Functional disorders of the gastrointestinal tract in young children. Functional disorders of the gastrointestinal tract in breasts: the role of diet and therapy

All this is functional disorders of the gastrointestinal intestinal tract. Why do such states arise, as far as they are dangerous and how to deal with them?

Functional disorders of the gastrointestinal tract are the states in which there is a combination of various symptoms from the digestive organs, but there are no structural or biochemical violations. The development of functional disorders of the gastrointestinal tract is based on three main groups of factors or their combination:

• The immaturity of the child's digestive system, which is characteristic, for example, for premature babies and for kids born with a low body weight. Such children have a later formation of the nervous regulation of the intestinal activity, later activation of digestive enzymes, especially those that are responsible for the splitting of fats, proteins of cow's milk, disaccharides (a variety of carbohydrates, to which, for example, sucrose, fructose, lactose) .
• Increased load on the digestive system of the baby that is not suitable for its age. Such a situation occurs both with an increase in the total nutrition, and with the elevated content of individual nutrients in the diet.
• A certain role in the development of dysfunctions in children is playing the state of the mother (or the child's environment). We are talking about the increased anxiety of family members, asocial conditions of life, serious violations of the routine of the day and the feed mode of the crumbs.

In the course of many studies, it was noted that the functional disorders of the digestion are much more commonly found among the firstborn, long-awaited children and children of the elderly parents, which, apparently, can be explained by greater anxiety and mortality of parents.

At the same time, the presence of dysfunction on the part of the digestive system may indicate not only for the disease of the gastrointestinal tract, but in some cases there is a symptom of the defeat of other organs and systems of the body. Therefore, any disorder in the work of the gastrointestinal tract is a reason for consulting a doctor.

In dysfunction of the digestive system, the following states may occur:

• disinfectants and vomiting;
• disorders that are manifested by pain in the abdomen (in infants - intestinal colic syndrome, which is characterized by the accumulation of gases in the intestine in combination with grapple pain in the abdomen and cry);
• violations of the chair with a tendency to constraint or periodic periodic periodic periods.

All these manifestations require different approaches in treatment. However, in all cases of functional disorders of the digestive system, treatment should be started with common events that are aimed at creating a calm psychological climate surrounded by a child.

The most important direction of the treatment of functional disorders of the gastrointestinal tract is dietherapy, which in some cases (not always) can be complemented by medication treatment.

Initially, it is advisable together with the pediatricr to analyze the daily and one-time supply and necessarily the liquid that the child receives, their correspondence and the actual mass of the body of the baby, the feeding mode and its technique.

Food Children up to 1 year

Natural feeding

Of course, the optimal nutrition for baby breast is the maternal milk. However, the dysfunctions of the gastrointestinal tract are observed and natural feeding. At the same time, the nature of the mother's nutrition becomes paramount. In a daily in the presence of dysfunction, a child should limit gas-forming products - cabbage, onions, tomatoes, apples, pears, grapes, peas, beans, black bread, kvass. It should also be avoided sharp, smoked products, dishes containing a large amount of fats, spices and pickles. In case of intestinal colic syndrome, gas-forming foods from a dietary woman are completely excluded. It is also necessary to limit dairy products (up to 500 g of dairy products per day, including cottage cheese, cheese, kefir, milk, and so on.), Since the excess of casein milk protein in the menu affects the composition of breast milk, which may cause digestive disorders from the kid, And also lead to the development of allergies. When climbing and instabilities of the chair, the crumbs of the mother need to limit the consumption of products such as cucumbers, beets, pumpkin, melon, plums, and when trends towards constipation - use less rice, bread products from the top grade flour, apples.

Artificial feeding

For children with functional disorders of the gastrointestinal tract, which are on artificial or mixed feeding, has now been proposed by special healing mixtures that a pediatrician can be prescribed.

With frequent joins, the use of adapted mixtures containing food fibers is recommended. Thanks to the fibers, these mixtures have a more dense consistency, which prevents jeeping. On the other hand, the presence of dietary fibers helps to normalize the intestinal motility and promotes the regularity of the chair. As a nutritional fiber, gluten of bob beans is usually used. Such milk mixtures include, for example, "Nutrilon Antirefluorux" ("Nutrition"), "Omneo" ("Nutrition"), "Friesov" ("Frisland"). All these mixes also have an impact on the frequency of the chair. Moreover, "Omneo" and "Friesov" have a distinct lifting effect and are recommended when trends towards constipation. At the same time, "Nutrilon Antirefluux" has a fixing effect and is recommended for children with a tendency to frequent and liquid stool. With a tendency to join and vomiting, the use of fermented fermentation mixtures should be avoided, which, due to lower pH, enhance jerking and contribute to the development of inflammation in the mucosa of the esophagus.

With a tendency to a liquid chair, a low-column mixture is prescribed to a child. With the trend towards constipation, it is better to avoid using a soy-based mixtures, as they have a fixing effect. During constipation, mixtures enriched (lacto and bifidobacteriums) can be recommended.

For the prevention and treatment of digestive digestive system dysfunctions in children born before the deadline, specialized mixtures for prematurenesses are recommended. An example of such mixtures can serve as "Human 0", "Fry-Sopra", "Enfallak", "Alprem", "Natal", "Preutrylak", "Predan" and others. Specialized mixtures for premature must be used during the first 2-3 The months of the life of the baby, and then go to the feeding by ordinary or therapeutic mixtures. With good tolerability of the first mixture, choose the usual or therapeutic mixture of the same firm. This will not only reduce the likelihood of dysfunction of the digestive system, but also reduce the risk of development.

Food of children from 1 year to 3 years

Functional constipation

Depending on the leading reason, functional constipation is divided into several types.

Most often, young children have an alimentary constipation, arising from the violation of the food regime, defective nutrition, insufficient consumption of liquid and vitamins of B.

The dyskinetic constipation is based on a violation of the motor function of the colon. In this case, its abbreviations can be too sluggish or, on the contrary, excessively intense (spasms).

There are still conventional reflex constipation. They develop if the child systematically suppresses the desire to "go in large", which leads to the recession of the rectum, increase the volume and sealing of the carts. This situation often arises when the kid due to psychological reasons can not go to the toilet in kindergarten, in an unfamiliar situation or not to his pot. When the child is emptying the intestines, the paths of large volume cause an extracting of the rear pass, which is accompanied by pronounced pain.

