Understanding children's gut health – poo

Since becoming a parent it is likely you have never discussed poo in its various forms quite so much. Like adults, baby and child bowel movements will vary from person to person. Some babies will have dirty nappies several times a day, some will only have a dirty nappy once or twice a week.

Being a first time parent, it is difficult to know exactly what is normal. Asking other parents about their baby’s nappy habits may only confirm your own usually needless fears.

This week, from 24 – 30 August it is Gut Week, organised by national medical research charity Core, The Gut Trust, St Mark’s Hospital in Harrow and Yakult. Its aims are to help people better understand the role of their digestive system and good gut health.

Consultant paediatrician and paediatric gastroenterologist,  Dr Warren Hyer, has advice for parents to help them understand the varying bowel movements of their children.

Babies

“The bowel movements for babies depend on whether they are breast fed. Many breast fed babies will poo a mustard stool up to 8 times a day. This is normal, but – the presence of any blood or mucous needs review as this might reflect a food allergy. Bottle fed babies tend to poo less often as milk calcium salts tend to constipate the stools.

Toddlers

“In infancy, many children tend to fear using the potty or toilet – and this can result in them clenching their buttocks or gripping the walls and surfaces grimacing in distress. Parents may interpret this as “struggling” to poo – this is far from the truth, since this is “faecal retentive behaviour” – a desperate attempt by the pre school child to hold onto their poo – panicking that passing it might hurt.

Younger Children

“In older children and adolescents, some children may only need to poo a couple of times a week. This is not constipation unless the stools are massive and hard. Soiling however, is frequently a consequence of significant impaction of stool in a full rectum leading to leaking and seepage. This is treatable but needs clearing out with laxative therapy – then continence swiftly will return.

“Stool frequency will also be affected by diet. Naturally, diets high in fibre will lead to bulky soft stools. Milk may harden stools. Many simple therapies are available to help children poo. There are softeners which are harmless e.g. lactulose, or stimulant medicines – particularly good in those who ignore the desire to poo or hold on e.g. senokot or movicol. Such therapies are safe in children but may be necessary for months.

Older Children

“Abdominal pain in children and adolescents is not caused by constipation – they may be constipated but this should not be the cause of their regular or daily tummy pains. These children should see their doctors, but treating their alleged constipation may not improve their pain. The doctor will explore other causes. These might include food driven intolerances, or gut inflammation, especially if they are unwell or losing weight.

“Take you child to the doctor if they have diarrhoea for more than 1 week, if you see blood in their diarrhoea, if they lose weight or have a fall in appetite, if they soil and leak stool into their pants or regularly complain of pain without another cause being apparent. But don’t gaze at all their poos – give your adolescent their privacy.”

The Gut Week campaign has now been running for eleven years and as a result  has encouraged more that 130,000 people to seek help.

The campaign has a dedicated website offering advice and information on gut-related problems. For more information, visit: www.loveyourgut.com