Intestinal colic in newborns. Functional immaturity of the gastrointestinal tract Immature intestine in a child what to do

When an infant who is less than six months old falls ill, parents in many cases diagnose him with colic and do not pay much attention to the newborn's malaise, waiting for him to outgrow the age of colic. This is how serious diseases go unnoticed and without treatment, and the health and life of the child are endangered.

In order not to confuse colic in newborns with something dangerous, you need to know their symptoms and be able to distinguish colic from other conditions.

Colic or not?

Called a variety of figures for the occurrence of infantile colic: from 3% to 70% of children. This condition develops in infants from the 3rd week of life to 3 months. If the child was born prematurely, then colic may begin later and last up to 4-5 months of age.

It is easy enough for attentive parents to distinguish colic from other conditions. We are talking about infantile colic when a child cries loudly, inconsolably and seemingly for no reason for more than 3 hours a day, at least 3 days a week.

It all starts with incomprehensible crying for 15 minutes, which occurs several times a week. Gradually, the duration and frequency of attacks increases and reaches a maximum by the age of six weeks. In the most difficult period, the interval between attacks can be 3-5 hours, and its duration can also reach up to 3 hours. At about 3 months, the bright symptoms of colic disappear, but anxiety in a child may occur up to 6 months.

It is noticed that colic usually comes at the same time, usually in the evening. In this regard, some theories of the occurrence of infantile colic have arisen.

If you suspect that your baby has colic, go to the doctor. Let him confirm or refute your fears and rule out the disease.

Where do colic come from? Causes.

This big medical mystery remains unsolved. Among the alleged causes of colic, two are most seriously considered: the immaturity of the digestive and nervous systems of the infant.

Immaturity of the digestive system.

When the baby is just born, he eats little, and his body easily absorbs food. After 2 weeks, the amount of milk or formula increases. Protein processing requires a lot of enzymes and bacteria, but they may not be enough. Then undigested food ferments in the intestines, a lot of gas is released, which the baby still does not know how to get rid of because of weak abdominal muscles. Gas pressure in the intestines causes discomfort and even pain - hence the hysterical crying.

Immaturity of the nervous system.

Particularly sensitive, impressionable children throw evening "concerts" in order to free themselves from the impressions and emotions accumulated during the day. The surrounding world constantly transmits information to the child's brain - about sights, sounds, smells. By evening, the nervous system is overworked, which the child feels physically, and the only way to relieve this tension is crying. More often, nervous strain causes colic in children born hard or prematurely.

Sensitivity to products.

Breast migraine.

Some experts argue that colic occurs from headaches that appear due to atmospheric phenomena.

There is an opinion that colic suffers more often from formula-fed children. Studies have shown that the likelihood of colic does not depend on the method of feeding, and the mixture itself causes colic in very rare cases.

Any newborn baby is born with an immature digestive system. The main organ for the production of enzymes - the pancreas in the first months is not able to process vegetables, fruits, juices, cereals and even fermented milk products. Therefore, doctors do not recommend introducing these products (complementary foods) into the baby's diet until 4-5 months, when enzymes “ripe” in most children. And even such a product as breast milk or an adapted milk formula - a breast milk substitute, not all children can normally absorb. The reason is the same: the immaturity of the enzymes. Therefore, it is not uncommon for children to have lumps of curdled milk in the feces (which is a variant of normal stool at an early age), colic (normally almost every child has up to 3-3.5 months).

The most important role in ensuring the normal functioning of the intestines is played by beneficial bacteria of the intestinal flora - they neutralize toxins and allergens, stimulate the intestines and produce up to 80% of the lactase enzyme - the one that digests milk sugar lactose - one of the key components of breast milk and milk formulas. So, a child is born with a sterile intestine, that is, there are no bacteria there. Bacteria begin to populate the intestines at the time of birth, the first 2 months the intestinal microflora changes several times a day, and then the stabilization process goes on until almost 1 year intestinal microflora. All this time, the child is predisposed to the development of dysbacteriosis, against which allergies, stool disorders, and secondary lactase deficiency can develop.

By the way, secondary lactase deficiency, accompanied by pain in the abdomen, liquid foamy stools, bloating, is one of the most common gastroenterological problems faced by young parents. The causes are dysbacteriosis and enzymatic immaturity. Usually the problem is solved by 4 - 5 months, but there may be a more protracted course. With secondary lactase deficiency, it is not necessary to deprive the baby of breast milk and transfer to lactose-free mixtures - this will only slow down the development of its own enzymes.

The immune system is inextricably linked to the gut. You can even say that the intestine is the largest organ of the immune system. A newborn baby receives an immune memory from the mother in utero, which helps to cope with harmful microbes at first. Breast milk plays an important role in the further development of the immune system. The immune system has to learn, and it takes a long time for staphylococci and fungi to stop being an impossible task for it. But in the first months, while immunity has not yet been formed, children often have “thrush” (caused by fungi of the genus Candida) and pustular pimples, and green feces (both of which can cause staphylococci). Any dysbacteriosis occurs against the background of weakening or immaturity of local intestinal immunity.

The condition of the skin directly depends on the work of the intestines. No wonder there is a catchphrase: "the skin is a mirror of the intestines." Up to 90% of what appears on the baby's skin is of intestinal origin (diathesis is one of the manifestations of dysbacteriosis). At the same time, it must also be taken into account that the skin of babies is very delicate, sensitive, prone to inflammation.

The immaturity of the liver and biliary tract is manifested by the state of physiological jaundice in newborns. More precisely, the immaturity of the liver is one of the causes of such jaundice (there are other reasons not related to gastroenterology). Physiological jaundice is considered acceptable for the first 2 weeks after birth. If the jaundice lasts longer, it is chronic jaundice that needs to be treated.

Summing up, we can say that any modern child is born insufficiently adapted to the environment. There is an explanation for this. The fact is that a person, like any living being, can change, adapting to changing environmental conditions - this is the process of adaptation. For a long time, environmental changes and human changes went in parallel courses, so the person adapted without any problems. But over the past 50 - 100 years there have been such rapid and significant changes in the environment that human changes simply do not keep up with these processes. Adaptation disorders are the most common modern problem. And children are much more likely than adults to suffer from adaptation diseases.