Treatment of constipation requires an individual approach in each concrete case. With recently emerged constipation, to achieve a positive effect, it suffices to change the nature of nutrition and increase physical activity.

Principles of diet and therapy with functional constipation:

• Frequent fractional nutrition. For children older than 1 year, food should be 5-7-time small portions. Be sure to follow the mode of meals. Deviations from the graph should not exceed 15-20 minutes.
• Increased in the diet of the content of products stimulating the intestinal emptying. Improving the intestinal motor function promotes nutrition rich in fiber (widespread use of various vegetables and fruits in raw or in dishes, dried fruits, bread from coarse grinding flour), enrichment of the diet with vegetable oils, fruit and vegetable juices with flesh. Recommend prunes in any form, including infusion, puree from dried fruit. Since plums contain organic acids, then, despite the relatively low content of the fibers in them, they contribute to the intestinal emptying in children with constipation.
• Exception of products rich essential oils (radish, onions, garlic), because They annoyingly act on the intestinal mucous membrane, reinforcing painful spasms and slowing down the promotion of the food lump on the digestive tube.
• Consumption of consumption of cholesterol products (butter - no more than 10-12 g per day for children from 1 to 1.5 years, no more than 15-17 g per day for children from 1.5 to 3 years; eggs are no more 0.5 pcs. For children from 1 year to 3 years; fatty meat excluded). To digest a large number of animal fat, high activity of digestive enzymes is required, which dramatically increases the load on the digestive glands and can aggravate the situation with constipation. However, in moderate quantities, the above products may be useful, as they contribute to the bile separation. Offer baby products containing animal fats for breakfast, it will contribute to the fit of the chair.
• Exception (restriction) of easily-friendly, refined products (products obtained by complex chemical, thermal and other transformations in production, such as confectionery and pasta from top grade flour, cornflakes, potato chips, rice and semolina cereals, etc.).
• Food should not be homogeneous, since the presence of pieces stimulates intestinal cuts and promotion of the food lump.
• A sufficient liquid must be provided in the diet: water, fruit and vegetable juices. The liquid is necessary, since due to the slow evacuation of the path masses from the intestine, their drying occurs, which, in turn, makes it difficult to progress on the colon. Recall that black tea and cocoa have a fixing effect.
• The use of fermented milk products containing lacto and bifidobacteria. It should be noted that the relaxing effect of fermented milk drinks varies depending on the method of their preparation and storage conditions. Equality drinks with acidity above 90-100 ° across the ternere (acidophilic milk, prokobvash, kefir) have a relaxing effect. One-piece milk, on the contrary, is not recommended for constipation. It should be noted that as the kefir strangles, its acidity increases significantly, since, as a result of fermentation processes, milk acid accumulates and carbon dioxide is distinguished. Two-day and especially three-day kefir has a fixing effect.

If the child has spastic constipation, for which the spasm of the intestinal muscles, abdominal pain, dense segmented feces (it is also called "sheep"), the dietary treatment is folded from two stages. The first stage (as a rule, no more than 5 days) - a period of gentle nutrition, the purpose of which is to relieve intestinal spasm and reduce the irritation of the thick intestinal mucosa. At the first stage, products rich in cellular shells (vegetables, fruits, rye bread) are temporarily excluded, as food rich in food fibers can cause gain pain. Applied gentle culinary processing (dishes are prepared for a couple, stew, baked in the oven). In the future (at the second stage) there is a gradual expansion of the diet. First, foods containing fiber tender, and subsequently a coarse consistency are added to food.

If the baby, in addition to the constipation, suffers from excess gas formation in the intestines (flatulence), excluded dishes from beans, cabbage, sorrel, spinach from the diet. Apple, grapes are not recommended from fruit juices.

Functional chairs

The discrepancy between the possibilities of the gastrointestinal tract and the food burden often leads to the election of a functional chair. At the same time there is a rapid (more than 2-3 times a day) the emptying of the intestine. To eliminate the intestinal infection, the doctor's consultation will necessarily need. Digestion disorder (duspection) often occurs with "single-sided" nutrition. For example, with excessive use of carbohydrates (sugar, honey, flour products, grapes, peas, beans, cabbage, etc.), as well as such drinks, like kvass, the intestines are created for the development of the ferrous flora. The fermentation dyspepsia is developing (increased gas formation, bloating and abdominal pain, a frequent frothy chair with sour smell). With preferential use of protein products, especially ram, pork meat, which is slower thanks in the intestines, it may occur with a rotten dyspepsia (a frequent dark chair with a rotten smell may be weakness, a decrease in appetite due to the body poisoning products of proteins rotting). Fat dyspepsia is due to excessive use of slowly digested fats (Chair is frequent, abundant, with fatty glitter).

Accordingly, in the treatment of such disorders, the normalization of nutrition is of paramount importance in accordance with age features and the needs of the child's body. Products rich in protein and fats (meat, fish, eggs), longer delaying in the stomach and requiring digestive glands for processing especially active gland to be given in the first half of the day. The dinner is given more easily dishes - dairy, vegetable and cereal. During periods of chairs, the kid suggests such "fixing" products like rice porridge, mucous soups. To prepare mucous soups, use rice, pearl, oatmeal, burglar cereals. The pre-grooved croup is poured into boiling water and boiled up to its complete rigging. Then the decoction is carefully filled with a sieve or pure gauze, not allowing wiping the cereals itself. In the mucous soup, you can add some salt or sugar, milk. All food must be homogeneous and necessarily warm. It is necessary to ensure admission to the body a sufficient amount of fluid. Mandatory condition is observing the treatment regime.

Irritable intestinal syndrome

This syndrome also refers to a group of functional diseases. This condition is characterized by changing the frequency and consistency of the chair (a tendency to constipation or diarrhea). In addition, pain and discomfort in the abdomen passing after defecation are noted. If the doctor put such a diagnosis to your baby, in nutrition, first of all, it is necessary to take into account the nature of the stool violation and adhere to the recommendations for the total nutrition volume, the volume of one-time portions, feed regimes.

It should be noted that the unregular chair in a child requires the obligatory consultation of the doctor to clarify the nature of the disease, since in addition to functional disorders, the constipation of the development of the gastrointestinal tract, spinal cord, sharp and chronic intoxication, endocrine disorders, etc., taking into account all the circumstances and Features of the child's health, a specialist gives specific advice on nutrition, lifestyle and, if necessary, prescribes drug treatment.

