Worried about your toddler’s digestive health? This article gives you the low-down on common tummy troubles your toddler can face and what you can do to help him.
By Dr Shilpa Sharma
Food provides your toddler with nutrition and the energy to do things. But all the fun a healthy child can have gets undone when indigestion sets in. Our expert takes a look at some of the common digestive problems that affect toddlers and suggests ways to handle them.
Colic/belly ache: The young child’s belly ache may represent hunger, fatigue, or a need to use the bathroom, or just too much excitement or worry. A child with mild pain smiles and plays comfortably. If the child is grimacing and frowning, and has stopped normal activities, the pain is moderate. If the child is lying down, legs flexed and crying, the pain is severe. Most chronic belly aches are functional, meaning that the pain is real, but is not the symptom of any disease like shivering in the cold or a runner’s leg cramp. But colic should not be ignored if accompanied by other symptoms like fever, blood in the stools, waking in the night with pain or pain with urination. A little love and attention will relieve most of the pain, but when it is severe, the child must be taken to a physician.
Gastroesophageal reflux: GERD is the bringing up of the stomach contents or acid into the oesophagus (the swallowing tube). Children may complain of any of these symptoms:
a) generalized stomach aches, around belly button and occasionally chest pain.
b) nausea or feeling as if they have just thrown up.
c) feeling of food coming back up and the need to re-swallow it.
d) may report a feeling that food is not going down correctly or a feeling that it is getting stuck. Some patients may complain of asthma symptoms such as cough or wheezing that are worsened by reflux.
To know more about GERD in babies, click here.
Diet is an important part of reflux management. It is better to avoid the products listed below to prevent reflux:
a) Medications such as aspirin, ibuprofen and alcohol-based products.
b) Spicy, acidic or tomato-based foods, fatty foods, citrus products, apple juice (apples are fine), cola, tea, coffee, hot chocolate, chocolate and liquorice.
Lactose intolerance: Lactose is the sugar found in milk and dairy products. Lactase, a digestive enzyme of the small intestine, helps to break down this complex sugar into two simple sugars. Deficiency or lack of lactase enzyme results in lactose intolerance.
Lactose intolerance can either be present at birth or may develop temporarily due to infection by rotavirus and giardia. Both of them affect the lining of the intestine where enzyme lactase is located, resulting in lactose intolerance. This type of lactose intolerance is transient or temporary and when the lining of the intestine returns to normal within three to four weeks, the lactose intolerance usually goes away.
The child may complain of distension and pain, excess burping, loud bowel sounds, excess gas and diarrhoea following ingestion of lactose, watery and explosive bowel movements. They may also feel a sense of urgency with bowel movements.
Alternatives to milk like soy milk can be used. But adequate supplementation of calcium in the diet is a must along with antibiotics for giardia.
Diarrhoea: It is caused by virus, bacterial and parasitic infections. Acute diarrhoea, often called acute gastroenteritis, is caused when stools are softer and more frequent than normal.
Diarrhoea mostly results in dehydration. Children with mild dehydration can be treated with special oral rehydration solutions (ORS). Although other drinks such as juices, colas and sports drinks are frequently used, they are not a good substitute for ORS, and can actually worsen the diarrhoea. Patients with more severe diarrhoea, vomiting and dehydration may require intravenous fluids in the hospital and appropriate treatment for the cause.
Constipation: Constipation is infrequent bowel movements, hard bowel movements, and difficulty in passing bowel movements or painful bowel movements. Constipation mostly occurs when solid foods are introduced, during toilet training, at the start of school, after the birth of a sibling, when parents are separated or divorced, on change of place or on change in diet.
Children may show symptoms like crossing their legs, standing on toes, or squeezing their buttocks together to try to avoid a bowel movement. These behaviours are called retentive withholding. It may result in stomach ache or pain in other parts of the abdomen, tears of the anus called anal fissures, blood in the bowel movements, soiling of the underwear with stool, difficulty in walking, and decreased appetite and activity level.
Constipation can be treated by education, behavioural modification, dietary modification and non-habit forming medications. High fibre foods include bran, apricots, apples, pears, melons, asparagus, beans, broccoli, carrots, beets, cauliflower, cereals, breads, and pasta. Increasing a patient’s physical activity is also helpful in promoting regular bowel movements.
The author is a Homeopathic Consultant.
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