Pediatrician Yuri Kopanev

All these are functional disorders of the gastrointestinal tract. Why do such conditions occur, how dangerous are they and how to deal with them?

Functional disorders of the gastrointestinal tract are conditions in which there is a combination of various symptoms from the digestive organs, but there are no structural or biochemical disorders. The development of functional disorders of the gastrointestinal tract is based on three main groups of factors or their combination:

The immaturity of the child's digestive system, which is typical, for example, for premature babies and for babies born with low body weight. In such children, there is a later formation of the nervous regulation of intestinal activity, a later activation of digestive enzymes, especially those that are responsible for the breakdown of fats, cow's milk proteins, disaccharides (a type of carbohydrate, which includes, for example, sucrose, fructose, lactose) .
Increased load on the baby's digestive system, not corresponding to his age. This situation occurs both with an increase in the total amount of food, and with an increased content of individual nutrients in the diet.
A certain role in the development of dysfunctions in children is played by the state of the mother (or the environment of the child). We are talking about increased anxiety of family members, asocial living conditions, serious violations of the daily routine and diet of the crumbs.

In the course of many studies, it was noted that functional digestive disorders are much more common in first-born children, long-awaited children and children of elderly parents, which, apparently, can be explained by greater anxiety and suspiciousness of parents.

At the same time, the presence of dysfunction in the digestive system may indicate not only a disease of the gastrointestinal tract, but in some cases is a symptom of damage to other organs and systems of the body. Therefore, any disorder in the work of the gastrointestinal tract is a reason for consulting a doctor.

With dysfunctions of the digestive system, the following conditions may occur:

disorders manifested by regurgitation and vomiting;
disorders manifested by abdominal pain (in infants - intestinal colic syndrome, which is characterized by the accumulation of gases in the intestines, combined with cramping abdominal pain and screaming);
stool disorders with a tendency to constipation or periodic periods of looseness.

All these manifestations require different approaches in treatment. However, in all cases of functional disorders of the digestive system, treatment should begin with general measures aimed at creating a calm psychological climate in the environment of the child.

The most important direction in the treatment of functional disorders of the gastrointestinal tract is diet therapy, which in some cases (not always) can be supplemented with drug treatment.

At first, it is advisable, together with the pediatrician, to analyze the daily and one-time amount of food and, of course, the liquid that the child receives, their compliance with the age and actual body weight of the baby, the feeding regimen and its technique.

Nutrition for children under 1 year old

natural feeding

Definitely the best nutrition for a child infancy is mother's milk. However, dysfunctions of the gastrointestinal tract are also observed with natural feeding. In this case, the nature of the mother's nutrition is of paramount importance. On a daily basis, if a child has dysfunction, gas-forming foods should be limited - cabbage, onions, tomatoes, apples, pears, grapes, peas, beans, black bread, kvass. Spicy, smoked foods, dishes containing a large amount of fats, spices and pickles should also be avoided. With the syndrome of intestinal colic, gas-forming foods from the diet of a nursing woman are completely excluded. You will also have to limit dairy products (up to 500 g of dairy products per day, including cottage cheese, cheese, kefir, milk, etc.), since an excess of casein milk protein on the menu affects the composition of breast milk, which can cause indigestion in a baby, and also lead to the development of allergies. With a weakening and instability of the stool in the crumbs of the mother, it is necessary to limit the consumption of foods such as cucumbers, beets, pumpkins, melons, plums, and with a tendency to constipation, eat less rice, bread products made from premium flour, apples.

Artificial feeding

For children with functional disorders of the gastrointestinal tract, who are on artificial or mixed feeding, special therapeutic mixtures are currently offered that a pediatrician can prescribe to a baby.

With frequent regurgitation, it is recommended to use adapted mixtures containing dietary fiber. Thanks to the fibers, these mixtures have a thicker consistency, which prevents regurgitation. On the other hand, the presence of dietary fiber helps to normalize intestinal motility and contributes to the regularity of the stool. The most commonly used dietary fiber is carob bean gluten. Such milk mixtures include, for example, Nutrilon Antireflux (Nutricia), Omneo (Nutricia), Frisovoy (Friesland). All of these mixtures also have an effect on stool frequency. Moreover, "Omneo" and "Frisov" have a distinct laxative effect and are recommended for constipation. At the same time, "Nutrilon Antireflux" has a fixing effect and is recommended for children with a tendency to frequent and loose stools. With a tendency to regurgitation and vomiting, the use of fermented milk mixtures should be avoided, which, due to the lower pH, increase regurgitation and contribute to the development of inflammation in the esophageal mucosa.

With a tendency to loose stools, the child is prescribed low-lactose mixtures. With a tendency to constipation, it is better to avoid the use of soy-based mixtures, as they have a fixing effect. For constipation, mixtures enriched (lacto- and bifidobacteria) can be recommended.

For the prevention and treatment of dysfunctions of the digestive system in children born prematurely, specialized mixtures for preterm infants are recommended. Examples of such mixtures are Humana 0, Fri-sopre, Enfalak, Alprem, Nenatal, Prenutrilak, Prenan, etc. Specialized mixtures for preterm infants must be used during the first 2-3 months of a baby's life, and then switch to regular or therapeutic formula feeding. If the first mixture is well tolerated, choose, if possible, a regular or therapeutic mixture from the same company. This will not only reduce the likelihood of digestive system dysfunctions, but also reduce the risk of development.

Nutrition for children from 1 year to 3 years

Functional constipation

Depending on the leading cause, functional constipation is divided into several types.

Most often, young children have alimentary constipation that occurs when there is a violation of the diet, malnutrition, insufficient fluid intake and B vitamins.

The basis of dyskinetic constipation is a violation of the motor function of the colon. At the same time, its contractions may be too sluggish or, conversely, excessively intense (spasms).

There are also conditioned reflex constipation. They develop if the child systematically suppresses the desire to "go big", which leads to overflow of the rectum, an increase in the volume and compaction of feces. This situation often occurs when a baby, for psychological reasons, cannot go to the toilet in kindergarten, in unfamiliar surroundings or not on your potty. When the child empties the intestines, large stools cause overdistension of the anus, which is accompanied by severe pain.

Treatment of constipation requires an individual approach in each case. With recent constipation, to achieve a positive effect, it is enough to change the nature of the diet and increase physical activity.

