Constipation is a condition when

• Passing motion becomes difficult or it’s not regular.
• Motion is hard and there is a sense of incomplete bowel emptying

Long standing constipation may lead to many serious health issues like fissure, piles, urinary tract infection, fecal impaction [ fecal matter changes to stone like consistency]. And slightly less serious issues like decrease appetite, acidity ,increase gas and abdominal distension. Though this blog is about children but whatever I am talking is relevant even to adults.

How to relieve constipation

I will be discussing this under four headings

1. Diet modification
2. Adequate water intake
3. Medication
4. Proper positioning of the child while passing motion

1. Diet modification

This is the most important aspect of treatment, we have to add more fibre in the diet as fibre helps in holding water in the intestine thus leading to soft motion. These are the foods which are rich in fibre –

–  Beans. All beans are good, whether baked beans, beans like kidney beans or beans in salads.

– Wholegrain and wholemeal. Skip white bread and pasta, look out for wholegrain and wholemeal on the labels.

– Brown or wholegrain rice. White rice doesn’t offer as much fibre.

–  Pulses. As well as beans, chickpeas and lentils are full of fibre. Try using whole dals than split ones as they give more fibre.

– Nuts. Almonds, pecans, and walnuts have more fibre than other nuts.

– Dried fruit. Like figs and dates are rich in fibre

– Bran based cereal and other healthy cereal options.

– Porridge. Porridge is made from oats which are a great source of fibre.

–  Vegetable. All green leafy vegetables[ spinach, methi, soya], beans [flat and round] , lady finger, green pea are rich in fibre

– Fruits. Raspberries, pears, apples, strawberries, chikku,banana are rich in fibre and these fruit should be eaten with the skin (except banana)

2. Adequate water intake

Water is important to make the motion soft. So adequate amount of water should be consumed , neither more nor less . Will discuss about it in detail in some other blog. Just to give a rough estimation children [ more than 2 yrs] needs around 50 to 100ml /kg body weight of water.

3. Medication

Medication has a role initially to relieve constipation and helps in setting up a routine of passing motion regularly. So discuss about it with a paediatrician.

4.  Proper positioning of the child while passing motion

If child is using western toilet then please make sure that his/her legs are properly supported on a stool instead of hanging mid air.This is important as this relaxes the child and helps in complete evacuation.

Please feel free to leave comments.

Dear Parents,

Loose motion is the second most common illness I see in my practice after throat infections. Besides the treatment of loose motion the biggest dilemma parent face is what food to be given to the child during the illness. I will be discussing diet in a child down with loose motion in 3 headings

1. For children less than 6months of age
2. For children 6 months to 1 yr of age
3. For children more than 1 yr of age

1. For children less than 6 months of age

Do’s -Mother’s milk is best for the baby so continue breast feeding. Babies who are on formula feed, their parent can change formula milk from regular [ NAN or Lactogen or Dexolac ] to Soya milk powder [ Nusobee or Isomyl soya] as its easily digestible. Electral powder [ ORS]  to be added in the diet.

Don’t ‘s – No outside food should be given, glucose water not to be given.

2. For children 6 months to 1 yr of age

Do’s – Breast feeding to be continued for the baby. In weaning food Dal , Cerelac, soya milk powder, fruits[ Banana or apple preferrably], ragi ,rava [ Sooji] are completely safe. Electral powder [ ORS], coconut water and juices can be given in the diet.

Don’t’s –  No dairy milk, No glucose water, fruits like mango and papaya to be avoided.

3. For children age more than 1 yr of age

Do’s – Keep the diet simple and bland.Dal rice, khicdi, pongal,sambhar rice, sandwiches, Cerelac , roti subzi , curd rice, fruits[ like banana, apple,chikku], dosa, in the non veg food egg can be given but it should be fully cooked[ boiled egg or omelette]. Electral powder [ ORS], coconut water and juices to added in the diet.

Don’t’s – No dairy milk .Spicy [ pickle, Spicy gravy, non veg food], sweet [ gulab jamun ,kheer, halwa] and oily food [ poori, vada , deep fried stuff] to be avoided as they are difficult to digest and many times increases loose motion. No glucose water.

Hope this blog helps in decreasing your dilemma in what diet to give to your child when he is suffering from loose motion.

Dear Parents,

I chose this topic today because I am pained by misery through which a child with night bed wetting goes through like the humiliation by the friends and relatives , scolding from their parent and feeling of guilt in the child . All this leads to decrease in confidence of the child.

