Infant dyschezia? Constipation? CMA?

[Bobbie098]

Sorry in advance for the long post but hopefully someone won't mind reading. I'd really appreciate any help.

My baby is 10w 4d old and has been having problems with bowel movements since about 3w old.

It was fine when first born then he started screaming and straining for at least an hour but his poo was perfectly normal and soft when he finally went. I read up about infant dyschezia and discussed it with my health visitor which she agreed with.

It then got progressively worse, the discomfort was lasting around 2 days before he'd finally go and then it was pretty explosive when he finally went because of how much he had stored up (4 to 6 full nappies back to back within an hour) and that seemed to upset him even more rather than relieve him. The GP then diagnosed constipation and put him on movicol. I questioned how it could be constipation when it was never hard in the slightest and the GP sent me the link below which states constipation can be "Passing a large amount of poo all at once. Even if it is soft/runny, storing up a large quantity of poo means that their lower bowel has been stretched, and this is not good for any baby."

eric.org.uk/childrens-bowels/baby-and-toddler-poo/

I felt massively guilty I'd not even considered constipation and he has been in pain for weeks so I used the movicol and he started having 2-3 poos daily with ease and was such a chilled, happy baby all of the time.

Health visitor then said she wasn't happy with this and she said there's no away at all it can be constipation if it's soft and the movicol is just delaying him learning to pass a normal poo by himself. So I took him to the GP again, saw someone different and they said they agree with the health visitor and to try him without movicol.

I haven't give him any for about a week now and it's like my happy baby has gone. He is only pooing every 2 to 3 days which would be fine if it was his normal but he is so uncomfortable and the screaming is worse than first time around, it goes on all day long on and off and he's bright red, hyperventilating, and streams of tears. He then falls asleep exhausted from crying, he's always half asleep when I feed him, and only wakes fully to scream again. I'm not convinced he's just building pressure to poo, he seems in agony.

When he was on the movicol we played and did tummy time a few times a day and he was giggling and making noises interacting with us when awake, but now we can't do anything stimulating with him.

I have another GP appointment but just wondered if anyone on here has any similar experience or advice?

In the past week he has also developed some reflux symptoms which he never had before and a small red patch of dry skin on one cheek. Could it be CMA? but then would his symptoms have improved with the movicol if it was CMA?

I'm so confused with it all.

Thank you in advance for any responses.

I'm sorry you're experiencing this and it's so stressful when your baby isn't happy. Well done for pushing for answers and input.

Fwiw Movicol is a known and well researched medication for children (I don't know as much about babies) it's considered very safe and unlike other types, not a medication that makes the bowel "lazy" or affects its functionality, so I'm surprised the GP agreed this was a risk. I am not a doctor, I have experience of kids using movicol.

Worth going back and describing the difference you've seen.

Also worth pushing to understand what's causing all this in the first place. It can be quite normal for babies not to poo, but clearly it can also indicate an issue.

@saturdaydressmare thank you for your kind words.

The first GP did mention what you've said about it not making the bowel lazy which is reassuring, but then the health visitor made me feel like a terrible mum for delaying his development. She basically said I ride it out now or I ride out in the future but either way these episodes are inevitable.

So confusing when you get conflicting advice from healthcare professionals.

If it doesn't physically affect the bowel do you think she meant that he would have a psychological/behavioural issue with having a poo? I don't know if that is even possible, and surely letting him have these screaming episodes is more likely to make him associate pooing with trauma.

Upset baby aside, I do have moments when I laugh to myself about how invested I've become in someone else's bowel movements in the space of 2 short months

Yes I bet you never expected to talk so much about poo.

I have enormous respect for HVs... but they're variable in my experience and some hold some funny views. I personally don't buy this behavioural point (that somehow your baby has to "learn" to poo and movicol is preventing this), and I definitely don't think you've done anything wrong at all. Baby's digestive systems continue to develop, I know it's worrying but this may not be a sign of an ongoing problem, it's surely too early to know (just as it would with eg CMPA, as some grow out of it and others don't).

The early weeks are so stressful and exhausting - please don't panic, you're doing an ace job and if baby is growing and engaging and you're seeing docs about your concerns that's the main thing!