Principles of diet therapy for functional constipation:

Frequent small meals. For children over 1 year of age, meals should be 5-7 times a day in small portions. Be sure to follow the diet. Deviations from the schedule should not exceed 15-20 minutes.
Increasing the content of foods in the diet that stimulate bowel movements. The improvement of intestinal motor function is facilitated by a diet rich in fiber (wide use of a variety of vegetables and fruits in raw form or in dishes, dried fruits, wholemeal bread), enrichment of the diet with vegetable oils, fruit and vegetable juices with pulp. Prunes are recommended in any form, including infusion, dried fruit puree. Since plums contain organic acids, despite their relatively low fiber content, they promote bowel movements in children with constipation.
Exclusion of foods rich in essential oils (radish, onion, garlic), because. they irritate the intestinal mucosa, intensifying painful spasms and slowing down the progress of the food bolus through the digestive tube.
Controlling the consumption of foods rich in cholesterol (butter - no more than 10-12 g per day for children from 1 to 1.5 years old, no more than 15-17 g per day for children from 1.5 to 3 years old; eggs - no more 0.5 pieces for children from 1 to 3 years old; fatty meat is excluded). The digestion of large amounts of animal fats requires high activity of digestive enzymes, which dramatically increases the load on the digestive glands and can aggravate the situation with constipation. However, in moderation, the above foods can be beneficial, as they promote the flow of bile. Offer your baby products containing animal fats for breakfast, this will help to improve the stool.
Exclusion (limitation) of easily digestible, refined products (products obtained by the method of complex chemical, thermal and other transformations in production, for example, confectionery and pasta from premium flour, corn flakes, potato chips, rice and semolina, etc.).
Food should not be homogeneous, as the presence of pieces stimulates intestinal contractions and the promotion of the food bolus.
The diet should provide a sufficient amount of liquid: water, fruit and vegetable juices. Fluid is necessary because, due to the slow evacuation of feces from the intestines, they dry out, which, in turn, makes it difficult for them to move through the colon. Recall that black tea and cocoa have a fixing effect.
The use of fermented milk products containing lacto- and bifidobacteria. It should be noted that the laxative effect of fermented milk drinks varies depending on the method of their preparation and storage conditions. Fermented milk drinks with an acidity above 90-100 ° according to Turner (acidophilic milk, yogurt, kefir) have a laxative effect. Whole milk, on the contrary, is not recommended for constipation. It should be noted that as kefir is stored, its acidity increases significantly, since as a result of fermentation processes, lactic acid accumulates in it and carbon dioxide is released. Two-day and especially three-day kefir has a fixing effect.

If a child has spastic constipation, which is characterized by spasm of the intestinal muscles, abdominal pain, dense segmented feces (also called "sheep"), dietary treatment consists of two stages. The first stage (usually no more than 5 days) is a period of gentle nutrition, the purpose of which is to relieve intestinal spasm and reduce irritation of the colon mucosa. At the first stage, foods rich in cell membranes (vegetables, fruits, Rye bread), as foods rich in dietary fiber can cause increased pain. Gentle cooking is used (dishes are steamed, stewed, baked in the oven). In the future (at the second stage) there is a gradual expansion of the diet. First, foods containing delicate fiber are added to food, and later - a coarser consistency.

If the baby, in addition to constipation, suffers from excessive gas formation in the intestines (flatulence), dishes from beans, cabbage, sorrel, spinach are excluded from the diet. From fruit juices apple, grape are not recommended.

Functional loosening of stool

The discrepancy between the capabilities of the gastrointestinal tract and the nutritional load often leads to a weakening of the stool of a functional nature. At the same time, frequent (more than 2-3 times a day) bowel movements are noted. To exclude an intestinal infection, you will definitely need to consult a doctor. Indigestion (dyspepsia) often occurs with a "one-sided" diet. For example, with excessive consumption of carbohydrates (sugar, honey, flour products, grapes, peas, beans, cabbage, etc.), as well as drinks such as kvass, conditions are created in the intestines for the development of fermentative flora. Fermentative dyspepsia develops (increased gas formation, bloating and pain in the abdomen, frequent frothy stools with a sour smell). With the predominant consumption of protein foods, especially lamb, pork meat, which is digested more slowly in the intestines, putrefactive dyspepsia may occur (frequent dark stools with a putrid odor, there may be weakness, decreased appetite due to poisoning of the body with products of rotting proteins). Fatty dyspepsia is caused by excessive consumption of slowly digested fats (stools are frequent, plentiful, with a greasy sheen).

Accordingly, in the treatment of such disorders, the normalization of nutrition in accordance with the age characteristics and needs of the child's body is of paramount importance. Foods rich in protein and fats (meat, fish, eggs), which linger longer in the stomach and require especially active work of the digestive glands for processing, are given in the first half of the day. For dinner, they give more easily digestible dishes - dairy, vegetable and cereals. During periods of relaxation of the stool, the baby is offered such "fixing" foods as rice porridge, mucous soups. For the preparation of mucous soups, rice, pearl barley, oatmeal, barley groats are used. The previously sorted cereals are poured into boiling water and boiled until it is completely boiled. Then the broth is carefully filtered through a sieve or clean gauze, avoiding rubbing the cereal itself. In the slimy soup, you can add a little salt or sugar, milk. All food should be homogeneous and necessarily warm. It is necessary to ensure the intake of a sufficient amount of fluid in the body. A prerequisite is the observance of the diet.

irritable bowel syndrome

This syndrome also belongs to the group of functional diseases. This condition is characterized by a change in the frequency and consistency of the stool (a tendency to constipation or diarrhea). In addition, there are pains and discomfort in the abdomen, passing after defecation. If the doctor has made such a diagnosis for your baby, in nutrition, first of all, you need to take into account the nature of the stool disorder and follow the recommendations regarding the total amount of food, the volume of single servings, and the feeding regimen.

It should be noted that an irregular stool in a child requires a mandatory consultation with a doctor to determine the nature of the disease, since in addition to functional disorders, constipation is caused by the presence of malformations of the gastrointestinal tract, spinal cord, acute and chronic intoxications, endocrine disorders, etc. Considering all the circumstances and especially the health of the child, the specialist gives specific recommendations regarding nutrition, lifestyle and, if necessary, prescribes medication.