Impact of products on the intestinal emptying function
Products contributing to intestinal emptying

• black bread;
• bread containing a significant amount of bran;
• cereals: buckwheat, barley, oatmeal;
• raw vegetables and fruits;
• dried fruits, especially prunes, kuraga, uryuk;
• meat with lots of connective tissue;
• mineral water;
• juices;
• kissels and compotes (especially from gooseberry, black currant, plums, cranberries);
• efficiency products: Prostokvash, acidophilic milk with high acidity, one-day kefir;
• sour cream, cream;
• chilled products

• products containing tannin: blueberries, black tea, cocoa;
• food in the grade;
• products of a viscous consistency: mucous soups, rubbed porridges, (especially manna and rice);
• warm and hot dishes

• low-fat meat and fish in chilled or cooked on a couple of way: souffle, meatballs, cutlets, puree, boiled low-fat fish;
• wheat bread from the highest varieties of flour (worm), crocks;
• freshly prepared freshly cottage cheese

Nadezhda Ilintseva, Pediatrician GKB number 1 Ulyanovsk

Discussion

Please tell me 1) as it belongs to the lack of chair in a child for 4-5 days, if it does not bother him; 2) How and what to eat nursing mom if she has a meteorism for many products (apples, kefir, dried apricots and almost all fruits, even for children's puree) and is it possible to treat it during feeding period

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Special food. Diet with diseases of the gastrointestinal tract. All this is functional disorders of the gastrointestinal tract.

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Gastrointestinal tract. Children's medicine. Child health, illness and treatment, clinic, hospital, doctor, vaccinations. Special food. Diet with diseases of the gastrointestinal tract.

Special food. Diet with diseases of the gastrointestinal tract. All this is functional disorders of the gastrointestinal tract. Why do such states arise, as far as they are dangerous and how to deal with them?

The work of digestive organs at an early age has its own specific features and therefore not every specialist involved in the treatment of adult patients can accurately diagnose and choose the best way to treat the diseases of the gastrointestinal tract in a child. Detection and treatment of diseases of the digestive organs in the child is engaged children's gastroenterologist. A highly qualified gastroenterologist can recognize and appoint a course of treatment of such diseases of the gastrointestinal tract in a child like gastritis, sigmoiditis, esophagitis, hepatitis, peptic diseases (duodenal ulcers, stomach), duodenitis, colitis and others.

The slightest concern about the burning and pain in the gastrointestinal tract in the child should alert you - effective treatment without possible complications of diseases of the digestive system depends on the inadequacy of the ailment at an early stage of development.

Children's gastroenterologist Be sure to inspect your child if the following symptoms appeared:
1. Vomiting, nausea, belching, heartburn
2. Violation of the defecation process
3. Chronic abdominal pain
4. Impairment of appetite
5. Bleeding of digestive organs
6. Unpleasant smell of mouth
7. Stool Violation (diarrhea, constipation, unstable stool)
8. Weight decline

Children's gastroenterologist He examines the child, hears the complaints and will make the collection of anamnesis on the development of the child, will find out the peculiarities of the possible previous treatment of diseases and the characteristics of the power mode. Then the gastroenterologist will prescribe additional examinations and diagnosis: kala tests for coprology, dysbacteriosis, carbohydrates,
general blood analysis,
ultrasound examination (ultrasound) of the digestive system organs,
if necessary, send a child to inspection by other specialists for a more accurate diagnosis.

Below is information about the main diseases of the organs of the digestive system in children who reveal children's gastroenterologist And then prescribes a course of treatment:

How to recognize the symptoms of diseases of the gastrointestinal tract near the baby?
The pain in the tummy in the baby of the breast is manifested by the bundle with legs, frequent anxiety, preventing the legs to the stomach, strong crying. The tummy at the kid can be dense, noticeably swollen, and publish specific sounds: transfusion and rumbling. The kid at the same time is full, strongly blushes, grinding.
Pain in the tummy in the infant can appear due to accumulation of gases, strong colic (spontaneous intestinal spasms), which leads to a breakdown of sleep and a decrease in appetite.

An experienced children's gastroenterologist will determine the reasons for the emergence of symptoms of diseases of the digestive organs in the infant. Causes can be a different:
1. The total immaturity of the digestive system in an infant characteristic of any infant at an early age (frequent colic and accumulation of gases - quite normal phenomena for completely healthy children up to 4 months of age)
2. Intestinal dysbiosis
3. Lactomatic insufficiency due to imperfection of enzymatic systems in the child's body
Lactose intolerance is a fairly common phenomenon for children up to 1 year. Lactose (or milk sugar) is contained in fermented dairy products, breast milk, cow's milk and children's milk mixtures. The lactation of the enzyme breaking lactose (lactase) in the body of the infant leads to poor tolerability of dairy food and poor lactose absorption (lactose intolerance).
Baby lactase deficiency can develop both due to hereditary predisposition, as well as in the background of the intestinal dysbiosis or general enzymatic immaturity. Symptoms of lactose intolerance in an infant infant: pain in the tummy during or after feeding, frequent liquid (and even frothy) chair (more than 10 times a day), blossoms of the tummy and weight loss. After the kid survey, the children's gastroenterologist can give a direction for the delivery of feces for carbohydrates to confirm the diagnosis.

In disruption of the balance of intestinal microflora with the developing dominance of pathogenic bacteria in the gastrointestinal tract, the operation of the digestive system is disturbed and dysbacteriosis begins in children. The feces analysis on dysbacteriosis (intestinal microflora study) allows you to accurately make a diagnosis and assign appropriate treatment to correct the intestinal microflora and restoring the health of the digestive system in the child.

Often To the children's gastroenterologist Children with periodically emerging sharp stomach pains that are not related to diseases of the digestive organs. The child complains of abdominal pain after transferred shocks, psycho-emotional stress. These are the so-called neurotic pain in children. After the examination, the gastroenterologist can advise you to consult with a children's neurologist, a children's psychologist, as well as with a cardiologist - pain in the abdomen can be part of the vegetual-vascular dystonia.

Why does a child hurt a belly? The most common causes of violation of the digestive system in children faced children's gastroenterologist In his healing practice:

1. Overbid
It is often found in very little children. Do you ever deny your chad in the additive? Do not be surprised if some time after overeating the child begins to complain about the pain in the tummy, he appears lethargy, apathy, light nausea.
If this happened, put the baby in the bed and if it broke out, let's drink a little cloth. Enzyme preparations can greatly facilitate the state, but they can be given only after consulting with a children's doctor!
And most importantly - try to teach a child to moderate food!

