Dyschezia or disordered defecation means difficulty in pooping. Infant dyschezia occurs in infants within six months of age who have difficulty passing soft stools. Infant dyschezia is also called ‘Grunting Baby Syndrome.’ Due to the strain, the infant’s face can turn red or purple during pooping. Infant dyschezia is self-resolving and is mistaken by parents for constipation.
What Is the Difference Between Adult Dyschezia and Infant Dyschezia?
In adult dyschezia, adults have difficulty and strain with pain before passing stools. Constipation can lead to dyschezia or be a side effect of other conditions, whereas infants have difficulty coordinating various muscle groups necessary to poop. These infants do not constipate but rather find it difficult to pass normal stools. Babies can cry to facilitate the necessary abdominal pressure to release poop. Once they learn to get accustomed to the reflex, the issue gets resolved.
What Are the Causes of Infant Dyschezia?
Successful pooping requires the coordination of two processes, that is:
Newborn babies have not developed the ability to coordinate between these two processes. Also, the babies have no control over the stool reflex, and the anal muscles do not relax appropriately. When the stool enters the rectum, signals are sent to the anal muscles to release them, but the pressure in the rectum of infants can be weak. The infants have not yet mastered pushing as well as releasing feces at the same time.
So, to get rid of the stools, the babies use their diaphragm (muscles between the lungs and stomach that help to breathe) and abdominal muscles to relieve the stools but hold the anus tightly. Hence, they cry hard till they can relax their pelvic muscles and pass out the stools. With the infant’s digestive system and brain-to-body communication development, infant dyschezia can be overcome by the infant within a few weeks.
How to Distinguish Infant Dyschezia From Constipation?
It is common for parents to become apprehensive when the infants find it difficult to release feces and cannot tolerate seeing their strain and cry. Parents often mistake dyschezia for constipation and try home remedies to cure the condition. But, infant dyschezia is not associated with constipation, unlike adult dyschezia. The stools passed by infants with dyschezia are soft and are not hard and bloody as in constipation.
How to Distinguish Infant Dyschezia From Colic?
Colic is a pain in the stomach and is common in babies. Infants with colic become restless, arch their backs, tightly hold their fists, pull their legs towards the stomach, cry uncontrollably, and turn red in the face. Experts also consider colic to be a part of the developmental process. For example, if a restless baby who cries uncontrollably poops after being fussy, then it is a case of infant dyschezia.
How to Diagnose Infant Dyschezia?
The pediatrician (child specialist) will ask about the baby’s symptoms and examine the baby physically to check the stomach and might ask for a stool test. If the stool appears normal and if it is confirmed that babies cry only to pass a normal poop, then it is diagnosed as infant dyschezia.
What Is the Treatment for Infant Dyschezia?
The condition is usually self-resolving. However, massaging babies regularly can stimulate the nervous system and develop brain-body coordination. The covering of the nerves is called myelin and is responsible for increasing the speed at which the information travels from the brain. Massage relaxes the muscle and enhances myelination. This can help with infant dyschezia, but it is not the primary mode of treatment.
What Is the Normal Pooping Frequency in Babies?
Pooping of breastfed babies ranges from several times a day to once a week with a large blowout, whereas formula-fed infants poop several times a day to once every four days. If the baby’s intake is normal and he/she appears healthy and happy, then this should not be a matter of concern. Formula-fed babies can have pasty stools making it difficult for these babies to poop, but it is not considered constipation.
What Should Not Be Done by Parents?
Apprehensive parents use various methods of rectal stimulation to help the baby get rid of the distress. This is wrong and must not be followed. It is only a temporary mode of relief, and doing so can delay the learning process in these infants, and they might depend on these ways of stimulation to pass stools in the future. It is to be understood by the parents that this is a normal part of development.
Laxatives (a medicine, food, or drink that helps to get rid of solid waste) must not be given to infants with dyschezia.
Switching to a fiber-rich formula or opting for a formula that relieves constipation must be avoided. This can cause diarrhea and lead to dehydration.
Inserting fingers into the rectum to ease the passage of stools must be avoided. This can cause injury or infection in infants.
When Can Babies Get Rid of Infant Dyschezia?
Normally, it takes a few days to weeks for the infants to get the hang of passing the stools with ease. So, infant dyschezia is a temporary condition. However, it can be stressful for parents to see their babies in distress during this period. Babies overcome the issue within two to three months.
How to Massage the Babies?
Massaging is done by:
Placing the index and middle fingers on the stomach and moving it clockwise while applying mild pressure. This enhances the circulation of the intestine.
Bringing the baby’s knees to the chest can relieve the pain and discomfort as the sphincter (a ring-shaped muscle that tightens or relaxes to open or close an opening in the body) relaxes.
Infant dyschezia is a short-term, self-resolving problem and part of the developmental process. The infants will try to gain control over the muscle groups involved in pooping within a few weeks. Babies cry to increase abdominal pressure, enabling them to release poop. This does not mean anything serious, and parents must be patient. If it has been long since the baby pooped or in case of hard stools, it is recommended to consult a pediatrician (child specialist).