This is a very complicated topic. It is also a topic that is not discussed with enough respect and appreciation. As an early intervention provider who primarily works with infants and those children with medical complexities, discussions about the bowels happen at every single visit. For an infant, how their bowels and digestive tract function is a basic foundation for their development. I describe this as one of the the basement for our house. As important as sleeping and eating, we can not function well if our digestive tract is out of order.
How do bowels work?
The simplified version: The bowels are a part of the digestive system. They happen to be at the very end of the digestive tract. The track begins in the mouth, moves to the esophagus, then stomach, followed by the intestines and finally ends with the expulsion of stool. There are additional organs that participate in the digestive process as well. The digestive system is responsible for breaking down our foods into nutrients and waste. The nutrients are absorbed into the body to be utilized for energy and other needs. The waste is excreted as a bowel movement. The movement of materials through the gut utilizes a process called peristalsis. All these organs work together to create the digestive system.
The big question: Why should this be a priority?
I have described a few scenarios that are impacted by bowels. This is not an exhausted list by any means. These are just a few of the experiences that a provider or family may notice. When we are working with a child who has a feeding difficulty, for example, we need to consider what is happening in the digestive tract including the bowels. A child will not want to eat if they are constipated. They could also be impacted by gas as a result of the foods they are eating. Reflux is another culprit when it comes to feeding. Although this is not in the bowels it can have an impact on the bowels in the form of gas. Sleep can also be impacted by any of the above mentioned issues. A child who is uncomfortable will be fussy which may impact their sleep. They may also avoid movements that make them feel uncomfortable or prefer positions that provide relief. Let's face it, constipation, loose stools and gas are very uncomfortable. Although this is not an exhaustive list of ways the bowels can impact a child’s development, it is meant to show that there can be wide ranging impacts.
What should we be looking for in the stool?
When discussing bowels, we need to know the frequency, consistency and color of the bowel movement. We strive for children to be regular, at least one movement every 3 days. Every child is different but if a child is less frequent it should be discussed with the physician. On the contrary we need to know if they are going constantly. This could cause skin breakdown or if loose, it could cause dehydration. If, for example, if the stool becomes hard like small pebbles or the child is straining when trying to pass their stool, this would be a reason for concern. Again contacting the pediatrician would be recommended. Generally once solids are introduced, stools should be the consistency of peanut butter. (Sorry for the food analogy! ) Excess gas, frequent spitting up, odd color that can not be attributed to what the child ate the day before or odd consistencies such as excess mucus in stool is of importance to note with the physician. When something seems off it is better to ask the pediatrician for guidance and let them be the ones to decide if any further action should be taken. It is always better to over report than under report.
What can we do at home?
The good news: there are many tools at our disposal in the home. When it comes to the consistency of bowel movements we can tell that a child may need to either eat less constipating foods or eat foods that encourage more frequent movements. Two common culprits of constipation are bananas and dairy. We may need to modify how much a child eats of these foods. When stools are too hard we may look to add foods that help with softening. This could be foods such as prunes or other fruits. When stools are really loose and frequent we may also consider foods that children don't tolerate well. They could have an intolerance for a specific food. We could also look at foods that are more binding such as bananas. When gas is a problem we can consider if there are dietary culprits or if it is something more. We would consider things such as broccoli and cauliflower or foods such as kale. I have noticed that with the introduction of pouches there are foods such and kale and quinoa within the pouch with many containing more than 3 foods. This will require more detective work to determine which if any food is causing the issue. We could also use positioning to assist with relief of gas. As a side note, positioning will also help with spitting up. We can make sure we are giving infants who drink from a bottle or nurse the opportunity to burp which relieves the gas that is building up. It should be noted that nursing mom also needs to consider what they are eating and the impact that can have on breast milk. A modified diet may be needed if your child is sensitive to certain foods. These are all tools that are effective in managing and course correcting when we notice early bowel signals. Contact a pediatrician if the problems persist.
Be the Detective.
We have to become effective and efficient detectives when it comes to bowel function. We need to get to the bottom or root cause of the issue. We first need to know our child's regular bowel habits. As we discussed, knowing the frequency, color and consistency of their stools. The use of journaling to look back at the foods that were eaten can be of benefit. We need to be very observant to see the differences in the bowel patterns, meaning we need to inspect each movement. This should help us to know if a child’s typical bowel routine is off. We could determine if there has been a longer time between movements or the opposite. It will also identify any changes to the consistency by observing what it typically looks like. I know this is not a fun topic but in my experience it is imperative to be very familiar with your child’s typical consistency, frequency and color of stool.
In conclusion:
Understanding everything about your child’s typical bowel habits will help you to advocate for your child effectively and early. Thus ensuring your are identifying any problems early on and decrease the long term impact that a problem could have. As an advocate of your child, being an expert in every area of your child's function is crucial: even with the their poop.....
Comments