2. Colic (spontaneous intestinal spasms)
If the child is completely small (several months from the nature), then colic usually provokes the air that is assembled in the intestine.
Colik's manifestations in a child - the baby crying hard for a long time after eating.
What you need to do - if you feed the baby with a breast, make sure that he captures the mouth not only the nipple, but also Aregol around him. Try to use only easily disabled products. And if your baby is on artificial nutrition, then consult with a children's doctor in order to pick up suitable option Baby food (mixture) for baby.
Prevention: Keep the baby vertically some time after feeding, until the excess air from the intestine is coming.

3. Pointing
You should alert too rare intestinal emptying in a child (only a few times a week), as well as the appearance of periodic pain in the tummy and frequent meteorism.
What you need to do: be sure to reduce the child to the examination To the children's gastroenterologist . The constipation may be a consequence of the functional disorders of the pancreas or the thyroid gland, as well as the liver. But such reasons are found not often and in most cases it is enough to change the lifestyle and child diet. Let's a child more products that perfectly activate the intestinal work, supporting the microflora balance - acidophilic milk, yogurts with bifidobacteriums, kefir, and dried fruits (driving, prunes, raisins) and vegetables in cheese and boiled form (carrots, beets, apples, tomatoes) .
Publishes in a child may also be a consequence of dehydration of the body - let's kid as much as possible liquid (juices, juice, compote).
The best way to combat constipation in a child is a full diet, drinking as much liquid as possible and walk more in the fresh air.

4. Purpose bacteria
Some of the most common bacteria causing diseases of the digestive system are salmonella and Shigella.
Symptoms of salmonellosis in a child - high temperature, diarrhea, diarrhea, vomiting, stomaching.
What to do? Be sure to show the child to the Children's doctor to clarify the diagnosis. Usually prescribe treatment with antibiotics. Treatment begins with the use of sorbents - activated carbon, Sillard, Smekt.
With shgellosis (dysentery), the child has a child's body temperature up to 38-39 degrees, a watery chair appears with an admixture of mucus and blood, painful urge to defecation.
What to do? Be sure to take the child to the pediatrician for the examination. With dysentery, antibacterial drugs are usually prescribed. It is necessary to give a glucose saline solution, and when the baby becomes better - replaced by it with a weak solution of unsweetened tea. Diet with dysentery - steam cutlets, cereals, baked apples. Let the fruit, berries and vegetables (care thoroughly).

5. Viral diseases
A rather diverse group of pathogens microorganisms - enteroviruses lead to a stomach disorder in a child.
Enterovirus diarrhea. Absolutely any child can get sick, taking a dirty toy in his mouth or talking with an infected peer. Typherovirus diarrhea is usually ill under the age of 4. Symptoms - an increase in temperature up to 38 degrees, cough, laid nose, hurts the throat. With diarrhea symptoms, specify the dosage of anti-inflammory drugs from the pediatrician and the treatment scheme. Let the child drink as much fluid as possible. Engage in the child's immunity.
Another disease caused by a certain type of enterovirus is hepatitis A in the child. The infection is transmitted through personal hygiene items, infected with dishes, water from under the tap (if the child swept raw water). Symptoms - the temperature is sharply rising, the child is tormented by nausea and sharp abdominal pain. The chair is discolored, and urine becomes dark yellow. The jaggility of the eye proteins is manifested, then - faces and then the whole body (signs of infectious jaundice).
When hepatitis A, the child will have to lie down for some time in the hospital. Diet with hepatitis A - vegetable soups, dietary meat (rabbit, turkey, chicken meat), dishes from stew, boiled and raw vegetables.
The best remedy for hepatitis A is a vaccination. Teach the child there are only moyful fruits and thoroughly wash your arms before eating.

6. Acetomonic crisis
The causes of occurrence are incorrect meals, frequent overwork, long-distance driving - severe stress for a children's body, leading to excessive production of ketone bodies in the blood (acetoneacetic acid and acetone).
Symptoms - the child often tears not digestible food with an admixture of bile. The temperature rises, severe abdominal pain appear. The child's mouth smells like acetone.
Be sure to take the child to the examination to the children's gastroenterologist To clarify the diagnosis. Every five minutes, let's give a child along a teaspoon of a solution of the regider or alkaline mineral water without gas. Make an intestine cleaning enema (2 teaspoons of soda per 200 grams of water). Let the child sorbent (Polysorb, Smekt, Sillard). Diet - For a few days, give the baby cereal, crackers, rubbed vegetable soups.
Full diet and the elimination of stressful situations will prevent the repetition of the child's disease with acetronomical crisis.

Analyzes and diagnostics that appoint children's gastroenterologist :
1. Calate tests for carbohydrates, dysbacteriosis, coprology
2. Biochemical blood test
3. Diagnosis of pancreas and liver
4. Gamma-glutamyltransferase, aspartaminotransferase, proteinogram (protein fractions), alpha-1-sour glycoprotein, bilirubin common, antitripsin, cholinesterase, etc.
5. Ultrasonic study (ultrasound) abdominal cavity

The sluggish intestine is a gastroenterological disease, accompanied by a decrease in the muscle tone of the patient's intestinal. The role of these muscles in a person's life is large enough, because they move the food used, and then respond to the movement of the carte masses in the body. If a muscular tone Reduced, Cal begins to accumulate in the guts, because of which the body is poisoned by harmful chemical compounds. Most often, this ailment arises in people aged, but young patients also suffer from gastroenterological pathology.

Sluggish intestines - symptoms and treatment

Often the sludge syndrome is striking people who do not comply with a healthy diet. If a person does not drink enough liquid, and in the daily diet there will be no fresh vegetables and fruits, then it is most likely to have to face such a disease as a lazy intestine.

According to statistical data, such syndrome occurs in people over 45-50 years old, which lead a passive lifestyle and regularly take drugs from the diseases of the cardiovascular system. Doctors note that regular activities of active sports or any type of physical activity contribute to the existence of the intestine.

And here there is a circle closure. Problems with intestinal defker lead to disorders of digestive processes in the body, which provokes the development of constipation. It is worth noting that not only the absence of stool affects the work of the digestive system.

