Consideration 41 - Functional Constipation - A Malady Learned From Infant Formulas

“Hard stools are rarely observed in exclusively breastfed infants, and firm or hard stools are often seen with the change from breast milk to standard infant formula or after the introduction of solids [ 18 ].”A Pooled Analysis of Growth and Tolerance of Infants www.hindawi.com/journals/ijpedi/2018/4969576/

A formula created ailment?

“Constipation is a very common presentation, both in primary and secondary care. Prevalence of functional constipation in children ranges from 4-36% [13]. In the hospital setting, paediatric constipation forms 3% of all referrals to paediatric practice and up to 25% to paediatric gastroenterologists. In addition a recent American study suggests that there is a cost of health resources for children with constipation, estimated at $3.9 billion/year [4].”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143086/

“Patient Education

It is very important to educate the family that using laxatives continuously for months may be necessary. This is particularly true in toddlers, because many months may pass before their association between the fear of pain and defecation is extinguished.

Caregivers should be reassured as to the safety of long-term laxative use, and the importance of persistent treatment should be strongly reinforced. Address the common misconceptions about laxative dependency and the increased risk of colon cancer due to long-term laxative usage.

Inform the family that relapses are common and are often associated with changes in the child’s daily routine (eg, vacations) or during times of stress. Also, inform the family that the requirement of intermittent therapy with laxatives into adulthood is not unusual.”

https://emedicine.medscape.com/article/928185-overview

“The longer that feces remains in the rectum, the harder it becomes. Passage of a hard or large stool may cause a painful anal fissure. The cycle of avoiding bowel movements because of a fear of painful defecation may progress to stool retention and infrequent bowel movements, a condition that is termed functional constipation…

Functional constipation is the cause of symptoms of constipation in more than 95 percent of children older than one year.5  However, when warning signs are present, organic causes must be considered”

 https://www.aafp.org/afp/2006/0201/p469.html

Let’s do some math regarding constipation.

Last year, in Canada, there were 385777 live births.

 “ Prevalence of functional constipation in children ranges from 4-36% [13].” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143086/

4-36% This is a very large difference of opinion regarding the “Prevalence of functional constipation in children”.  I can only speculate why there is such a difference in “scientific” examination of this problem. Perhaps there are constipation “deniers” and constipation “promoters. “In the medical profession, according to their professional interests.  This gives a 20% rate of constipation in children and infants.

 An earlier quote states that, “Hard stools are rarely observed in exclusively breastfed infants,”

So I will reduce the 20% to 19%. Since 95% of children have functional constipation means they got it in infancy and therefore should be included in the calculation.

385777 X .19   = 73297  infants and children with constipation. Let’s assume that these infants cry for 2 hours per day twice per week for 1 months of the year

73297 X 2 X 2 X 4 = 1172752 hours of crying per year.

24 X 365 = 8760 hours per year.

1172752 divide by 8760 = 134 infants or children screaming right now. An above quote suggested that some of the constipation in infants was due to the introduction of solid foods. So I will cut the number in half. This gives 67 infants or children crying due to problems with infant formulas.

My father had problems with constipation. When working away from home, he had stewed prunes to eat. He would eat a prune and then spit the prune pit into his spoon. He would fling the prune pit away with a significant vigor. I remember him stating “It seems to help if you try to defecate each morning, regardless if you succeed in defecating or not.” This sounds like functional constipation.