast. The child should be relaxed after a while sitting on the toilet. A younger child may be encouraged to sit for about 15 minutes. The mother or others can engage him with something interesting like a toy or a book or a puzzle. If he does not evacuate, he must not be forced to do so.The diet should have more of fibre in the form of fruits like figs (fresh as well as dry), raisins, plums, apricots and prunes; vegetables especially leafy vegetables, raw vegetables, peas, and beans; sprouts; Give him chapatti, unpolished rice and enough liquids. Skip the noodles.
Q: My baby's stools have black spots in them. Why is this so? His stools are dark yellowish in colour. He is also constipated. I gave him banana powder mixed with formula milk. Now what should I give him?
A: The stools of your child are normal. You must wait till your baby is 6 months before you give any outside food.
Q: The problem with my 2 months old baby is that she is not regular in her bowel movement. Sometimes she does not have bowel movement for 2-3 days. I am very worried about her health. She is breastfeeding. Is she constipated? What should I do to regularise her bowel movement?
A: Bowel movements of new born children vary a lot. Not passing stools for 3 - 5 days as well as passing 15 to 20 small frequent stools are normal. There is no need to worry and no treatment is required. As the child grows her bowel movements will normalise. In fact, in some children such a pattern may persist even till 5 years.
Q: My son is 2 months old. He passes very irregular motions. He passes a stool once in 8-10 days. Sometimes his motion is very sticky, other times it is harder. What can I do to regularise his motion? Is he being underfed?
A: Bottle fed babies are more likely to be constipated than breast fed babies. Babies on breast feeding usually open their bowels well. I am bit concerned about the weight of the baby. A newborn should gain around 30gms a day. Unless your baby's birth weight is less than 2.5kg, his weight gain is not satisfactory. If a baby is adequately fed, he or she should pass urine adequately and sleep for 3-4 hours after a feed apart from gaining weight. You should see a paediatrician immediately to rule out surgical problems like 'Hirschprung disease' where the nerves of the lower part of intestines are not well developed and prevent the bowel from opening. Some medical problems also result in constipation, and should preferably be addressed soon.
Q: I have started giving solid food like kichdi (rice and mung dal) with salt, jeera powder and turmeric, twice a day. I give her milk 4 times a day, and some fruit, soup or biscuit. But she doesn't pass stools daily. Sometimes she passes stools after 2 days. The stool is very hard, and it does not come out easily.
A: Stool patterns in babies are highly variable and cannot be compared to the adult pattern of daily passage of motions. Try this home remedy: Take half a glass of water, and boil a ripe tomato in it. After it is nicely cooked, squeeze and extract the juice. Filter off the juice and add a pinch of salt and give it to the child every day for 15 days. Motions will become softer.
Q: The problem with my three month old baby is that he is not regular with his bowel movements. Sometimes he goes without a bowel movement for 2-3 days. I am worried about his health. He is breastfeeding. What should I do?
A: Breastfed babies should have bowel movements more frequently than bottle-fed babies. Make sure he is getting enough breast feeds. He should be gaining around 30gms (1 oz) every day, should be passing plenty of urine and should be able to sleep well for 3-4 hours after a good feed. If he does all these things, there is no need to worry. Does the mother have any diet restriction? Removing such restriction may help. If he is still having a problem, contact your health visitor or your family physician for laxatives. But I personally do not feel that is necessary.
Q: My baby is 26 days old and weighs 3.6 kgs. She seems to be constipated. Her stool is hard. Do you have any home remedy? Can I give her Milk of Magnesia, honey and boiled sugar water?
A: We do not call it constipation. It is called infrequent stools. There is no need to worry, and no treatment is required.
Q: I have a 5-month old son. He does not pass motions daily and is highly constipated most of the time. In the last week I had given him a suppository thrice. Is it safe to use a suppository? I have a bad cold for which I have been taking Avil. Is it safe to take such tablets, since I am breastfeeding my baby?
A: The stool pattern of breast fed babies is highly variable. Children may not pass stools for 4-7 days, or they may pass stools 12-15 times with every feed. There is no need for any treatment for either. Suppositories are habit forming and can damage the rectal mucosa. Do not use suppositories. Drugs are excreted in breast milk in extremely small quantities, so don't worry about the Avil. If your child gets drowsy, take a milder antihistaminic.
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