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Baby born 5 weeks premature, was in NICU for jaundice.On iron and is having hard bowels. Worried of hershbergers disease?

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Our baby, born 5 weeks premature (Oct 3) had normal BM first two weeks of life. Had janudice after 10 days, put in NICU on bili-light for 3 days. Upon release from hospital pediatrician put him on iron. Has since had a hard time with bowel movements. Is breastfeeding well, and after large "bloweout" BM is happy and eats well. Then will get very fussy and acts like he has a lot of belly pain when he tries to eat again-eats very little. He won't nurse well, and cries like he is really in pain-his legs double up and he screams. I took him off iron a week ago but he still grunts a lot and struggles with BM except upon situmulation. I am concerned for a possibility of hershbergers disease. Tonight he is really screaming. Should I go to the ER or wait for morning to see pediatrician?
Posted Mon, 30 Apr 2012 in Child Health
Answered by Dr. Radhika 1 hour later

Thanks for the query.

I have gone through your query.

Your child has immense pain in the abdomen and associated bad bowel movements.
You could try giving the baby warm fluids to drink in small quantities.
Try immersing your baby in a warm bath so that the water is around chest-high. When your baby is relaxed in the bath, massage baby's abdomen so that it will ease him in passing his stools.
A common treatment for constipation in babies is to feed them prune juice diluted with water.

Constipation in babies may also be confused with or accompanied by gas and bloating. You can use over the counter drops for gas problem such as Mylicon, but be sure to follow the directions on the insert carefully. Also, a warm compress on the tummy may serve as a relief and comfort to gassy or constipated babies.

During episodes of colic, an otherwise healthy neonate or infant aged 2 weeks to 4 months is difficult to console.

If you're certain an iron-fortified formula contributes to constipation, use all the treatments recommended. If baby is still constipated, try using a low- iron formula for two months. Then, once your baby's intestines are more mature and his toleration increases, you can switch back to a fortified formula.

Hirschsprung disease is a developmental disorder of the enteric nervous system .It is normally seen in males and new born.

Hirschsprung disease should be considered in any newborn with delayed passage of meconium or in any child with a history of chronic constipation since birth. Other symptoms include bowel obstruction with bilious vomiting, abdominal distention, poor feeding, and failure to thrive.

You could visit the pediatrician in case the symptoms persist.

Ultrasound abdomen will show any abnormalities.

Hope I have answered your query. I will be available for follow up queries, if any.

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