I will try to explain why night bed wetting happens. When a normal child sleeps at night and his/her urinary bladder gets full then a signal goes to the brain from bladder that its full and child wakes up to pass urine but in a child with history of night bed wetting there is failure of the signal from bladder to brain which leads to overfull bladder leading to involuntary release of urine in the night without any fault of the child.

Usually 70 % of the children come out of this problem on their own by age of 10 yrs and 99 % by age of 16 yrs.

It is a medical problem and can be treated, so please consult a pediatrician for it.

Dear Parents,

I chose this topic because 90 % of the times I see parents doing sponging in a wrong way.I will be talking about this topic stepwise

1. Before starting sponging please give child medicine for fever like Syrup Crocin or Brufen or Meftal in required dose. It should be given atleast 30 to 40 min before starting sponging

2. Take water at room temperature [ neither warm nor cold ] for sponging

3. Take cotton cloth for sponging

4. Basis of sponging is that water evaporates by taking body heat resulting in decrease of temperature. So more the surface area more the evaporation thus better decrease in temperature

5. Remove all clothes of the child ,then wipe full body [ increasing the surface area] from top to toe.After wiping  switch on the fan at low number let the child dry. After drying put the clothes back on the child

6. Sponging/ Wiping to be done only once

Most of the times I see parents putting wet cloth only on the forehead while sponging, this technique reduces temperature only in movies not in real life. Please tell your friends and family also about the right technique of sponging.

Hope this blog was helpful. Please feel free to leave comments.

Dear Parents,

I usually talk about it to parents when there child already had one episode urinary tract infection [UTI]. So I thought why not discuss with all of you so that you all can take necessary steps to prevent UTI in your child. There will be four headings in which I will be discussing this and will elaborate each one separately

1. Avoiding Constipation
2. Timed or Regular voiding
3. Normal water intake
4. What does not cause UTI?

1. Constipation 

Constipation though on first thought looks not associated with UTI but is a major contributor to cause UTI. Constipation causes increase stool load in lower intestine and rectum which presses the urinary tract infront and this leads to UTI. To relieve constipation in a child more fibre to be added in the diet [like fruits , vegetables,whole dal]. Fiber helps in retaining more water within the intestine.So smoother evacuation.Talking about diet in constipation is itself one topic will discuss it later in some other blog. But would like to enumerate few things

Food stuff which are rich in fiber – Green leafy vegetable, beans, lady finger, drumstick, chikku, apple , banana,  whole dals [ not split dal]etc.

Food stuff not rich in fiber – Potatoes, rice, carrot,  grapes, mango etc [ Surprised!!!]

2. Timed or Regular Voiding

It means that child should be encouraged that he goes to pass urine every 3 to 4 hours. This practice is more important for a child who already had one episode of UTI, so it is not required for a normal child. This practice prevents stasis of urine thus preventing UTI.

3. Normal water intake

Its a old myth that child with UTI should consume more water but it has been found in studies that this practice is not useful, on the other hand increases the severity of UTI. Excess water stretches the urinary bladder which allows the bacteria to infiltrate deeper in the bladder wall.

4. What does not cause UTI?

Will enumerate these like using common toilets, dirty nappy pads.

Hoping this blog was helpful. Please feel free to leave your comments

Dear Parents,

In my daily practice I see frequently that parents don’t ask me this question when they do its already late and child is suffering of some infection. To prevent any type of skin infection in private parts regular cleaning is very important, cleaning to be done with plain lukewarm water not with soap or dettol water which is a common practice. Soap/Dettol decreases the pH of the mucous membrane and predisposes it to bacterial or fungal infection. This was about cleaning now comes what other things to look for while cleaning. Will discuss this gender wise

Girl Child – for a girl child while cleaning if you see little white discharge, it’s normal. If the discharge is more or foul smelling then u should get alert and meet your paediatrician to take his opinion. Any rashes or discolouration also to be consulted with the doctor

Male Child – there should be no discharge at all from penis. Important thing is that while cleaning penis you should always try to retract the skin over the Glans [ or head] of the penis , in a normal condition we should be able to retract the skin completely. If u are not able to retract then it’s a matter of concern and you need to meet your paediatrician. If you are not able to retract the skin then this condition can lead to local infections, urinary tract infections and difficulty to participate in sexual intercourse later in life.

Hoping this blog was helpful, Please feel free to leave your comments.