The most common causes of the sluggish intestine include:

• various chronic diseases (Parkinson's disease, hypothyroidism and so on);
• hemorrhoids and the presence of cracks on the walls of the rear pass;
• obesity (the presence of cellulite in the visceral zone negatively affects the peristaltics of the patient's intestinal);
• dysbacteriosis;
• severe stress (hard work or lack of opportunity to go to the toilet at any time);
• consequences of admission of some medicines;
• violation hormonal background. Often during pregnancy or in breastfeeding, hormones, overwilling the body of the woman, slow down the intestinal work. It makes it difficult to move the movement of feet and the uterus, which increases when having become a child.

These are just the most common factors contributing to the development of this pathology. Therefore, if you do not enjoy sports, do not eat right, then feel the whole none of the slurger syndrome.

Characteristic symptoms

In normal operation, the intestine should empty daily, from 1 time per day, but if this figure is significantly lower than usual, then you most likely have problems with the work of the intestine. What are the signs of this disease and how dangerous is it dangerous for the patient's health? To respond, you must first get acquainted with the main symptoms. This is dry in the oral cavity, heartburn, bloating, discomfort in the abdomen and constipation. If one constipation is tormented periodically, then others, on the contrary, almost every day.

In addition, the patient may notice the appearance of the following signs:

• decline in appetite;
• increased nervousness;
• fatigue and inhibition;
• the total weakness of the body.

The combination of such symptoms may indicate into intoxicating the patient's body, the appearance of which occurs during the poisoning of various toxins. The main factor contributing to the development of intoxication is the accumulation of cartwesters in the patient's intestine.

On a note! If toxins are in the body too long, it can lead to a violation of the liver, deterioration of the condition of the skin and nails, as well as to hair loss. The sluggish intestine can deliver a lot of trouble if medical care is not rendered on time.

How to treat sluggish sinth

Most people with the appearance of constipation or problems with the work of the digestive system are immediately engaged in self-medication, we take laxatives or drink teas with the laxative effect in the hope of making their suffering as quickly as possible. But such actions may not only help, but also harm your body by violating the digestive system.

Sluggish intestines - treatment

Despite the large temptation to take drugs having laxative properties, you need to remember that they can all cause addictive, as a result of which their active ingredients will not act on time on you as it was before. For the treatment of sluggish intestines, recipes of traditional medicine, medical gymnastics and a special diet are most often used. Now consider each of these methods that have a long-term effect, separately.

Food

The first and most important thing is to be done when the first signs of the lazy bowel appears - this is to revise your daily diet. Regular use of some products has a positive effect on the peristaltics of the intestinal tract. It is recommended to eat fermented daily daily milk products (yogurt, kefir, yogurt), raw vegetables and fruits, which contains many fiber. It is possible to improve the operation of the digestive tract with seaweed, cabbage, carrots, cucumbers, beets and zucchini. Among the fruits that have light laxative properties, it is worth highlighting oranges, tangerines, figs, peaches, melon and prunes. Add them to desserts or consume fresh.

Therapeutic diet in the treatment of lazy bowel syndrome and other gastrointestinal diseases lies in the abandonment of a number of products, among which:

• canned;
• smoked food;
• fat;
• fat fish;
• radish;
• peas;
• refined food.

Some bad habits Also can lead to problems with the work of the intestine. First of all, it concerns alcoholic and coffee. If possible, try to limit the number of these beverages. This will avoid not only problems with the digestive system, but also other serious diseases.

Previously, it was noted that regular sports improves the work of the gastrointestinal tract, so in the syndrome of a sluggish intestine, experts recommend often walking on foot, do the morning exercise. There are many different exercises that contribute to the normalization of the work gastrointestinal work, but this does not mean that it is necessary to carry out everything. Select several of them for yourself and periodically change the exercises for a variety.

Effective exercises in the treatment of a slurid bowel:

• stand straight, put legs on the width of the shoulders. Straightening hands in front of me, sway to the parallel 5-10 times;
• breathing exercises. Try to delay your breath for 5 seconds, then relax and exhale the air. Repeat the procedure 10 times;
• lie back to the floor and lay down legs with hands, taking the star position. Then lift your knees and try to reach your chest. In the upper position, you need to grab your knees with your hands and with the help of hands to reach your knees to the forehead. In this position, it is necessary to stay for 2-3 seconds, after which it returns to its original position;
• stand on all fours, leaning on my elbows. In this position, it is necessary to raise your legs alternately as high as possible. Repeat the exercise 5-6 times.

On a note! Gymnastic exercises are useful to complement the healing massage of the abdomen. To do this, you need to lie on your back, bend in the knees of legs and gently massage abdominal cavity tips fingers. Movements should be circular. Perform a massage daily, preferably immediately after charging.

Folk remedies

When combating a sluggish intestine, it is well shown various recipes folk medicine. Below are the effective and most common means.

Table. Folk medicine in the treatment of a slurid bowel.

On a note! The sludge syndrome without proper treatment can lead to the development of serious pathologies. If in the intestine the nutrients will be accumulated for a long time, then in the end they will rot, because of which the mucous membrane is inflated.

Problems with intestines can be avoided. To do this must be observed step-by-step instructionsshown below.

Step 1. Increase the amount of fiber used. It consists of individual plant products that your body cannot digest, so the fiber is not absorbed by the body and passes without lingering. Most people use a little fiber (from 20 to 40 mg), but much more for healthy digestion is required. Your body needs soluble and insoluble fiber.

To increase the amount of fiber, more oats, peas, beans, apples, citrus, carrots and barley should be used. It will also help control blood cholesterol.

Step 2. Drink a lot of water. The combination of water with water will increase the efficiency of the digestive system. Liquid will help soften and destroy the products so that your body can absorb nutrients. It will also soften the chair. Doctors recommend drinking up to 2 liters of water per day, but the number you need will vary depending on the weight of the body, as well as from other factors (on how active you are active and from the climate of your region).

If in the evening you have headaches, feel fatigue, nausea and reduced sweating even in hot weather, then you may have to drink more water.

Step 3. Eat fermented products (foods that are obtained as a result of the fermentation process) daily to activate healthy intestinal bacteria. Consumption of fermented products, such as yogurt, kefir and sauerkrautIt will help to replenish the balance of bacteria in the digestive system.

Not only is this diet fights diarrhea and constipation, it can also prevent several other health problems:

• diarrhea after treatment with antibiotics;
• an irritable colon syndrome;
• vaginal infections or urinary tract infections;
• cold and flu.