Effects of foods on bowel function
Products that promote bowel movement

black bread;
bread containing a significant amount of bran;
cereals: buckwheat, barley, oatmeal;
raw vegetables and fruits;
dried fruits, especially prunes, dried apricots, apricots;
meat with a lot of connective tissue;
mineral water;
juices;
kissels and compotes (especially from gooseberries, black currants, plums, cranberries);
fermented milk products: curdled milk, acidophilic milk with high acidity, one-day kefir;
sour cream, cream;
chilled products

Foods that delay bowel movements

products containing tannin: blueberries, black tea, cocoa;
mashed food;
products of a viscous consistency: mucous soups, pureed cereals, (especially semolina and rice);
warm and hot meals

Indifferent Substances

lean meat and fish in chopped or steamed form: soufflé, meatballs, meatballs, mashed potatoes, boiled lean fish;
wheat bread from the highest grades of flour (stale), crackers;
freshly prepared fresh cottage cheese

Nadezhda Ilyintseva, pediatrician, City Clinical Hospital No. 1, Ulyanovsk

Nadezhda Ilyintseva

Discussion

Please tell me, 1) how does the child feel about the absence of stool for 4-5 days, if it does not bother him; 2) how and what to eat for a nursing mother if she herself has flatulence for many products (apples, kefir, dried apricots and almost all fruits, even for baby purees) and is it possible to treat this during the feeding period

25.11.2008 00:12:22, Dinara

Comment on the article "Special nutrition. Diet for diseases of the gastrointestinal tract"

Toxorbin (Toxorbin) - Will cleanse the body of all toxins! "TOXORBIN" - a biogenic concentrate based on a natural complex of the zooglea substrate, eco-extracts of plants and concentrates of natural components aimed at the complex cleansing of the digestive system, blood, lymph, bronchopulmonary system, ENT organs, mucous membranes of internal organs, eye organs, brain vessels , genitourinary system, musculoskeletal tissue, skin, intercellular fluids from products ...

Sandoz, one of the world's leading manufacturers of generic drugs, announces the expansion of the Linex for Children® product line in Russia and presents a long-awaited new product - Linex for Children® drops. This form of dietary supplement is designed specifically for the youngest children. Immediately after birth, the microflora of the gastrointestinal tract (GIT) begins to form in the baby, and in all children this process proceeds individually. Due to problems with...

The completely natural desire of any woman - to know the happiness of motherhood - for one reason or another, sometimes requires the intervention of doctors. When diagnosing infertility and the ineffectiveness of conservative methods of treatment, assisted reproductive technologies (ART), in particular in vitro fertilization (IVF), are used. However, in order to increase the effectiveness of the IVF program, a certain preparation of a woman is necessary, since during ART the patient receives a significant, sometimes long...

Acute pyelonephritis (inflammation of the kidneys) is one of the most common diseases of the urinary system in children; is a disease that is an acute microbial-inflammatory process in the pyelocaliceal system and tubulointerstitial tissue of the kidneys. Ways of kidney infection in pyelonephritis: ascending (more often in older age groups, in girls the vulva can be the source of inflammation, in boys - the inflamed foreskin, glans penis) hematogenous (in ...

I fell in love with fiber tenderly after spring weight loss. Now I try to take it regularly. A close relative of the fiber helped to cope with a very delicate problem that has tormented her in the past few years - constipation. For reference: fiber is dietary fiber found in vegetables, fruits, cereals and beans. It is not digested by the digestive enzymes of the body, but is processed by the beneficial intestinal microflora. Fiber is either water-soluble or insoluble. Insoluble...

Section: Nutrition (we restore the gastrointestinal tract after rotovirus 1 month). What to feed after rotavirus? When the eldest had been ill with them (in 1g10m), there was no special diet (she is allergic to cow protein).

Most of the Russian population does not read the label on the purchased food. This conclusion was reached by the Federal State Statistics Service, which conducted a massive study of the eating habits of our fellow citizens and the most common diseases associated with them. Indeed, in modern conditions it is difficult to accuse people of inattention, because when compiling labeling, the main attention is paid to the presence of GMOs, the state quality mark, weight and calorie content ...

Useful vitamins, trace elements from products make up for the growing body their lack in breast milk or formula. Therefore, mothers need to introduce complementary foods from 4 months into baby food without fail, regardless of whether breastfeeding baby or artificial. The sequence of complementary foods depends on various factors, for example, pediatricians give the following advice: children with a lack of weight from 4 months are first injected with cereals, and children who have a good weight - vegetable puree. About products...

By the age of about one year, children can eat regular food from the family table and do not require specially prepared meals. It is still not recommended to add salt and sugar. Children eat slowly, so special care must be taken to allow extra time and attention to be given to them. It is impossible to scold a baby if he has not coped with something or refuses something, food should be a source of positive emotions! There are two categories of children in whom the terms and products of the introduction ...

Any woman at least once in her life was on a diet. In most cases, the lost kilograms returned, and even the extra ones were added. When overweight diet is necessary throughout life. For almost any disease, the doctor prescribes special nutrition (for ulcers, gastritis, diabetes, etc.). What should be the basic rules when following a diet? On fasting days, food must be made low-fat and low-carbohydrate. You need to burn more calories than you consume...

Special food. Diet in diseases of the gastrointestinal tract. Foods rich in protein and fats (meat, fish, eggs), which linger longer in the stomach and require especially active processing. In addition, there are pains and discomfort in the abdomen ...

The desire to have a beautiful figure often goes beyond all boundaries and is harmful to health. Many people exhaust their bodies for months with training and special diets based on solid restrictions. New developments of scientists will allow you to forget about the torment forever - it will be enough to inject yourself with a vaccine or use perfume daily that provides the effect of losing weight. There are many different diets in the world. Some of them help you lose weight, some don't. But you should definitely know...

No better way lose weight in a shorter time than diet. Fast or express diets top the list of the most effective methods for rapid weight loss, well ahead of all other nutrition programs. Recently, more and more people are fond of diets, because celebrities contribute to their popularization. If the diet helped Rihanna or Britney Spears, then it will help me. But which diets are the most effective and guarantee rapid weight loss? The most effective diets Almost all effective diets ...

