We study the diaper. What will tell baby chair?
With the birth of the child, the mother has a lot of fears associated with the health of the baby and the correctness of care for him. These fears are easy to dispel.
Young parents are looking at the contents of the baby diaper with interest and trepidation ... A familiar picture? The chair often causes concern to the mother and is really able to talk about the health and illness of the baby - you just need to be able to “read between the lines,” that is, to understand the signs of the body.
Get to know the norm
While the baby lives and develops in the womb, it accumulates in its intestines. meconium. It is a homogeneous tar-like mass of dark olive, almost black, almost odorless. It consists of condensed cells of the intestinal mucosa, amniotic fluid swallowed by the baby, etc. Normally, meconium begins to secrete crumbs from the intestines after birth and is therefore also called original feces (sometimes meconium is excreted intrauterinely: in case of an unfavorable course of labor or at the very end of pregnancy, the oxygen starvation of the fetus causes premature bowel movements, in which case meconium enters the amniotic fluid and stains them green). The baby's chair is represented by meconium, usually in the first two or three days, that is, until the moment when the mother has a large amount of milk. Sometimes it happens that after the discharge of the main mass of meconium, for example, during the first days, before the mother’s milk comes, there can be no stool in the crumbs. This is due to the fact that the colostrum, which feeds the baby in the first few days, is absorbed by the body almost completely, so there is no slag left in the intestine - therefore, there is simply nothing to stand out.
After the mother has established active lactation, the baby’s stool gradually becomes mature, as a rule, passing through the transitional stage. Transient Called a chair that combines the features of original feces and mature stools, it has a pasty consistency, a yellow-green color and a sour odor. Mature the stool is distinguished by a clear yellow color, a uniform, mushy consistency (it is often compared to a thin sour cream), and the smell of sour milk. Its frequency is the higher, the younger the child: in the first weeks after birth, bowel emptying can occur practically after each feeding, that is, 5–8 times per day, and sometimes 10 times.
Gradually, the stool decreases to about 1-3 times per day, however, there is a rare variant of the norm, when the mother's milk is so completely absorbed by the baby’s body that there is almost no undigested residue in its intestines. In this case, bowel movement can occur once a few days, sometimes even once a week. This is due to the fact that only sufficient filling of the large intestine with waste (undigested food debris) is a signal for contractions of the intestinal walls, leading to emptying. That is why the intestine must first "accumulate" the remnants, then to throw them out. As a rule, such a feature of the assimilation of mother's milk becomes apparent in babies not earlier than 1.5-3 months. Let's make a reservation: stool frequency 1 every few days can be considered the norm only if three conditions are met: when fully breastfed (that is, the baby does not receive anything except mother's milk), at least 1.5 months of age and the absence of any signs of ill health - pains and bloating in the abdomen, discomfort and difficulty in emptying the intestines - that is, when a crumb eats well, it is correctly gaining weight and does not bother him.
Artificial or Mixed Feeding Chair it may not be any different from normal mature stools when breastfeeding, or it may have a more “adult”, putrid odor, a thicker consistency and a darker, brownish color. Bowel emptying when mixed or artificial feeding should occur at least 1 time per day, everything else is considered constipation.
Now that we are familiar with the "ideal" process, it is necessary to get acquainted with possible deviations from this.
Greenery in the chair
It often happens that the "correct" type of stool is not installed for a long time, and the feces, even against the background of active lactation, the mother retains the transitional features for a long time, that is, has a clear greenish tint, sometimes it also shows mucus. There are several reasons for this.
- Malnutrition (the so-called "hungry" chair). Often this is due to the mother’s lack of milk. Factors that make it harder for babies to “get” milk from the breast can also be flat and retracted nipples, tight breasts, especially after the first birth.
- Predominance of fruits and vegetables in the diet of a nursing woman in comparison with other products.
- Inflammation of the intestinal mucosa in the baby. The hypoxia (oxygen deprivation) of the fetus, transferred during pregnancy and / or childbirth, is a very frequent reason for this. This pathological condition affects many tissues in the body, including the intestinal mucosa, which is then restored for quite some time. In addition, inflammation of the intestinal mucosa can be caused by the influence of synthetic substances - flavors, dyes and preservatives, and any artificial compounds present in the mother’s diet, penetrating into breast milk and directly affecting the intestinal mucosa, i.e. the use of mother’s products containing synthetic additives: sausages, smoked products, all types of canned food, juices of industrial production, dairy products with fruit and other aromatic fillers. Finally, a very common cause of intestinal inflammation is a violation of the normal intestinal microflora - in other words, intestinal dysbacteriosis (or dysbiosis), when there are few representatives of normal microflora, but so-called conditionally pathogenic microbes, that is, pathogens that under adverse conditions can cause inflammation, multiply in the intestines. In this case, the mucosa suffers as a result of the influence of conditionally pathogenic microorganisms and their metabolic products. The risk of developing dysbacteriosis increases significantly if antibacterial drugs were prescribed to the mother and / or baby.