Step 4. Replenish the daily diet with various additives. It is best to do this after consulting a doctor to avoid unwanted consequences. The doctor will help you with the choice of drugs and dosages.

Add the necessary vitamins to your diet. The most useful vitamins are those that are necessary for the proper functioning of the body. We are talking about vitamins A, B, C and D. They are needed to your body for processing proteins, carbohydrates and fatty acids, absorbing iron and maintaining immune functions. Additives can help avoid different ailments, but it is possible only with normal dosages.

Step 5. Eat less salted, sweet and fatty products. In large quantities, they can not only provoke the appearance of pain in the stomach, but also significantly worsen digestion, cause constipation and other problems with the intestines.

Step 6. Singing at least 30 minutes a day. Regular classes are positively affecting the work of the digestive system. Exercises reduce stress, control your weight and help the intestines to work normally.

Activity should be sufficient to increase the heart rate. Do you like - it can be, for example, fast walking, jogging or cycling. If there are other health problems, such as high blood pressure or heart problems, discuss your plans for exercises with your doctor.

Video - Restoration of the dried intestine

All that may be with a nervous system of a premature child can be divided into 2 large and unequal groups. First, even if nothing bad happened with nervous cells and brain blood flow, all the same cell nervous system It turns out very immature and sometimes not "capable" to carry out the correct regulation of all organs and systems. To establish these relationships it takes time. So, in the first days, the baby does not know how to suck himself, because the nervous impulse is not transmitted correctly to the muscles that participate in sucking. The child is fed for a long time through the probe, while the sucking reflex is not formed. Very often such children, already learned to suck, swallow badly. The child holds food for a long time in a small amount and only then swallow it. Feeding takes a lot of time, usually parents adapt to feed the baby from pipettes, small portions. In addition, such a child has long, sometimes up to 2-3 years old, feed liquid food due to the fact that chewing muscles are poorly developing. Due to the immaturity of the nervous system of the stomach and intestines, such children are usually abundant, intestinal colic continues to be 5-6 months old. There are often constipation, because the nerve regulation of the intestines is very imperfect.

Children who doctors have been forced to breed long through the probe, and long on artificial ventilation, usually begin to speak, incorrectly pronounce sounds, because the reflexes that regulate muscle tone participating in the pronunciation of sounds for a very long time. Therefore, almost all deeply premature children require the help of a speech therapist. Moreover speech therapy classes Even before the child starts talking in order to normalize the tone of the muscles of the language, form the right development of speech muscles.

Due to the deep immaturity, premature children are late in engine development, they are late to hold the head, take a toy, turn over. After six months, immaturity is not so pronounced, and the child is developing faster. Often, the premature baby "confused" motion skills: the child begins to get up first, then sit down, it may later learn how to crawl, perhaps he will walk on tiptoe. Medicines from immaturity Two - time and your patience.

If your baby is less lucky, in addition to the deep immaturity of the nervous system, the nervous system can suffer from lack of oxygen, which is experiencing a premature child with a severe course of pregnancy and childbirth. If the oxygen starvation of the brain was not too heavy and long, then the changes that occurred in the cells will be reversible and will not lead to severe consequences. In the first months, such children may be more excited, have sleep disorders. In the future, they are well evolving and 1,5-2 years have no different levels of development from daddy peers. But if nevertheless, damage to the cells could not be avoided, then the result of this may be "breaks" of the vessels of the brain and hemorrhage into the ventricles of the brain. In 1-2 month of life, the state of such children is usually heavy, and they need medical care and long-term surcharge.

In case of hemorrhages, the walls of small vessels are bursting, it can lead to an increase in intracranial pressure. The intracranial pressure increases due to excessive fluid formation in the ventricles of the brain, which presses on the surrounding fabrics. With small hemorrhages, the condition in most cases is rapidly compensated, the outflow of the liquid from the ventricles is normalized, and the hemorrhages are dissolved without a trace. In other words, hemorrhages 1 and 2 degrees can pass without a trace for the child, however, this does not mean that it should not be observed and treated for 1-2 years of life.

Heavy hemorrhages when "rushes" large vessels, blood fills all brain ventricles, cause significantly more serious consequences, lead to, seizures, developmental delay, motor disorders. Such children need permanent help of a neonatologist, a neuropathologist and other specialists, in particular control of neurosensory organs (hearing and vision), since these brain zones can be damaged. If the baby is very lingering in his development, you need to carefully watch if it does not have convulsion. The attacks are very different and sometimes do not remind the convulsions at all. A child can dug his eyes to the side and to dy up for a few seconds, putting up a tongue, make an unusual finished movement with their hands and legs. Especially you should alert if the child begins or extensions how many times in a row of the series. With any suspicion of convulsive attacks, the baby needs consultation of a neuropathologist, carrying out the electroencephalogram. If possible, take a video so that the neuropathologist can see the prevailing attacks.

In premature children who suffered a severe lack of oxygen, irreversible death of nerve cells directly in cerebral tissue can occur. This is the hardest type of defeat, and it is called perivnricular lekomali. When the cells of the white, and sometimes gray matter of the brain are destroyed, and sometimes the gray matter of the brain is destroyed, and they are formed in their place. This damage to the brain is established using the ultrasound of the brain. Over time, these cysts are "closed", and after 6-8 months of age, they are no longer visible on ultrasound. The outcome in such children may be different: from minimal motor disorders with motor awkwardness and normal development of the psyche, before the formation of paresses, paralysis with a delay in psychomotor development.

The diagnosis of intracranial hemorrhage and perivativericular lekomolation is very serious, but is not the final sentence. What will be the outcome in this case In the first months of life, no one knows. The brain cells of the premature child continue to develop offside, the fabric is very plastic and it can partially take on the function of damaged cells. Also again, we want to say: do not lose hope, treat the child, try to help him, develop it, to fulfill the appointment of the attending physician. And you can even with a very serious situation to get a fairly good result. Moreover, science goes forward, and every day new knowledge and assistance methods appear.

Digestive problems at a premature baby

The main care of the parents of the premature child is the problem of the increase in body weight and, indeed, it is of paramount importance as the main indicator of the physical well-being of the baby. It should be noted that the growth rate of physical indicators (body weights, the length, circle of the head and chest) in the premature child will differ significantly from those of his diligent peers. At least until 6-9 months, your baby will be more "small", and the basic value at this time acquires mandatory weight control: in the first weeks and months of life daily (at the same time, it is necessary to take into account the correctness of the child's daily weighing, which must be carried out in one and The same time, preferably before the first morning feeding or in the evening, before swimming), and then monthly. What should alarming you first is the drop in body weight or the absence of its increase (the kid "stands" in weight). The reasons can be both quite serious and caused by the errors of feeding, the insufficient number of breast milk at the mother. Naturally, in any case, you need to consult a pediatrician to clarify the reasons and eliminate them.