Vitalact is a fermented milk product, which includes a whole range of beneficial microorganisms: lactic acid bacteria, kefir fungus and acidophilus bacillus, which makes it indispensable in baby food. This product is intended for children over 1 year old. Vitalakt has a number useful properties– improves appetite, has a positive effect on metabolism, normalizes digestion processes, in the process of fermentation, microorganisms synthesize a complex of vitamins and biologically active substances...

In the first months of a child's life, intestinal colic is the main reason for parents to visit a doctor. Approximately 20 to 40% of children cry at night by 6 weeks of age, suffering from intestinal colic, which is manifested by restlessness and crying, twitching of the legs, tension and bloating, which decreases after the passage of stool and gas. Usually intestinal colic begins in the evening and is more common in boys. To describe intestinal colic in infants, the so-called ...

IN school age more than half of the children complain of recurring abdominal pain. In some cases, pain disappears without a trace and does not require serious treatment, but in 50-70% they continue to bother patients, turning into chronic gastroenterological diseases. There are a large number of diseases that are accompanied by pain in the abdomen. By nature, acute, chronic and recurrent abdominal pain are distinguished. Acute abdominal pain may be due to acute ...

Special food. Diet in diseases of the gastrointestinal tract. All these are functional disorders of the gastrointestinal tract.

Special food. Diet in diseases of the gastrointestinal tract. Nutrition of a child under 3 years of age with diseases of the gastrointestinal tract. Gastritis: how to lose weight with such a disease.

Gastrointestinal tract. Children's medicine. Child health, diseases and treatment, clinic, hospital, doctor, vaccinations. Special food. Diet in diseases of the gastrointestinal tract.

Special food. Diet in diseases of the gastrointestinal tract. All these are functional disorders of the gastrointestinal tract. Why do such conditions occur, how dangerous are they and how to deal with them?

Everything that can be with the nervous system of a premature baby can be divided into 2 large and unequal groups. First, even if nothing bad has happened to the nerve cells and cerebral blood flow, the cells of the nervous system still turn out to be very immature and sometimes not “able” to carry out the correct regulation of all organs and systems. It takes time to develop these relationships. So, in the first days, the baby does not know how to suck independently, because the nerve impulse is not transmitted correctly to the muscles that are involved in sucking. The child is fed through a tube for a long time until the sucking reflex is formed. Very often, such children, having already learned to suck, swallow badly. The child keeps food in the mouth in a small volume for a long time and only then swallows it. Feeding takes a lot of time, usually parents adapt to feed the baby from a pipette, in small portions. In addition, such a child has to be fed liquid food for a long time, sometimes up to 2-3 years, due to the fact that chewing muscles develop poorly. Due to the immaturity of the nervous system of the stomach and intestines, such children usually spit up profusely, intestinal colic sometimes continues up to 5-6 months of age. Often there are constipations, because the nervous regulation of the intestines is very imperfect.

Children whom doctors were forced to feed through a tube for a long time, and who were on artificial ventilation for a long time, usually start talking late, pronounce sounds incorrectly, because the reflexes that regulate muscle tone involved in the pronunciation of sounds take a very long time to form. Therefore, almost all very premature babies need the help of a speech therapist. And speech therapy classes necessary even before the child begins to speak in order to normalize the tone of the muscles of the tongue, to form the correct development of speech muscles.

Due to the deep immaturity, premature babies are late in motor development, they start late to hold their heads, take a toy, and roll over. After six months, immaturity is no longer so pronounced, and the child develops faster. Often, motor skills are “confused” in a premature baby: the child starts to get up first, then sit down, it may be too late to learn to crawl, perhaps he will walk on tiptoe for a long time. There are two cures for immaturity - time and your patience.

If your baby is less fortunate, then in addition to the deep immaturity of the cells of the nervous system, they can suffer from a lack of oxygen that a premature baby experiences during severe pregnancy and childbirth. If the oxygen starvation of the brain was not too severe and prolonged, then the changes that have occurred in the cells will be reversible and will not lead to serious consequences in the future. In the first months, such children may be more excitable, have sleep disturbances. In the future, they develop well and by 1.5-2 years do not differ in the level of development from full-term peers. But if, nevertheless, damage to the cells could not be avoided, then the result of this may be “ruptures” of the vessels of the brain and hemorrhages in the ventricles of the brain. In 1-2 months of life, the condition of such children is usually severe, and they need medical care and long-term nursing.

With mild hemorrhages, the walls of small vessels “burst”, this can lead to an increase in intracranial pressure. Intracranial pressure rises due to excess formation of fluid in the ventricles of the brain, which presses on the surrounding tissues. With small hemorrhages, the condition in most cases is quickly compensated, the outflow of fluid from the ventricles normalizes, and the hemorrhages resolve without a trace. In other words, hemorrhages of 1 and 2 degrees can pass without a trace for the child, however, this does not mean that he does not need to be observed and treated at 1-2 years of age.

Severe hemorrhages, when large vessels “rupture”, blood fills all the cerebral ventricles, causes much more serious consequences, leads to convulsions, developmental delay, and motor disorders. Such children need the constant help of a neonatologist, neuropathologist and other specialists, in particular, the control of neurosensory organs (hearing and vision), since these areas of the brain can be damaged. If the baby is greatly delayed in its development, you need to carefully observe if it has seizures. Seizures are very different and sometimes do not resemble convulsions at all. The child can look away and freeze for a few seconds, stick out his tongue, make unusual fanciful movements with his arms and legs. You should be especially alert if the child strongly bends or unbends how many times in a row in a series. With any suspicion of convulsive seizures, the baby needs to consult a neurologist, conduct an electroencephalogram. If possible, make a video recording so that the neurologist can see the attacks that alerted you.

In premature babies who have suffered a severe lack of oxygen, irreversible death of nerve cells directly in the brain tissue can occur. This is the most severe type of lesion, and it is called periventricular leukomalacia. With periventricular leukomalacia, cells of the white and sometimes gray matter of the brain are destroyed, and in their place are formed. This brain damage is established by ultrasound brain. Over time, these cysts "close", and after 6-8 months of age they are no longer visible on ultrasound. The outcome of such children can be different: from minimal motor disorders with motor awkwardness and normal development of the psyche, to the formation of paresis, paralysis with delayed psychomotor development.