What to do? In the presence of green in the stool should first eliminate malnutrition baby. Of course, in addition to violations of the stool, other symptoms will be noted: the baby may show discontent with the breast, if the milk does not stand out well from the nipple, it does not fall asleep after feeding and / or never stand for more than 1-1.5 hours between feedings, reduced rate of weight gain and growth. When severe malnutrition in a child can decrease the amount of urination (normally it is at least 6-8 per day), urine can be more concentrated (in normal, it is almost colorless and has only a slight odor). Then you should proceed according to the situation: in case of insufficient lactation - switch to feeding “on demand” or “according to the first cry”, more often apply the baby to the breast, allow him to stay at the breast as much as he wants, give both breasts for one feeding, be sure to feed breastfeed overnight, take medications that stimulate lactation. If the cause of malnutrition lies in the irregular shape of the nipples, it may be worthwhile to use special nipple pads during feeding. In any case, if you suspect malnutrition, it is better to contact a pediatrician, as well as a breastfeeding consultant.
Next, you should carefully check the mother's diet. All products containing synthetic additives are subject to unconditional exclusion. We should not forget that it is often the cause of intestinal inflammation in infants that may be synthetic vitamin preparations taken by the mother (including for pregnant and lactating), therefore, their use should be excluded. You should also take care that the amount of fruits and vegetables in the diet does not prevail over the other products (these "gifts of the earth" contain a large amount of acids, the excess of which in breast milk can cause inflammation of the mucous membrane in the intestines of the baby).
Now that we have created all the possible prerequisites for the proper nutrition of the crumbs, it is worth being guided by his well-being. If a baby gains weight and weight well, he is not worried about abdominal pain and allergic reactions, he is generally healthy and cheerful, interested in the world around him according to his age, then you can ignore the only symptom - the green color of the stool: will reflect the effects of hypoxia or the presence of intestinal dysbiosis in the baby. In the human body, especially the recently born, everything goes according to its laws and with individual speed. The colonization of the intestines with the “right” microbes is not a process of one day or even one week, therefore even perfectly healthy children can have a transitional chair for up to a month or even more. If this does not prevent the baby from developing normally, you can not interfere in this process. All the same, a drug for dysbacteriosis has not yet been created better than mother's milk. The only thing that does not interfere with the protracted signs of dysbiosis is to pass the mother's milk for planting, to make sure that it does not contain pathogenic microbes (if they are found, their sensitivity to antibacterial drugs is determined, then antibiotics are most effective for this case for this period, breastfeeding is usually stopped).
If the baby’s health is not all right (for example, he is suffering from intestinal colic, or allergic skin reactions are noted, or he is not gaining enough weight and height), then some tests should be done - a coprogram and analysis of feces for flora (or, as they say on dysbacteriosis). The coprogram will show how digestion processes are going on in the intestine, and can confirm the presence of mucosal inflammation (an increase in the number of leukocytes in the feces, a sharply acid reaction, the presence of hidden blood) will indicate this. In the analysis of flora, the main attention should be paid to the presence and / or number of pathogenic microorganisms - those that normally should not occur in the intestine or whose number should not exceed certain limits. The number of "friendly" microbes can be completely unrepresentative, if the feces were analyzed after two hours after collection. Since this is exactly what happens in the overwhelming majority of cases, then the number of normal microbes in this analysis can be ignored. Detection of pathogenic (pathogenic) microbes (provided that mother's milk was analyzed, and the mother was treated if necessary) serves as a reason to prescribe special preparations to the baby. As a rule, the treatment is carried out with phages - special viruses that destroy a certain type of pathogenic microbes and do not affect the flora as a whole. In some cases, antibacterial drugs may be prescribed, taking into account the sensitivity of the pathogenic bacteria to them. Completing the treatment with drugs that contribute to the restoration of normal microflora.
White lumps in the baby's chair
Sometimes in the feces of the baby you can see white lumps, as if someone had mixed the coarse curd there. If this symptom is marked against the background of the normal physical development of the child (it is well gaining weight and growing), then it is evidence of some overeating: more nutrients enter the body than it needs to meet real needs (when the breast is offered not only to satisfy hunger, but any calming down). There is absolutely nothing wrong with this, since the infant's body is perfectly adapted to this sort of "overhaul": it simply throws out too much in the form of such undigested white lumps. At the present time, when the course of feeding is “on the first cry”, most healthy children at least from time to time have such a stool feature. If this symptom is accompanied by a shortage in weight or growth, especially if this lag is exacerbated, the enzymatic deficiency of the digestive glands most likely takes place, which does not allow the digestion of the nutrients to be properly digested. In this case, the pediatrician or gastroenterologist may prescribe replacement therapy with enzyme preparations.