The main problems on the part of the digestive system in the premature baby faced almost all parents are intestinal colic. The word comes from the Greek "colikos", which means "pain in the colon". Colic - parotid abdominal pain, accompanied by a pronounced child's concern. The attack, as a rule, begins suddenly, the child screams loudly and more or less longs, redness of the face or the pallor of the nasolabial triangle can be marked. Belly will go and tense, legs are tightened to the stomach (can instantly straighten up), the feet are often cold to the touch, the hands are pressed against the body. The attack sometimes ends only after the child is completely extended. Often a noticeable relief occurs after the death of feces and gases.

Premature children are especially predisposed to coliks, while some babies have frequent and intense attacks, which can be compared with generic pain, and certainly requiring drug intervention. Apparently, the main reason for these suffering kid may be the immaturity of the neuromuscular apparatus and the enzymatic intestinal system. And because of this, the tendency to elevated gas formation, as a result of which the pressure on the intestine wall increases and muscle spasm arises.

The cause of discomfort and bloating can also be irrational feeding. Some products, especially with a high carbohydrate content, can contribute to excessive fermentation in the intestine. Intestinal allergies also cause a child crying caused by a sense of discomfort in the stomach. But the causes of colic are not limited to these states. It is important to diamitude to diagnose diseases that require surgical intervention. Therefore, in the absence of an effect from the usual measures aimed at eliminating colic (special windy herbal teas, simethicon preparations, cleaning enema, the use of a gas-conductive tubule, abdominal massage, dry heat to the abdomen), the child must be carefully examined in a medical facility.

Dyspepsia (diarrhea, constipation) in a premature child - phenomenon frequent and exciting parents and pediatricians. With breastfeeding, a chair may have a chair after each feeding together with gases (frothy) and liquid enough. In children receiving mixtures, a chair is more rare - 3-4 times a day. The absence of a chair in the kid more than 1 day can be considered constipation. The cause of dyspepsia is the immaturity of the intestinal neuromuscular apparatus, violation of the formation of the intestine biocenosis, transferred bacterial infections, long-term antibacterial therapy, treatment of iron preparations, anticonvulsant drugs (what was appointed to your child in life indications) can lead to a disorder of intestinal innervation, as a result The inflammation of its mucous membrane arises changes in the trophic of the gum mucosa.

Digestive disorders increased fat breast milk or its substitutes; The immaturity of the enzymatic function. In all these cases, there are special corrective mixtures of breast milk substitutes, preventive preparations that can help your child, but it is very important to coordinate their use with your pediatrician.

Jumping syndrome can also disturb the parents of the premature child. The most frequent reason for this is immaturity and temporary (passing) smooth gastric muscles - the so-called "Duoden-Gastric Reflux". Most often, he arises from premature babies, eating for a long time through the probe. Also possible causes of joins may be aerofagium (when the baby with greed swallows the air together with food). The masses at jeeping look abundant by binding them with air and usually do not change the well-being of the baby. In this case, you need to be patient and wait when the toddler's stomach "will donate", while observing the recommendations on proper feeding, holding the child after feeding vertically for 10-15 minutes. Quite quickly, improvement occurs and when the mixtures of thickeners (frisov, nonryon-antirefluux) occurs in the power of mixtures. Medicinal preparations are better to give a child before feeding. However, there are situations in which the urgent consultation of a specialist is necessary. If there are strengthening of blood in the swelling masses, if they are so abundant that the child does badly adds in weight, if the toddler's well-being is broken - do not hesitate, please contact the doctor!

The state of the bone system and joints

The phenomena of morpho-functional immaturity in a premature child often apply to the musculoskeletal system. The imperfection of neuromuscular regulation, the weakness of the ligaments, the excess mobility of the joints can lead to changes in the correct position of the limbs, head and spine of the child.

Often the baby holds the head in a fixed position on one side. The reason for this may be congenital shortening of the neck muscle with one of the sides, traumatic damage to the spine or cervical muscles when removing the head in childbirth or only the "usual" position of the head, that is, the child in this position "lay" most of the time in the uterus. The correct diagnosis is always installed by the doctor, and the earlier it happens, the more effective there will be treatment.

The prematurity, especially in a combination of the improper intrauterine position of the fetus, as a rule, is accompanied by underdevelopment of hip joints or "dysplasia". The most difficult version of this pathology is the hip joint. The diagnosis is set shortly after the birth of a child and requires an early start of treatment based on the legs in the hip joint. Currently, an effective method in identifying developmental development deviations is ultrasound scanning, which is necessarily carried out by all children in 1 and 3 months of life or more often if a disease was found.

Considering that the problems described in premature children are especially common, each kid must repeatedly appease with orthoped. As a rule, the first consultation children receive in 1 month of life, then in 3 and at 12 months. When identifying pathology, consultations may be more. Timely detection of deviations will help quickly begin treatment and grow a child healthy.

We tried in an affordable form to tell about the most common problems of 1 years of life of a premature child. All of them require attention, observation and timely treatment. We persistently recommend that you contact the specialists who are purposefully engaged in the health and development problems of such children - it will help to avoid mistakes and unnecessary unrest.

We wish you happiness and health to you and your babies!

Skriphets Peter Petrovich,
children's Ophthalmoshurgerg, Candidate of Medical Sciences

Comment Article "The premature child is not a sentence for a family! Part 2"

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A premature child is not a sentence for the family! Part 2. Receive who raises deeply premature babies born weighing less than 600 grams.

A premature child is not a sentence for the family! Part 2. Receive who raises deeply premature babies born weighing less than 600 grams.

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Colics in newborns are found quite often, about 30-50% of children, regardless of gender, racial affiliation and residence. Young parents, due to the lack of due experience in care of children, do not have the concepts, why there were intestinal colic in the baby, and how to facilitate his condition. Naturally, the only right solution in such a situation is the consultation of the pediatrician. Intestinal colic diagnose in newborns by the following signs: the child is long and unsetsually cry, shouts, it is almost impossible to calm himself, it is strung out and sucks with legs. The relief of the state occurs after the defecation or disheaval of the gazikov.