The diagnosis of intracranial hemorrhage and periventricular leukomalacia is very serious, but not a final verdict. What will be the outcome in this case in the first months of life, no one knows. The brain cells of a premature baby continue to develop out of utero, the tissue is very plastic and it can partially take over the function of damaged cells. Again and again we want to say: do not lose hope, treat the child, try to help him, develop him, follow the doctor's prescription. And you will be able to get a fairly good result even in a very serious situation. Moreover, science is moving forward, and every day new knowledge and methods of providing assistance appear.

Digestive problems in a premature baby

The main concern of the parents of a premature baby is the problem of weight gain and, indeed, this is of paramount importance as the main indicator of the physical well-being of the baby. It should be noted that the growth rate of physical parameters (body weight, length, head and chest circumference) in a premature baby will differ significantly from those of his full-term peers. At least up to 6-9 months, your baby will be “smaller”, and at this time obligatory weight control becomes of primary importance: in the first weeks and months of life, daily (at the same time, it is necessary to take into account the correct daily weighing of the child, which must be carried out at one and the same time). the same time, preferably before the first morning feeding or in the evening, before bathing), and then monthly. What should alert you in the first place is the drop in body weight or the lack of its increase (the baby "stands" in weight). The reasons can be both quite serious and due to feeding errors, insufficient breast milk in the mother. Naturally, in any case, you need to consult a pediatrician to clarify the causes and eliminate them.

The main problems of the digestive system in a premature baby, which almost all parents face, are intestinal colic. The word comes from the Greek "kolikos", which means "pain in the large intestine". Colic - paroxysmal pain in the abdomen, accompanied by severe anxiety of the child. The attack, as a rule, begins suddenly, the child screams loudly and more or less for a long time, reddening of the face or pallor of the nasolabial triangle may be noted. The abdomen is swollen and tense, the legs are pulled up to the stomach (they can immediately straighten up), the feet are often cold to the touch, the arms are pressed to the body. The attack sometimes ends only after the child is completely exhausted. Often noticeable relief comes after the passage of feces and gases.

Premature babies are particularly prone to colic, with some babies experiencing frequent and intense seizures that can be compared to labor pain in severity, and will certainly require medical intervention. Apparently, the immaturity of the neuromuscular apparatus and the enzymatic system of the intestine may be the main cause of these sufferings of the baby. And because of this, the tendency to increased gas formation, as a result of which pressure on the intestinal wall increases and muscle spasm occurs.

The cause of discomfort and bloating can also be irrational feeding. Some foods, especially those high in carbohydrates, can contribute to excessive fermentation in the intestines. Intestinal allergies also cause a baby to cry due to abdominal discomfort. But the causes of colic are not limited to these conditions. It is important to diagnose diseases requiring surgical intervention in a timely manner. Therefore, in the absence of the effect of the usual measures aimed at eliminating colic (special carminative herbal teas, simethicone preparations, cleansing enema, the use of a gas tube, abdominal massage, dry heat on the abdomen), the child should be carefully examined in a medical institution.

Dyspepsia (diarrhea, constipation) in a premature baby is a frequent and exciting phenomenon for parents and pediatricians. When breastfeeding, a child's stool can be after each feeding, along with gases (foamy) and quite liquid. In children receiving mixtures, stools are rarer - 3-4 times a day. The absence of a chair in a baby for more than 1 day can be considered constipation. The cause of dyspepsia is the immaturity of the neuromuscular apparatus of the intestine, a violation of the formation of the intestinal biocenosis, bacterial infections, long-term antibiotic therapy, treatment with iron preparations, anticonvulsants (what was prescribed to your child for health reasons), can lead to a violation of intestinal innervation, as a result inflammation of its mucous membrane, changes in the trophism of the mucous membrane of the colon occur.

Digestive disorders due to the increased fat content of breast milk or its substitutes; immaturity of enzymatic function. In all these cases, there are special corrective mixtures - therapeutic breast milk substitutes, preventive drugs that can help your child, but it is very important to coordinate their use with your pediatrician.

The regurgitation syndrome can also bother the parents of a premature baby. The most common cause of this is the immaturity and temporary (passing) smooth muscles of the stomach - the so-called "duodeno-gastric reflux". Most often it occurs in premature babies who have been fed for a long time through a tube. Aerophagia (when a baby greedily swallows air along with food) can also be a possible cause of regurgitation. Masses during regurgitation look plentiful due to their binding with air and usually do not change the baby's well-being in any way. In this case, you need to be patient and wait until the baby's stomach "ripens", while observing the recommendations for proper feeding, holding the baby vertically after feeding for 10-15 minutes. Quite quickly, improvement also occurs with the introduction of mixtures - thickeners (Frisov, Nutrilon-antireflux) into the diet. Medicines are best given to the child before feeding. However, there are situations in which urgent consultation with a specialist is necessary. If there are streaks of blood in the regurgitation masses, if they are so abundant that the child is not gaining weight well, if the baby’s health is disturbed during regurgitation - do not hesitate, consult a doctor!

Condition of the skeletal system and joints

The phenomena of morphological and functional immaturity in a premature baby often extend to the musculoskeletal system. Imperfection of the neuromuscular regulation, weakness of the ligaments, excessive mobility of the joints can lead to changes in the correct position of the limbs, head and spine of the child.

Often the baby keeps his head in a fixed position on one side. The reason for this may be a congenital shortening of the neck muscles on one side, a traumatic injury to the spine or cervical muscles during the removal of the head during childbirth, or just a “usual” position of the head, that is, the child “lyed” in this position most of the time in the uterus. The doctor always establishes the correct diagnosis, and the sooner this happens, the more effective the treatment will be.

Prematurity, especially in combination with an incorrect intrauterine position of the fetus, is usually accompanied by underdevelopment of the hip joints or "dysplasia". The most severe variant of this pathology is a dislocation of the hip joint. Diagnosis is established shortly after birth and requires early treatment based on hip abduction. Currently, an effective method in detecting abnormalities in the development of the joints is ultrasound scanning, which is mandatory for all children at 1 and 3 months of age, or more often if a disease is detected.

Considering that the described problems are especially common in premature babies, every baby should be examined by an orthopedist several times in the first year of life. As a rule, children receive the first consultation at 1 month of life, then at 3 and at 12 months. If pathology is detected, there may be more consultations. Timely detection of deviations will help to quickly begin treatment and raise a healthy child.

