Abstract
Objective: Constipation is the infrequent and painful passage of hardened stools, occurring less than three times a week, often accompanied by excessive straining and discomfort. Functional constipation is the most important gastrointestinal complaint of childhood. Limited literature explores the correlation between functional constipation and infant nutrition. Our study aims to investigate the association between maternal and infant nutrition and functional constipation among infants between 1-4 months.
Method: The research is a cross-sectional study. Two groups involved cases from the pediatric clinic, which presented complaints of constipation within the age range of 1 to 4 months, and the control group, which consisted of individuals without any reported constipation issues. Mothers participating in the study completed a questionnaire comprising two sections: one focusing on patient assessment and the mother’s diet.
Results: The study encompassed seventy-five cases reporting constipation issues, with the control group comprising thirty cases. Functional constipation was most observed at 78 days of age. Children experiencing functional constipation exhibited lower weight and height values, demonstrating statistical significance. Additionally, 94.7% of infants facing defecation challenges had a history of meconium within the first 24 hours of birth. Factors such as alterations in familial defecation patterns and a history of constipation among first-degree relatives were notably higher in the case group. The incidence of functional constipation was notably elevated by cesarean section and those not receiving breast milk. Furthermore, maternal dietary habits indicated higher consumption of milk, fruit juice, yogurt, vegetables, and legumes among the healthy group, with statistically significant disparities observed.
Conclusion: Functional constipation in infants can associated with cesarean section, a high number of siblings, low parental education levels, familial history of altered defecation patterns, and constipation among first-degree relatives; additionally, formula feeding, maternal consumption of low-fiber foods, and inadequate fluid intake by the mother.
Keywords: functional constipation, infant, mother, nutrition
Copyright and license
Copyright © 2024 The author(s). This is an open-access article published by Aydın Pediatric Society under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
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References
- van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101:2401-9. https://doi.org/10.1111/j.1572-0241.2006.00771.x
- Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch Dis Child. 2007;92:486-9. https://doi.org/10.1136/adc.2006.098335
- Benninga MA, Voskuijl WP, Taminiau JA. Childhood constipation: is there new light in the tunnel? J Pediatr Gastroenterol Nutr. 2004;39:448-64. https://doi.org/10.1097/00005176-200411000-00002
- Di Lorenzo C. Childhood constipation: finally some hard data about hard stools! J Pediatr. 2000;136:4-7. https://doi.org/10.1016/s0022-3476(00)90039-8
- Baker SS, Liptak GS, Colletti RB, et al. Constipation in infants and children: evaluation and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1999;29:612-26. https://doi.org/10.1097/00005176-199911000-00029
- Aguirre AN, Vítolo MR, Puccini RF, de Morais MB. Constipation in infants: influence of type of feeding and dietary fiber intake. J Pediatr (Rio J). 2002;78:202-8. https://doi.org/10.1590/s0021-75572002000300007
- Afzal NA, Tighe MP, Thomson MA. Constipation in children. Ital J Pediatr. 2011;37:28. https://doi.org/10.1186/1824-7288-37-28
- Cunningham C, Taylor HG, Minich NM, Hack M. Constipation in very-low-birth-weight children at 10 to 14 years of age. J Pediatr Gastroenterol Nutr. 2001;33:23-7. https://doi.org/10.1097/00005176-200107000-00004
