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Stomach and bowel problems

Stomach and bowel problems are very common in young children. However, it’s important to keep a close check on their condition and to be able to read the signs that indicate the development of a more serious problem.

Vomiting and posseting

How are vomiting and posseting different?

• It’s very common for babies to vomit frequently in the early weeks as they adjust to feeding and as their bodies develop.
• Vomiting is different to possetting, which means bringing small quantities of milk back up.
• When your baby possets there will only be a small amount of liquid.
• But when your baby vomits there will be quite a lot of it, and it may frighten your baby into crying.

How should I deal with vomiting?

• Vomiting causes your baby to lose precious fluids.
• So to prevent him from becoming dehydrated give him an electrolyte solution or clear liquids like water.
• Once he’s stopped vomiting, give him small amounts of water, or if recommended, an electrolyte solution every half an hour to an hour.
• The Food Safety Authority of Ireland recommends you continue to give formula feeds at full strength to ensure your baby is not getting dehydrated.
• If your baby is still continuing to vomit, contact your GP immediately.
• Keep his fluid levels up by giving him plenty of cooled boiled water.
• Don’t give your baby any anti-nausea medicines, either prescription or over-the-counter, unless your GP has prescribed them for this particular bout of vomiting.

When should I worry about vomiting?

In the first few months, vomiting is normally due to problems relating to feeding. When your baby’s a few months old, the more likely cause is a stomach virus or bug. However, vomiting can sometimes be due to more serious problems such as an infection of the respiratory system, urinary tract or even the ear. If you notice any of the following problems as well as vomiting, you should contact your GP:

• Severe abdominal pain.
• A swollen abdomen.
• Lethargy or severe irritability.
• Convulsions.
• Strenuous, repeated vomiting or vomiting that continues beyond 24 hours.
• Signs of dehydration, including a: dry mouth, lack of tears, depression of the ‘soft spot’ on your baby’s head, and decreased urination.
• A little blood in the vomit is usually nothing to worry about and is caused when regurgitation causes tiny tears in the blood vessels lining the oesophagus.
• But do call your GP if your baby continues to have blood in his vomit or if the amount of blood is increasing.

Constipation

• Even when its appearance is soft or liquid, you’ll notice your baby straining to pass any kind of stool.
• The straining in itself doesn’t mean your baby is constipated, as constipation is the infrequent passing of very hard stools. This is more common in bottle-fed than breastfed babies as breastmilk has a laxative effect.
• True constipation occurs when a stool in the lower intestine is pinched by the tightening of muscles. The longer it remains in the gut, the firmer and drier it becomes.
• If your newborn passes hard stools less than once a day, it is generally considered that your baby is constipated.
• If you have noticed this, check with your Public Health Nurse or your GP.

How can I treat constipation?

• Before you do anything, you should check with your GP or Public Health Nurse, and you may be asked to take your baby for an examination.
• If you are not breastfeeding, you can still help your baby have a softer stool that’s similar to breastfed babies, by choosing an infant formula milk containing prebiotics, such as Aptamil infant formula milks.
• Like breastmilk, Aptamil infant formula milks contain prebiotics, which will help your baby to have a softer stool.
• For an older baby who is on solids, ask your Public Health Nurse about adding a few tablespoons of puréed prunes to his morning cereal, or giving him two teaspoons of prune juice.

Diarrhoea

• Bowel movements in newborns do tend to occur frequently.
• The bowel movements of breastfed babies are usually soft, yellowish and even a little liquid.
• They may occur up to five times a day, and may happen immediately after each breastfeeding session.
• Within a month, breastfed babies should be down to one or two bowel movements per day.
• The bowel movements of formula-fed babies tend to occur one or more times a day.
• The occasional loose stool is normal, whether you are breast or bottle-feeding.
• However, if your child begins frequently passing smelly, watery, mucus-streaked stools as much as a bowel movement per feed after the first month or if he has a fever or appears to be losing weight, it may be diarrhoea.
• Consult your GP or Public Health Nurse.

What causes diarrhoea?

• Diarrhoea occurs when the inner lining of the intestine is injured, usually by an infection.
• The lining then leaks fluid and allows food to pass through without absorbing any nutrients.
• This kind of damage to the lining can be caused by gastrointestinal infections, colds, antibiotics, and too much fruit or juice in the diet.
• It can also be caused by food poisoning, allergies or intolerances, and may sometimes accompany teething.

Can it be prevented?

• You can help reduce the chances of your baby getting diarrhoea by washing your hands thoroughly for at least 15 seconds with an antibacterial soap after handling soiled nappies or using the toilet.
• Breastfed babies tend to suffer less with diarrhoea, as elements in breastmilk inhibit the growth of the micro-organisms which cause diarrhoea.

Treatment

• Provide drinks of cooled, boiled water in between feeds to increase your baby’s overall fluid intake.
• Only use anti-diarrhoeal medicine if it’s prescribed by your GP.

When should I call the doctor?

Diarrhoea will usually clear up on its own. But if your baby has loose, watery stools for more than 24 hours, call your GP. You should also consult your GP if your baby displays the following symptoms of dehydration:

• Dry skin or lips.
• Listlessness.
• Tearless crying.
• Discoloured hands and feet.
• Strong yellow coloured or diminished urine output.

These other symptoms are also cause for concern, so contact your GP immediately if they develop:

• Your baby refuses to eat or drink.
• Has a fever which lasts longer than 24 hours.
• There’s blood in her stools.
• The diarrhoea is accompanied by vomiting.
• Your baby’s abdomen is distended.