We tried to tell in an accessible form about the most common problems of the 1st year of a premature baby's life. All of them require attention, observation and timely treatment. We strongly recommend that you contact specialists who purposefully deal with the health and development of such children - this will help to avoid mistakes and unnecessary worries.

We wish happiness and health to you and your kids!

Skripets Petr Petrovich,
pediatric ophthalmic surgeon, candidate of medical sciences

Comment on the article "A premature baby is not a sentence for the family at all! Part 2"

The Ministry of Health of the Russian Federation will expand the risk group during vaccination. It will be supplemented by premature and underweight children, who will also need to receive a vaccination against Haemophilus influenzae. Thus, the Ministry of Health of the Russian Federation will change the National calendar of preventive vaccinations. The draft order provides for an increase in the number of children who are at risk - namely, with an anomaly in the development of the intestine, oncological diseases, premature and underweight children. For this...

An amazing story happened to the pregnant Alena Avdeeva in the Miass maternity hospital. Miass doctors during a caesarean section discovered she had a cyst instead of a multiple pregnancy, which surprised both parties. During the operation, the cyst was removed by doctors, - a REGNUM correspondent says. This sad event destroyed the hope of the failed mother and she turned to the police. I wanted to find out if there really were no children or if something had happened to them. Alena was observed in ...

A premature baby is not a sentence for a family at all! Part 2. If the oxygen starvation of the brain was not too severe and prolonged, then the changes that occurred in the cells will be. Intracranial pressure rises ...

At present, the optimal mode of delivery for infected women has not been fully determined. To make a decision, the doctor needs to know the results of a comprehensive virological study. Natural childbirth includes a whole range of measures aimed at adequate pain relief, prevention of fetal hypoxia and early rupture amniotic fluid reduce injuries of the birth canal in the mother and skin of the baby. Only when all preventive measures are observed ...

The unborn child said: “I am afraid to come into this world. There are so many unfriendly, evil Eyes prickly, smiles crooked ... I will freeze, I will get lost there, I will get wet in heavy rain. Well, to whom I quietly snuggle up? With whom will I stay, left alone? The Lord answered him quietly: “Do not be sad, baby, do not be sad, the good angel, he will be with you, As long as you mature and grow. He will undead, rock you, Leaning down, sing lullabies, He will press you tightly to his chest, He will carefully warm his wings. First tooth...

Name of examination Expiry date 1. Blood group, Rh factor 2. General analysis blood count 14 days 3. Complete urinalysis 14 days 4. Glycosylated hemoglobin (only for patients with type I and type II diabetes) 3 months 5. Biochemical blood test: total protein –. Urea, creatinine. K, Na–Blood sugar - Bilirubin (by fractions) 14 days 6. Blood clotting time: (Duke or Sukharev) or coagulogram 14 days 7. HIV, RW, HbS, HCV (have a PASSPORT with you) 3 months 8. ECG 1 month 9...

Not only diarrhea can cause concern for mothers, but also fatty baby stools as a symptom of serious disorders in the body. In a healthy baby, feces are usually of a uniform consistency, yellowish in color, soft and free of blood and other fluids. The emptying process should be painless. Constipation and diarrhea are not good, but isolated cases do not indicate any abnormalities in the body of the crumbs. But fatty stools can signal serious violations in the work of the pancreas ...

What to do for the first 10 minutes after a fall: * Do not think that the child will forever remain disabled * Do not think that this is “nonsense”, that “all children fall” * Really assess the child’s condition: is there soft tissue swelling? Is the child behaving unusually? * Call a doctor. It is better to exclude a serious injury (after X-ray or tomography studies) than to miss it. Sound the alarm * Pallor of the skin and changes in the reactions of the baby. The child becomes lethargic and drowsy or excessively...

Three times we went to Turkey with children. Once we had rotovirus. With a call to an ambulance to the youngest. Then I was taught prevention. The doctor of the highest category, the paid aunt came to the house. A few days before departure and on the day of departure, Arbidol and Viferon suppositories. Now the children are 8 and 13 years old with their grandmother in Bulgaria, the third week ends.In the residential complex 2...

The other day on the pages of livejournal magazine, a post was published “Supernanny - is it bad?” In search of a nanny, Nastya found exactly the one that would seem to be happy with any mother. ‘’ The nanny helped to overcome all the problems that scare young mothers so much - how to potty train, wean from a pacifier, teach them to fall asleep on their own. And by the child it was clear that the nanny was a treasure. But there was a climax in the nanny-family relationship, and the child demanded the presence of a nanny. The question arises: to be good ...

Nastya was born at 33-34 weeks. Prematurity, triple entanglement of the umbilical cord and difficult labor (stimulation, pressure on the abdomen, anhydrous period of about 14 hours) led to serious consequences: 2 weeks in intensive care (including 10 days on mechanical ventilation), a month in the neonatal pathology department and, as a result, in a month and a half the child and his mother finally got home with the following diagnoses: subacute intracerebral hematoma of the left parietal region and subdural hematoma in the posteromedial surface of the left hemisphere...

A premature baby is not a sentence for a family at all! Part 2. Respond who brings up very premature babies born weighing less than 600 grams.

A premature baby is not a sentence for a family at all! Part 2. 7ya.ru - an information project on family issues: pregnancy and childbirth, parenting, education and career, home economics, recreation, beauty and health, family relationships.

A premature baby is not a sentence for a family at all! Part 2. If the oxygen starvation of the brain was not too severe and leukomalacia, cells of the white, and sometimes gray matter of the brain are destroyed, and cysts form in their place.

The most common disorders of the digestive tract in childhood, fortunately, are functional, i.e. not associated with a change in the structure of the body. Usually, functional disorders are associated with a change in motor function, immaturity of the enzymatic, absorbing functions of the digestive system. The most common functional disorders Gastrointestinal tract in children of the first year of life are: intestinal colic, regurgitation syndrome (regurgitation), functional constipation.

Infant colic - what is it?

Uncontrollable and continuous crying of a child for several hours can be caused by colic, especially if the child eats well and is usually calm. Colic in babies does not pose a health risk, but it naturally worries parents. Colic occurs in almost all babies. Infantile colic can begin in a baby at the age of two weeks and last up to three months.