- Gomes RC, Maranhão HS, Pedrosa Lde F, Morais MB. Fiber and nutrients intake in children with chronic constipation. Arq Gastroenterol. 2003;40:181-7. https://doi.org/10.1590/s0004-28032003000300009
- Corkins MR. Are diet and constipation related in children? Nutr Clin Pract. 2005;20:536-9. https://doi.org/10.1177/0115426505020005536
- Comas Vives A, Polanco Allué I; Grupo de Trabajo Español para el Estudio del Estreñimiento en la Población Infantil. Case-control study of risk factors associated with constipation. The FREI Study. An Pediatr (Barc). 2005;62:340-5. https://doi.org/10.1157/13073247
- Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527-37. https://doi.org/10.1053/j.gastro.2005.08.063
- Del Ciampo IR, Galvão LC, Del Ciampo LA, Fernandes MI. Prevalence of chronic constipation in children at a primary health care unit. J Pediatr. 2005:78:497-502. https://doi.org/10.2223/JPED.906
- Iacono G, Merolla R, D'Amico D, et al. Gastrointestinal symptoms in infancy: a population-based prospective study. Dig Liver Dis. 2005;37:432-8. https://doi.org/10.1016/j.dld.2005.01.009
- Pashankar DS. Childhood constipation: evaluation and management. Clin Colon Rectal Surg. 2005;18:120-7. https://doi.org/10.1055/s-2005-870894
- Croaker GD, Pearce R, Li J, Nahon I, Javaid A, Kecskes Z. Idiopathic slow transit constipation is rare. But delayed passage of meconium is common in the constipation clinic. Pediatr Surg Int. 2007;23:1153-9. https://doi.org/10.1007/s00383-007-2021-8
- Weaver LT, Lucas A. Development of bowel habit in preterm infants. Arch Dis Child. 1993;68:317-20. https://doi.org/10.1136/adc.68.3_spec_no.317
- Cunningham C, Taylor HG, Klein N, Minich NM, Hack M. Constipation is a problem among former < 750-gram birthweight children. Pediatr Res. 1998;43(Suppl 4):100. https://doi.org/10.1203/00006450-199804001-00590
- Duman N, Utkutan S, Ozkan H, Ozdoğan S. Are the stool characteristics of preterm infants affected by infant formulas? Turk J Pediatr. 2000;42:138-44.
- Tunc VT, Camurdan AD, Ilhan MN, Sahin F, Beyazova U. Factors associated with defecation patterns in 0-24-month-old children. Eur J Pediatr. 2008;167:1357-62. https://doi.org/10.1007/s00431-008-0669-2
- Weaver LT, Ewing G, Taylor LC. The bowel habit of milk-fed infants. J Pediatr Gastroenterol Nutr. 1988;7:568-71. https://doi.org/10.1097/00005176-198807000-00015
- Lucas A, Sarson DL, Blackburn AM, Adrian TE, Aynsley-Green A, Bloom SR. Breast vs bottle: endocrine responses are different with formula feeding. Lancet. 1980;1:1267-9. https://doi.org/10.1016/s0140-6736(80)91731-6
- Kocaay P, Eğrıtaş O, Dalgiç B. Normal defecation pattern, frequency of constipation and factors related to constipation in Turkish children 0-6 years old. Turk J Gastroenterol. 2011;22:369-75. https://doi.org/10.4318/tjg.2011.0238
- Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014;58:258-74. https://doi.org/10.1097/MPG.0000000000000266
- Abrahamian FP, Lloyd-Still JD. Chronic constipation in childhood: a longitudinal study of 186 patients. J Pediatr Gastroenterol Nutr. 1984;3:460-7. https://doi.org/10.1097/00005176-198406000-00027
- Akyıldız N, Urgancı N, Nuhoğlu A. Kronik konstipasyonlu olgularımızın değerlendirilmesi. Türkiye Klinikleri J Pediatr. 2005;14:66-9.
- Staiano A, Andreotti MR, Greco L, Basile P, Auricchio S. Long-term follow-up of children with chronic idiopathic constipation. Dig Dis Sci. 1994;39:561-4. https://doi.org/10.1007/BF02088343
- Özyacıoğlu N, Polat S. 12 aylık çocuğu olan annelerin bazı sağlık sorunlarında başvurdukları geleneksel uygulamalar. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2004;7:13-5.
- Mouterde O. Constipation in infants and children: how should it be treated? Arch Pediatr. 2016;23:664-7. https://doi.org/10.1016/j.arcped.2016.03.003
- Arce DA, Ermocilla CA, Costa H. Evaluation of constipation. Am Fam Physician. 2002;65:2283-90.