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25 November, 2019 00:00 00 AM

Vomiting and constipation in newborns

DR WRISHI RAPHAEL
Vomiting and constipation in newborns

Vomiting and constipation in newborn babies may become a cause for concern if the symptoms persist beyond the first twenty four hours of life. In our country where the majority of childbirths take place at home in the absence of skilled birth attendants or sterilized equipment, it is common for newborns to develop life threatening infections of the umbilicus or sepsis (infection of the blood). These neonates often come to hospital with associated symptoms like respiratory distress, dehydration, jaundice and fever and often require vigorous resuscitation, intravenous fluids and antibiotics. Only after adequate fluid replacement, phototherapy, frequent breast feeding and elimination of infection, can these children begin to thrive. However, in some children it may take several days for the vomiting and bowel irregularities to decline.

 Needless to say, the economic sanctions for the state to bear are enormous as most of these sick babies come from humble background and their families are unable to bear costs of such expensive therapy. It is not uncommon for these families to be refused admission to government hospitals due to lack of beds or equipment; thus contributing to the ever increasing number of infant deaths in our country.

 Other reasons for vomiting and constipation in babies include congenital (being born with) diseases like Meconium Ileus due to Cystic Fibrosis, Hirschsprung’s Disease etc. Meconium is the sticky, tarry stool babies should pass within 24 hours of birth. If a baby does not pass meconium within 24 hours, there will be catastrophic consequences like bilious (greenish in color due to presence of bile) or non bilious vomiting, abdominal distension and /or intestinal perforation (due to increased intra-abdominal pressure).

Hirschsprung's disease is a condition that affects the large intestine (colon) and causes problems with passing stool. Hirschsprung's disease is present when a baby is born (congenital) and results from missing nerve cells in the muscles of part or the baby’s entire colon.

A newborn who has Hirschsprung's disease is usually unable to have a bowel movement in the first days after birth. In mild cases, the condition might not be detected until later in childhood. Hirschsprung's disease is treated with surgery to bypass or remove the diseased part of the colon

Meconium Ileus is a disease which almost always, presents as a feature of Cystic Fibrosis. Cystic fibrosis is a life-threatening disorder that causes severe damage to the lungs and digestive system. The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines can't fully absorb the nutrients in the food you eat. The result is often:

Foul-smelling, greasy stools

Poor weight gain and growth

Intestinal blockage, particularly in newborns (meconium ileus)

Severe constipation

 Often more then ever, parents in rural areas are unable to recognize these signs until symptoms get really severe but by then, operative measures may prove futile.

 Signs & Symptoms of Meconium Ileus and Hirschsprung’s Disease are very similar. Both diseases may present with delayed passage of meconium, abdominal distension and vomiting; however the degrees of constipation and vomiting between the two diseases may vary.

In Meconium Ileus, the frequency of bilious vomiting will be more then Hirschsprung’s Disease; conversely in Hirschsprung’s Disease constipation may be more prominent. In both cases, intestinal obstruction in neonates is extremely difficult to treat, requires operative treatment and time is of the essence if the child is to be nursed back to health.

Newborns who are having problems with passing stool beyond the first day of birth must be seen and treated at the nearest pediatric facility. The Ministry of Health and Family Planning must also be wary in their efforts to make sure that there are skilled birth attendants in unions around the country. That way some of the avoidable causes of vomiting and constipation in babies may be easily avoided. n (Reprint)

 

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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