Hi op

You’re not alone. My baby is nearly 7 months and I regularly take poo pics and send a pic of each poo to My partner. My camera roll is full of them

my boy was exactly the same. Constantly straining trying to poo but nothing was happening. It was like he was trying to push but he didn’t know how st that age then all of a sudden he could do it and loads came out

my boy did get constipated and the gp
tried fobbing me off but I showed them a pic and ended up getting lactulose. The dose they gave caused diarrhoea and you could hear his guts bubbling. In the end for a good few weeks he was on comfort milk and 1ml of lactulose a day. As long as he got 1 poo out a day he seemed ok.

i also questioned everything, reflux, CMPA etc. eventually it all settled out. I would say by 14 weeks he could poo normally, I do think it was just learning to poo

Try not to google everything and worry. It’s all normal and baby is still developing. I drove myself mad googling everything 🌸

I honestly thought I would never be so interested in poo until I had a baby. Colour, texture, amount ... my gosh.
"What's his poo like?"
"He hasn't had a poo all day"
"Did you get my picture earlier re DS poo? Didn't look right"

Genuine texts to my partner almost daily...!
My HV said they can be all sorts of shapes sizes colour and frequency. Said I only needed to worry if there was blood. Not sure if that's good advice or not...

We were put on dairy free milk for severe eczema which kind of helped. I know CMA can have a number of signs. DS also had bad wind and hiccups a lot.

Keep going back to the doctor with your concerns but the first few months are pretty rough with no clue what's wrong worh them. Sometimes it is something but sometimes they just need time to adjust to the world and their bodies

And as PP says don't Google. You will get all sorts if extremes that really are incredibly rare.
Trust the professionals but keep going back if the advice isn't working/you are worried

you found a treatment that works- just put him back on it, and park any thoughts of other problems for now. Movicol is not going to make him not know how to poo, and you can gradually decrease it and see how you get on. The danger of getting too far down the rabbit hole that i google is that you end up trying all sorts of medicines, and, unlike movicol, a lot of the reflux stuff has bad effects on the gut biome and can even cause increase fracture risk in the future.

Thank you all for your advice and sharing your experiences.

I have started the movicol again and agreed with the GP that we will have regular reviews and trial reducing it in a few weeks when he will have hopefully grown out of any issues 🤞

Did get myself in a panic with Google but glad I posted here 💙

My ds is 5 almost 6 weeks and he was the most content happy boy until about 2 weeks ago and we thought he was getting colic but then I noticed the straining and thought infacol had constipated him as he hadn't been to the toilet in 4 days well he then went 4 times and again the next day once and I read about infant dyschezia so went to the doctors he prescribed lactulose 2.5ml once a day if he hasn't gone for a day but it means one day he's straining since 4am then goes and the next day afew grunts but is OK but then cycle happens again. Did a Dr say the comfort milk and 1ml each day or thats what you did yourself. I'm so scared he's going to become reliant on medicine to go. Sorry for the long post.

No to be fair doctor didn’t really help us at all, I did a bit of research and went with the comfort milk. With the lactulose, he gave a dose of 2.5ml a day I think and I could literally hear his guts bubbling and he had diarrhoea so was too much. We decided 1ml a day and probably did until he was about 12 weeks ish. Then he learnt to go himself and it helped xx

Ok I think it has ALL the hallmarks of CMPA. 4 poos in an hour, absolutely classic sign. My DD was the same and had it. The poos were smelly and green/mucusy which is another sign.

The doctors annoy me so much! They said my boy had a heart murmur they are common and I shouldn't worry and left I wasn't asked did I have any questions or anything. When I said I think he might have dyschezia he sort of shrugged like could be and then prescribed the lactulose. Was it prescribed even for the days he went I got told 2.5ml after one day of him not going? Xx

Hi OP. My baby is having similar issues. Do you mind sharing what happened with your baby in the end?

@Solicitor123 sorry you're going through this. It ended up being cows milk protein allergy. He is almost 2 and a half now, and it still affects his bowel movements. Definitely wasn't dyschezia, but the GP who said constipation was kind of right but only because of the milk allergy causing it. Even now if he was to have any dairy his primary symptom is to not have a bowel movement for a few days, be really uncomfortable, and then finally pass a really soft, explosive poo. I think the movical helped him feel more comfortable because it was preventing the pain lingering for a few days, but constipation in itself wasn't the primary issue. Hope that makes sense.

The GP only finally considered CMPA when my son started projectile viomiting one day. But they had been pretty dismissive before that based on bowel issues alone.

Wishing you both all the best, let me know if I can help with anything else x