Most pediatricians were previously inclined to the fact that the chicks in the newborn appear as a result of the violation of the feeding regime of the baby, the errors in the mother's nutrition, etc. Today, in the first place among the factors contributing to the development of intestinal colic in children, there is an immaturity of the gastrointestinal tract.

Why arise colic in newborns? The essence of the problem in ...

Perhaps, it should be started with the fact that colic in children of the first months of life is considered a normal phenomenon, and, as a rule, do not require treatment. However, calmly look at how the child shouts and crying from pain, no parent will not be able. For some time, it is possible to facilitate the condition of the baby with the help of symptomatic therapy, but about it a little later. In order for the colic in the newborn to cease to be the main problem, it is necessary to know the nature of their occurrence.

The immaturity of the gastrointestinal tract (gastrointestinal tract).

Due to the fact that at the birth of the gastrointestinal tract, the baby is absolutely sterile, in the first few days its population of microorganisms occurs, which subsequently form intestinal microflora. Problems with digestion and the appearance of colic in the newborn are often associated with a disorder of intestinal microflora, as a result of which food digestion is difficult. And if you still add the immaturity of the enzymatic system, the problems with the peristaltic (violation of motility) and the error in the nutrition of the mother - the appearance of intestinal colic in the newborn will become a completely natural phenomenon.

IMPORTANT! The disorder of the intestine microflora is most characteristic of children on artificial feeding. This is due to the fact that in breast milk contains a bifidus factor, which contributes to the intestinal settlement by bifidobacteria.

Why is the intestinal microflora violated in a newborn? The fact is that normal in the intestines inhabit both "good" and conditionally pathogenic microorganisms. The "good" microbes include intestinal chopsticks, lactobacillia and bifidobacteria, which are not only responsible for the quality of digestion of food, but also participate in the formation of the body's immune protection. If for any reason, the content of beneficial bacteria decreases, conditionally pathogenic microorganisms begin to reproduce actively and prevail in quantity. As a result, food is digested badly, and the child suffers from spasms, meteorism and constipation.

IMPORTANT!It is impossible to say that it is the wrong food of mom that causes intestinal colic in a child, but it has his little merit. The use of a nursing mother in food products contributing to the constation (rice, blueberries) and increased gas formation (cabbage, legumes, flour, dairy products, raw vegetables and fruits), aggravates the number of colic in a child.

What to do?

With the appearance of intestinal colic, the newborn should first eliminate the development of the dysbacteriosis - a state in which the ratio of bifidobacteria and conditionally pathogenic microflora is disturbed towards the prevalence of the latter, due to the reception of antibiotics, long-term illness, as well as other factors contributing to the decrease in the immune properties of the body. The reason for the development of dysbacteriosis in the first days of life is often the close contact of the child with the medical staff, as a result of which his intestines are inhabited by representatives of the National accident infection (streptococcus, hemolytic staphylococcus, etc.).

For this purpose, the feces analysis is carried out on dysbacteriosis, the main indication for which is the violation of the chair: constipation, liquid feces for three or more days, a mix of mucus or undigested food, a foam chair, etc.

Analysis of the feces on dysbacteriosis allows us to estimate the ratio of the amount of beneficial bifidobacteria (as well as lactobacilli and intestinal sticks) to the number of conditionally pathogenic microorganisms (mushrooms, clostridium, enterobacteria). In addition, using this analysis, you can identify bacteria that can cause severe disease, such as salmonellosis or shgelles.

IMPORTANT! Most of the probiotics are released in a pharmacy without a recipe, but the decision to appoint medicinal preparations We must take only the attending physician.

Incorrect applying to the chest.

Often, colic in newborns develop as a result of ingestion of a large amount of air during feeding. This happens in those situations where the baby is not completely or incorrectly captured the breast - only the nipple without halo. With this attachment, the child is very difficult to suck, he quickly gets tired and falls asleep, while hearding the intestines with the appearance of pain, while heating the bowel.

What to do?

Watch the baby completely captured the nipple. Most true sign proper applying: The child rests on the nose in the mother's chest. The appearance on the nipples cracks indicates the incorrect attachment of the child to the chest. In this case, it is recommended to consult with breastfeeding consultant.

Lactase insufficiency.

As mentioned above, the immaturity of the enzymatic system leads to poor digestion of food, which contributes to the development of fermentation processes in the intestine and, as a result, increased gas formation.

Lactose is an enzyme designed to split milk sugar - lactose. With the appearance of colic, the newborn should be suspected precisely lactase insufficiency, which is also manifested by the instability of the chair, weight loss, the development of dysbacteriosis. Lactase insufficiency can be acquired (hypologist), against the background of infectious diseases of the intestine, an allergic reaction, etc. The cause of congenital lactase insufficiency can be burdened heredity (intolerance to the protein of cow's milk in close relatives), as well as prematurity.

What to do?

To exclude lactase deficiency, as one of the causes of colic in a newborn, it is necessary to analyze the feces on the determination of carbohydrates and the level of acidity. Normally, in the chair, the newborn, the amount of carbohydrates does not exceed 0.25%, while the pH acidity of the feces should be more than 4. When diagnosing lactase insufficiency, further treatment tactics will be known only after a complete examination. Thanks to the appointment of lactase preparations, in most cases it is possible to preserve breastfeeding and normalize the work of the baby gastrointestinal tract.

In addition, the causes of development colic in a newborn can be:

• purpose of hydrochloric acid from the stomach in the esophagus (if a child after feeding most of the time is in a horizontal position);
• emotional lability of the mother;
• unfavorable atmosphere in the house (loud noise, bright light, long-term separation with mother), etc.

Colics in newborns. Means "ambulance" help.

As long as the reason for the development of intestinal colic is not established at the kid, it is possible to alleviate its condition using:

• wind turbines (dill driver, tea with fennel, decoction of chamomile pharmacy);
• lad out a child on the tummy;
• light massage tummy clockwise, alternately bending legs in the knee and hip joints;
• golden diaper attachment to the toddler toddler.

If the above methods for assisting with colic in the child were ineffective, it is possible to use a gas-conductive tube, pre-groaping the tip of a vaseline or children's cream.

Colics in newborns - a difficult period in the life of a young family, which you need to just survive. In the absence of serious violations of the head of the colic, the child owns themselves to the three-four months of life, so it is expedient to be patient and choose the expectant tactics.