Tuesday, January 3, 2012

new mom tip: constipation

This is for moms out there who might need some more unsolicited advice...you know you can't get enough of it!

There are a few things I've learned in my very seasoned 8 months of having a child (and my whopping 2 months on pediatrics as a medical student). The topic of discussion today is one of my favorites and very near and dear to my heart: constipation.

Let me preface this by saying my baby is formula fed. I suck, I am poisoning my son, I know this. I did my best with breastfeeding and pumped for 5 months. Maybe next time I'll do better. Maybe not. Either way, formula fed babies get constipated often and it's no fun. We are transitioning from soy to cow's milk based formula in hopes that it is less constipating. We will see. 

So a week or so ago I realized that Parker had not had a normal bowel movement in at least a week. He had only had occasional tiny, hard, powdery poop. I had been trying to get him back to normal by giving him apple juice and feeding him apple everything (apple sauce, chicken and apples, apple oatmeal, etc). I figured apples are high in fiber and full of fructose, so this should do the trick. Apparently, I'm retarded. If I had thought about it for a second, I would have realized the A in BRAT diet is for apples. And what is the BRAT diet for? Diarrhea. So I had been inadvertently contributing to Parker's constipation.

Of note, apple juice is good for constipation (the nurse told me that the sugars are processed differently in apple juice vs apple sauce/apple baby food). At least I wasn't causing a complete bowel obstruction.

Well I learned all this extremely useful information from calling up my pediatrician's nurse, and she also informed me that they sell laxative suppositories for kids ages 2-5 years (Fleet's makes them, they are glycerin suppositories and I think they are called Pedialax). You can cut them in half lengthwise and give them to infants! Now why didn't they teach me this in medical school? Oh ya, I was too busy learning more useful information on rare leukodystrophies. Why would I waste my time learning about all the common things that happen to babies?

So the suppository worked like a charm.

Tips for suppository use in infants
1. Only use when your baby reallllly needs it, and then only do it once to pop the cork, so to speak. Babies can actually become dependent on them, so you want to use sparingly to basically only empty and open up the rectum.
2. Like previously mentioned, for infants cut the children's suppository in half lengthwise.
3. When you insert the suppository in the baby's booty, it doesn't need any lubrication. It will go in easily. (By booty, I mean anus...you have to put it up there. Sorry if this seems obvious, but you would be surprised what people do when you aren't very literal with instructions. One time I had a patient who was swallowing medicine that was meant to be put in her vagina.)
4. It will go in easily, but it won't stay in easily. Once you get it in the baby's butt, hold their buttcheeks closed for as long as your baby will tolerate (this may be only a couple seconds). You can reinsert the suppository and keep trying.
5. Give up when you and your baby are both exhausted of trying to hold it in. Even if only a tiny bit is absorbed, it will (probably) do the trick!

As far as prevention goes, I've learned that yogurt for breakfast (if your baby is at least 6 months old) has worked wonders. I don't know if this is just unique to Parker's GI tract, but I suspect not. Probiotics are a miracle, for adults AND babies apparently. I have found yogurt to be much more useful than juice, although others swear juice is a good preventive measure too. I am sure I don't need to go into the "evils" of juice...I don't buy into it, but form your own opinion.

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