Child constipation and soiling – Instructions for home and treatment
A child's bowel function is individual: some defecate several times a day, some less often than every day. In principle, a child should defecate daily or almost daily. Young babies have different patterns of bowel function and their stomachs may function very irregularly. Constipation is a common problem (up to >25% of % children), which should be treated early so that it does not become a long-term problem.
1. When is constipation a problem?
A child is constipated if they have at least two of the following symptoms for a month:
Defecation is infrequent – usually less than every other day. Sometimes constipation can occur even if you defecate almost daily
The stool is hard or defecation is painful.
The child is clearly holding back or afraid of defecating.
The feces are very large.
Defacing: Feces accidentally leak into the pants (for children over 4 years old).
Signs of pawning: An infant may stretch their body and tense their buttocks. A toddler may stand on their tiptoes, hold their legs tightly together, or rock back and forth.
2. Self-treatment of constipation
Diet
Fiber: Add whole grains (rye bread, oatmeal), vegetables, fruits and berries.
Natural softeners: Plum or mango puree, grated pear, and malt extract (for infants) help.
Liquid: Make sure your child drinks enough water.
Power: Reduce foods that harden the intestines, such as bananas, white bread, cocoa, and blueberry juice. Limit excessive milk consumption.
Toilet routines
Regularity: Teach your child to sit on the potty or seat for 10–15 minutes after every meal.
Correct position: Use a footstool on the bassinet so that the child's feet are firmly on the surface and the position is squatting.
Positivity: Never criticize for mistakes. Reward for successes (e.g. a sticky note).
3. Defecation (Encopresis)
Soiling is the involuntary leakage of stool into the pants. Nearly 90% of % cases are caused by severe constipation: a hard stool mass (blockage) in the colon prevents normal bowel emptying, causing loose stool to flow past the block uncontrollably.
It is not intentional: The child is not aware of the stool coming in or the possible smell. The child should not be punished for making a mess.
Care: The fouling will improve when the underlying constipation is effectively treated.
4. Medication
If self-care is not enough in a month, medication should be started according to the instructions of a doctor or clinic.
Cushions: Macrogol or lactulose preparations soften stools. They must be used long enough (weeks or months) for the rectum to recover and the child to learn that defecation no longer hurts.
Evacuation: If there is a large fecal impaction in the intestine, treatment is often started with enemas.
5. When should I see a doctor?
Contact a clinic or doctor if:
The constipation has lasted for over a month and self-treatment is not helping.
There is blood in the stool.
The child has severe stomach pains.
A newborn/small infant defecates exceptionally infrequently (less than once a week).
The mess starts again even though the child has already learned to be neat.
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