CONSTIPATION
In the chapter, "[The Feeding Problem]," constipation in bottle-fed babies was discussed. The bowels should move at least once in twenty-four hours. The passages are frequently very hard and leave the body only after a very great effort of straining. This constipation, often continuing until late childhood, should be corrected in the following manner:
In early infancy—as early as the fourth month—prune juice may be given as directed elsewhere, while in later months prune pulp or fig pulp, which has been carefully rubbed through a fine-mesh colander, may be given at meal time. By the time the baby is eleven or twelve months old, strained apple sauce may be given.
We deplore the use of the water enema as a regular daily procedure; in its place we suggest the use of the enema of oil or the introduction into the rectum of a gluten suppository or in obstinate cases a glycerine suppository. Abdominal massage should be daily administered. With a well-oiled hand, begin on the right abdomen and proceed upward to the lower border of the right ribs and across to the left side and down. This should be repeated many times at a regular hour each day. The mother should select an hour for the bowels to move, preferably after the forenoon feeding, and if the child is too small to sit upon the toilet chair, a gluten suppository may be placed into the rectum before the forenoon feed and some time during the middle of the day the bowel movement will be found in the napkin.
For the older child, before a certain meal each day, a well-vaselined piece of cotton may be inserted in the rectum; this often produces a bowel movement immediately after the meal. Laxative foods, such as bran, stewed figs, stewed prunes, or a raw apple, should be used faithfully—as repeated medication never corrects the difficulty, but usually prolongs it.
To immediately flush out the bowel, a soapsuds enema or a plain water enema may be allowed to flow into the lower colon, or a glycerine suppository inserted into the rectum will quickly bring a bowel movement. These methods are only of temporary value; a regular habit should be formed, if possible, to bring about a natural, normal bowel movement. When necessary to resort to drugs—such remedies as cascara sagrada, milk of magnesia, or syrup of rhubarb, are satisfactory, as well as our old stand-by—castor oil. Regular habits must be insisted upon, and if the mother pays attention to regularity at stool in early childhood very little trouble will be met later on in adolescence and adult life.
Chronic constipation often produces abnormal conditions about the rectum such as fissures, hemorrhoids, or prolapse, which may be of serious import.