Causes of colic in babies:

The exact causes of colic in infants are unknown to science. Previously, it was customary to associate them with indigestion in a child. Flatulence aggravates colic, but it cannot be said with certainty that this is the only cause. A possible cause of colic in infants is often called an undeveloped nervous system.

Colic symptoms:

Uncontrollable crying of a child in the afternoon and evening
The child cannot calm down, constantly tossing and turning
Babies raise their head and pull their legs up to their belly
The child's face suddenly turns red
Baby's feet get cold
The child clenches his fists tightly
The child does not want to sleep or wakes up frequently
Some babies refuse to eat when they have colic.

Massage of the abdomen, a warm diaper, putting mom on her stomach can alleviate the condition. In case of inefficiency, Baby Calm or Espumizan (Sab Simplex) is recommended.

The regurgitation syndrome is understood as the reflux of stomach contents into the oral cavity. Most often, regurgitation is observed in the first 4-5 months of life. They are facilitated by: rapid sucking, swallowing air, overfeeding, violation of the feeding regimen, inadequate selection of mixtures, etc .; pylorospasm; perinatal damage to the central nervous system (CNS).

Proper attachment to the breast or feeding from a horn reduces regurgitation. It is also important to lay the baby on his stomach before feeding and upright position for 20 minutes after it. Often spitting up babies need to create an elevated position in bed on their side. You can raise the legs of the bed by 10-15 cm on one side.

Usually by 3 months the number of episodes of spitting up decreases significantly. If persistent regurgitation persists, this means that the child needs additional examination and diet therapy. With artificial feeding, it is also necessary to pay attention to the feeding regimen of the child, the adequacy of the selection of milk mixtures, their volume, which should correspond to the age and body weight of the child. The child should receive an adapted milk formula. Preference is given to special anti-reflux milk mixtures, as they form a denser clot in the stomach, which slows down emptying. With the ineffectiveness of diet therapy, it must be combined with drug treatment. When referring to a doctor, pay attention to the relationship of regurgitation with food (occur immediately after feeding or delayed).

Constipation is understood as defecation disorders, which are manifested by an increase in the intervals between defecation acts in comparison with the individual physiological norm and / or with systematic incomplete emptying of the intestine. This is manifested by the lengthening of the intervals between acts of defecation (more than 32-36 hours); a long period of straining - at least 25% of the total defecation time, dense stool (optional sign). The occurrence of constipation is due to dyskinesia of the colon (weak or strong contractions), a violation of the act of defecation - (spasm of the rectal sphincters, weakening of smooth muscles, etc.) or a combination of these factors.

Risk factors for the development of constipation in children of the first year of life include early artificial feeding, perinatal damage to the central nervous system, prematurity, immaturity of the newborn, food intolerance, intestinal dysbiosis, aggravated heredity for gastrointestinal diseases. Treatment of functional constipation in children of the first year of life includes diet therapy and, if necessary, drug treatment. The purpose of diet therapy depends on the type of feeding.

In children who are breastfed, it is necessary to normalize the diet to avoid overfeeding. Taking into account the fact that the composition of breast milk to a certain extent depends on the mother's diet, it is necessary to correct the woman's diet. Foods with a high amount of animal fats should be excluded from the mother's diet as much as possible, replacing them with vegetable oils. There is a direct connection between the occurrence of constipation in children with similar problems in the mother in the postpartum period, therefore, in the diet of a nursing woman, it is necessary to include foods that stimulate intestinal motility - fermented milk products, foods high in nutrients (vegetables, fruits, dried fruits, cereals, bread coarse grinding, etc.), it is necessary to observe the optimal drinking regimen.

Since constipation in children in the first months of life is often a manifestation of food allergies, foods with a high allergic potential should be eliminated from the mother's diet, and especially cow's milk, fish, nuts, the consumption of which is the most common cause of food allergies in children of the first year of life. The introduction of complementary foods into the diet of constipated breastfed children should be carried out, in accordance with the recommended feeding schedule, not earlier than 4–5 months of age.

Complementary foods in children with functional constipation should begin with the introduction of foods high in dietary fiber: fruit juices with pulp (apple, plum, prunes, apricot, etc.), fruit purees from the same fruits, then vegetable puree (zucchini puree, colored cabbage, etc.), grain complementary foods - buckwheat, corn porridge. In the absence of the effect of the ongoing dietary correction, it must be combined with drug therapy - lactulose preparations (duphalac, normase, lactusan, etc.)

For formula-fed children with constipation, mixtures containing oligosaccharides, which have a pronounced prebiotic effect, and also somewhat stimulate intestinal motility (Samper Bifidus), can be recommended. This mixture can be recommended for daily feeding in full or in quantity 1/3-1/2 of the required amount at each feeding, in combination with a regular adapted milk formula. The mixture is prescribed until a stable therapeutic effect is achieved. After that, the question of the advisability of continuing feeding with a mixture with lactulose should be decided by the doctor individually - depending on the condition of the child. Other mixtures can also be used, such as Frisovoe (Friesland Foods, the Netherlands), Nutrilon Comfort (Nutricia, the Netherlands).

Often these conditions are accompanied by intestinal dysbacteriosis, i.e. a violation of the quantity and ratio of flora. It is never an independent diagnosis and is more often temporary. In this case, the stool can be frequent or, on the contrary, rare. Deviations from the norm in the frequency and appearance of the stool does not always mean that the child is necessarily sick with something. However, a baby's stool can be a useful sign of nutritional adequacy or a symptom of an allergy. In such cases, changing the way you feed or eliminating the allergen is all that is required to solve the problem.

Often parents insist on regular examination of the child for dysbacteriosis, not realizing that the maturation of the intestinal flora takes time and can take place without our intervention. The constant intake of biological preparations is also unreasonable. The same temporary and secondary condition is lactase deficiency - a decrease in the amount of an enzyme that digests milk sugar. This condition is manifested by liquefied and foamy stools, bloating when taking milk. When the main cause of the disorder (intestinal infection, food allergy ...) is eliminated, it also goes away. Primary lactase deficiency is genetically determined and, fortunately, is rare.

Thus, functional disorders of the digestive system do not need enhanced treatment, but more often require the normalization of the mode and nature of feeding and, especially, our patience.