Quite often, parents may encounter the fact that the baby’s stool is liquefied, watery, sometimes foaming, has a sharper sour smell, and in some cases a changed color - mustard or greenish. On a cotton diaper, this feces leaves around a watering zone. Often, the stool is emitted in small portions, even with the discharge of gases. The acidic reaction of feces often causes stubborn diaper rash. This picture is observed in violation of the digestion of lactose - milk sugar, when for some reason the amount of lactose entering the intestine with my mother's milk exceeds the amount of the lactase enzyme necessary for its digestion. This can be either with an excess of lactose in milk (hereditary predisposition of the mother , an excess of fresh milk and dairy products in its diet), or with reduced production of lactase by the digestive glands of the crumbs. Undigested carbohydrates "squeeze" a large amount of water into the intestinal lumen, which is why feces have a thin, watery character.
Often, lactase deficiency is accompanied by intestinal dysbiosis: the acidic reaction of the intestinal contents prevents the intestinal colonization of the correct flora, and the lack of the required number of beneficial microorganisms, in turn, reduces the ability to digest carbohydrates. If this does not interfere with the development of the baby (as we have said, its signs are a normal increase in height and weight, the absence of intestinal colic and stubborn diaper rash), this condition can be left without treatment. In the overwhelming majority of cases, lactase deficiency is a transient problem and disappears without a trace with age (by about 9-12 months the activity of the digestive glands increases so much that the baby's body easily begins to cope not only with fermented milk products, but also with fresh milk). Severe and lifelong violations of lactase production are almost always genetically determined: I should think about this variant of the hereditary disease if the closest relatives in the family suffer from lactase deficiency in adulthood. To confirm the diagnosis, in addition to coprological research, feces for carbohydrates are analyzed. With confirmed lactase deficiency, mother first needs to adjust her diet: exclude fresh milk, if this step is ineffective, significantly reduce the amount of fermented milk products (the exception is cheese, which is practically absent milk sugar). If all of these measures fail, the doctor may prescribe lactase replacement therapy.
Constipation in the baby
Constipation is considered to be the absence of an independent stool for more than a day (of course, except in cases of complete milk digestion), as well as cases when bowel movement is difficult and is accompanied by significant discomfort.
When breastfeeding constipation is quite rare, and the main reasons they have two: poor maternal nutrition and disorders of intestinal motility, including spasm of the anal sphincter.
Improper nutrition of the mother is expressed by a tendency to foods rich in proteins and easily digestible carbohydrates, lack of dietary fiber, therefore, when the child has constipation, the mother should first normalize her diet: give preference to cereals (especially buckwheat, unrefined rice, oatmeal), whole grains bread, include boiled vegetables in the diet. Some products (peaches, apricots, prunes, dried apricots, figs, boiled beets, fresh kefir) have pronounced laxative properties. In many cases, they will allow you to normalize not only your own chair, but also the baby’s chair.
If such measures do not lead to anything, most likely there is a violation of intestinal motility (hypotension or, on the contrary, spasm) and / or sphincter of the sphincter of the anus. With sphincter spasm, discharge of gas from the intestines is also difficult, therefore constipation is often accompanied by marked intestinal colic. К сожалению, с этими состояниями практически невозможно бороться домашними способами, так как они связаны с нарушением нервной регуляции тонуса гладких мышц и являются последствиями родовой травмы или неблагоприятного течения беременности. Если им сопутствуют другие симптомы, заставляющие вас обратиться к неврологу (возбудимость или, наоборот, заторможенность крохи, нарушения сна, метеозависимость, нарушения мышечного тонуса и др.), то лечение, назначенное им по поводу неблагополучия центральной нервной системы, часто помогает улучшить и ситуацию с запором, Если при отсутствии стула малыша беспокоят боли и/или вздутие в животе, можно попробовать поставить газоотводную трубочку, что позволит мягко простимулировать анус. При искусственном вскармливании запоры, к сожалению, встречаются намного чаще, так как переваривание молочных смесей представляет собою большую трудность для пищеварительной системы младенца. Во многих случаях нормализовать ситуацию позволяет замена половины суточного рациона малыша кисломолочной смесью (постепенно вводить кислые смеси можно после 3 недель жизни). После 4-6 месяцев жизни можно ввести в рацион малыша отвар и пюре из чернослива, которые помогают справиться с запором в большинстве случаев.
Если названные меры не помогают нормализовать ситуацию (как при естественном, так и искусственном вскармливании), педиатр может назначить и некоторые медикаменты: свечи с глицерином (в первые 6 месяцев жизни разовая доза составляет ¼-½ свечи), дюфалак, микроклизмы "Микролакс".
Вот основные "тайны", которые может таить в себе подгузник вашего крохи. Мы попытались научить вас распознавать некоторые сигналы младенческого организма, но хотим еще раз напомнить: любую диагностику и тем более назначение лечения должен проводить только врач.