CONSTIPATION is the result of tired overworked bowels. It is an aftermath of diarrhea and purging and of enervating influences. It is the reaction from overaction.
The greatest single cause of constipation in infants is overfeeding. The constant overfeeding of infants results in diarrhea and finally, an overworked colon, which is to tired and exhausted to function efficiently.
"Passing Enervation and Toxemia which are basic causes and omnipresent where there is any departure from the normal health standard overfeeding is first, last and all the time the cause of constipation in childen," says Dr. Tilden. Overfeeding is followed by imperfect digestion, flatulency, bowel discomfort, loose movements with curds in the stools. The amount of the curds increases as the digestive impairment becomes greater and, finally, the stools may become hard, dry and even lumpy. Children that are properly cared for and properly fed never have constipation.
Medical authors give as a cause of constipation, a "lack of food." But it is obvious that in these cases there is no real constipation. The bowels in such cases do not move simply because they are empty or nearly so.
I received an agreeable surprise while preparing the manuscript for this book, by finding, while reviewing two medical works on the care of children, that some of these, at least, are beginning to present a rational view of constipation in infancy. One of these books, jointly written by three leading child specialists, Drs. Morse, Wyman and Hill, declares: "In any case constipation is the least of evils in a breast-fed baby and ought not to cause any anxiety. Many mothers worry most unnecessarily about what they think is constipation, when there is really nothing the matter with the baby. It must be remembered, in this connection, that it is not necessary for every baby to have a movement every day, and that the consistency or the stools may vary normally in different babies." It is greatly to be regretted that these authors do not take the same view of the hand-fed baby.
The second such book, by Belle Wood Comstock, M. D., says: "If baby's bowels do not go over twenty-four hours without moving, do not worry. Patience is usually all that is necessary, and if baby is all right in every way, he is willing to wait a day and give his bowels a chance. Over anxiety and fussing have laid the foundation for many a case of chronic constipation. #### Never begin milk of magnesia, Castoria, or any laxative--just walt.
I have seen babies go for three days without a bowel movement and no harm result. These babies were sick and in such cases, even Dr. Comstock would resort to the enema, or other means of forcing action.
Dr. Comstock cautions: "Don't don't ever give soapsuds enema, Castoria, or castor oil. Castor-oil days for babies are past." Would to God that they were! But there are still too many doctors, nurses and parents giving this and other purgatives to babies. For instances Morse- Wyman-Hill say, castor oil "is by far the best and most efficient cathartic. Its action is rapid and very thorough, and it does not ordinarily cause griping."
Parents should never give purgatives of any kind to their children, whether the doctor advises it or not. Purgatives are the chief cause of chronic constipation. They upset the whole digestive tract, deranging their secretions and leaving them dry and exhausted.
Morse-Wyman-Hill say: "Great care must be taken in the use of both suppositories and enema not to establish a bad habit. It is very easy to so accustom the baby to them that it will not move its bowels without them, although the need for them has long passed."
A measure that "loosens the bowels" does not cure the difficulty, says Dr. Page. "It only produces more or less purgation." "For my own part, speaking with relation to the constipated habit so common, I consider that we should look for a remedy to the promotion of the general health, and having decided upon the diet, we should avoid frequent changes of amounts and proportions, which are always made at the risk of the system not getting accustomed to any one variety."
Page also says: "Sometimes there is no occasion for a movement for a day or two--no evidence of a desire for one. To use purgatives or injections in such cases is mischievious. A change of diet, or in the weather, may temporarily affect the babe. In bringing one over-fed bottle baby to three meals, four days passed, and then he had an easy, natural movement; then three days and another; then two. After this he had regular daily passages."
While in ordinary cases I never give nor advise an enema, there are rare cases in bottle-fed infants, where the milk curds are so large that they become impacted in the colon and in such cases a bowel movement, without aid, seems almost impossible. The child will grunt and strain and cry, but the impacted curds will not move. In such cases a warm water enema should be employed.