Page 38 - Winter2020

Reading Between the Lines

By Merinda Teller

Some Solutions for the Problem of Infant Constipation

With the birth of a child, new parents em- stools, and large, hard stools accompanied by straining or pain. 7
bark on a steep learning curve. One of the first The vast majority of published studies on pediatric constipation focus
bodily mysteries that inexperienced parents on the condition known as “functional” (or “idiopathic”) constipation—
must rapidly learn to decode involves the baby’s so-called due to the absence of any structural or biochemical explanation
elimination patterns. Most crucially, parents for its occurrence. Most researchers remain at a loss to say why this form
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want to know whether their baby is peeing and of mystery constipation is so widespread in the young.
pooping normally.
Unfortunately, it appears that constipation BREAST VERSUS BOTTLE: WHAT IS “NORMAL”?
in the young is not only frequent but often begins In infants, researchers quite reasonably point out that understand-
in the first year of life. One study estimates that ing “abnormal defecation” and constipation requires first knowing what
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up to half of all infants may experience gastroin- normal pooping looks like. Ascertaining what is “normal,” in turn,
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testinal symptoms (including colic and “spitting requires knowing what the baby is eating, because breastfed and formula-
up” as well as constipation). Systematic reviews fed infants do not have the same stools or pooping patterns. In fact, as
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assessing constipation prevalence worldwide parenting websites put it, “The stool of [a] formula-fed baby is totally
have estimated that the affliction affects from different from the stool of [a] breastfed baby.” 9
1 to 31 percent of infants and toddlers, and Thanks to the digestibility and “natural laxative” properties of
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anywhere from 0.5 to 87 percent of children breast milk, constipation in breastfed babies seems to be rare, at least
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and adolescents. initially. Infants who are exclusively breastfed in the first few months of
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Pediatric constipation may be common, but life produce stools that are more frequent, softer and of a different color
it is not innocuous. Researchers observe that and smell compared to the stools of conventionally formula-fed babies
while it can start out as a “simple complaint,” (see Table 1). A Dutch study published in 2014 found that the feeding
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constipation that is ignored can lead to fecal approach (breast, formula or a mixture of the two) could explain up to
impaction and eventually even affect a child’s 24 percent of the observed differences in how often babies defecate.
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growth and development. The Dutch researchers also proposed that “green-coloured stools in
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Constipation is also highly uncomfortable standard formula-fed infants. . . be considered normal”; however, some
for children, “characterized by infrequent bowel medical websites flag green stools as a possible sign of slow digestion,
movements, hard and/or large stools, painful food allergies, food intolerances or other problems. This should come
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defecation, sometimes in combination with fe- as no surprise to readers of Wise Traditions, as digestive difficulties
cal incontinence, and. . . often accompanied by and allergies are well-known problems associated with commercial soy
abdominal pain.” Indicators of constipation in formula—an “abnormal” baby food if ever there was one. Typical soy
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babies include straining to pass stools, painful formula not only contains high levels of unhealthy soy phytoestrogens but

TABLE 1. Stool characteristics of breastfed and formula-fed infants in the first few months of life

BREASTFED FORMULA-FED
FREQUENCY 3+ times per day 1+ times per day
TEXTURE Soft, runny, “seedy” Firmer, bulkier, like “peanut butter”
COLOR Yellow/mustardy Brown, orange or green
ODOR Mild-smelling Smellier (more like adult poo)

36 Wise Traditions WINTER 2020