OUR BABES

Wanganui Chronicle, Volume 80, Issue 254, 26 October 1937, Page 10

OUR BABES

CONSTIPATION IN OLDER | CHILDREN —... I

(By

"Hygeia.")

As we have been discussing the cause and cure of constipation in infants, this seems a suitable opportunity to refer to the simple rational curative treatment for constipation in older children. LLot uf eul, one mpst remember that the same rules hold good for the Older cmid as lor the baby—indeed they apply right through life, as do all the great simple rules of healthy living. That is to say, the toddler as well as the baby needs — Regular habits. Fresh air day and night, not coddling in stuffy rooms. Abundance of out-door exercise. Freedom of movement, without the hampering and coddling effect of too much heavy clothing. The right food and plenty of water to drink (the water preferably boiled and cooled). Habit A habit is a definite line of action carried out more or less involuntarily in response to certain stimuli. In other words, a dtertain set of circumstances may be used to produce a certain response or action. If circumstances and actions are repeated regularly, the action finally becomes automatic and involuntary—that is, it comes about without exercise of I conscious thought or will power. I That is why habit formation is so tremendously important in childhood, and why it behoves us to spare no pains in establishing good body habits | from infancy. These are the ultimate i foundations of all-round obedience. ; One need hardly say that the baby | who has been trained from the earliest days to have a regular daily bowel movement is very unlikely to suffer from genuine or persistent constipation when he comes to be a "big boy.” Irregularity and neglect to cure constipation in the first year is the usual precursor of later trouble, and if the tendency is allowed to go on undirected through childhood anything connected with the transfer of the body to or ±rom the mortuary. In presenting the case for the plaintiff, Mr. J. R. ‘Callaghan submitted that Guthrie admitted (inter alia) that he had given instructions for the embalming, that he was executor for the estate, and that he had asked Mr. Baird for the £350, of which the widow received nothing. The embalming, said the counsel, cannot be regarded as an estate liability, but as a personal liability to Guthrie. In either case, defendant’s duty as executor was to pay all debts and legacies due from the estate before anything further was done. The expense of embalming and taking the body to China was an unreasonable one according to the degree of life of the deceased and the amount of the estate. If the embalming was an estate debt then it came under the category of ‘funeral expenses’ and as such would be entitled to preferential payment. As embalming expenses had never been held as funeral expenses this must be a personal debt of Guthrie's. The debt had been incurred subsequent to the death of the deceased, and defendant had no right to foist such a charge on the estate, nor the charge of having the body taken to China. This was a custom, perhaps, but not an invariable one, and had never been done at the expense of the creditors. The estate was insolvent after the £350 had been taken out, and this work had been, done for Guthrie’s convenience to facilitate the transport of his brother’s body Guna. The fact that a portion r debt had been paid by the official did not in this case release Gptnrie from liability for the balance. Judgment In reviewing the evidence, His Worship upheld the view taken by plaintiff’s counsel. A salient feature of the defence was Guthrie’s admission that he had given instructions for the embalming, which definitely put this in a different category from an ordinary debt. It was perfectly clear that defendant had made himself liable for this debt by cable, and if ever there was a case where the equity and good conscience clause meant anything it did so in this case. Judgment was entered accordingly for plaintiff for £44 0s 2d, with £2 Court costs, £4 3s solicitor’s fee and £2 2s for the evidence taken at Timaru.

the seeds of infinite trouble in later life may be sown. However, sometimes illness or other unavoidable circumstances break the good habits of early days, and for some reason the small child is or becomes constipated. Then is the time when it is worth while to concentrate all efforts on establishing habits of regularity once and for all. It is “never too late to mend,” but the later bad habits are left unchecked or good ones unformed the harder it is to put things right. j raining the Toddler A low nursery chair with a special seat, under which a chamber can be placed is a very useful piece of equipment. It is much easier to teach a child this lesson if one can tic him to a chair and know that he is safe and well supported than it one has to rely solely upon seating him on his litt’e chamber, one disadvantage of which is that it affords such a tempting easy means ol locomotion and exploration! It. is very amusing to see (or hear) an enterprising toddler propelling himself around the room in this manner, but it is not conducive to serious consideration of the business of the moment! Similarly it is a great mistake just to seat the child, surround him with toys, and then leave him to amuse himself. The associations are all with play, and the business of emptying the bowl tills no place in his mind. Any distractions tend to defeat the purpose in view. Everything possible must be done to make him realise that this is work, not play time, and to associate all ideas with the function to be performed until the desired result is obtained. I Then the child should be taken up ‘immediately, and the line of thought definitely changed. ' Posture. —The position in which | the child sits is important. The i chair should be low enough to allow I the feet to be firmly planted on the floor, and the buttocks should be lower than the knees. In other words, the squatting position is best; it aids voluntary movement of the bowels, principally by affording support to the abdominal muscles. Time.—The main point, is that the time should be the same day after day. Directly after breakfast is usually quite the best time, as it is the time least liable to irregularity and interruption. Fresh Air and Exercise, Ovcrclothing and coddling generally in warm, stuffy rodms is very enfeebling. Children should sleep in cool, airy rooms and run about outdoors as much as can possibly be managed. Even on dull, cold days, if the child is properly clad and is warm there is no reason why he should not play out in the open air. The cool bath affords excellent stimulation, and can be taken with benefit by almost all children, provided care is taken to lower the temperature very gradually day by day, and to establish good circulation after the bath by thorough, brisk rubbing down and vigorous exercise. Abdominal massage (carried out systematically and thoroughly as described a week or two ago in connection with constipation in infants is an excellent supplement to general exercise and stimulation of fresh air, sunshine, and healthy outdoor play. Diet The food should be plain and wholesome, and the meals regular, with no pieces and no milk between. Only water (and of that the more the better) or fruit juice should be given between the three regular meals. The worst kind of diet is one consisting largely of soft, mushy foods, white bread, biscuits, highly relined starchy foods, etc., and lacking in fruit and vegetables. Too much milk may tend to cause constipation. Indeed, the giving of too much milk to the older child is the cause of refusal of many necessary foods in the diet. Half to one pint of milk a day is enough for the normal older child, provided he is having a good mixed diet. Remember that boiled milk is binding in effect, and when preparing the milk for the child do not heat above 155 deg. Fahr., or do more than scald it, except for some special reason. Laxative Foods.—Foods which hav? a considerable amount of undigested residue tend to be laxative, because, for several reasons, these foods and this residue stimulate the action of the bowel. The following foods come in this category: Spinach, carrot, celery, lettuce, cauliflower, onion, etc., raw ripe fruits, dried fruits such as prunes, dates, raisins, etc., wholemoil bread, bran, coarse oatmeal, oatcake, etc. Stewed fruits and juices, especially prunes, arc good. Honey and treacle

tend to be laxative, and may be j given for a change sometimes. But- I ter and good dripping are good forms I of fat, and should be included in the daily menu. Too much cream may have a constipating tendency. A Warning. —Great care must be taken in first introducing the laxative foods. They may irritate the bowel and set up indigestion and diarrhoea if given in large amounts, or given when the child is too young, especially if the child does not masticate thoroughly and is inclined to bolt his food. All new foods should bo given in small quantities at first, finely mashed or sieved, in the first half of the secon year. Stone fruit may be particularly upsetting and undesirable, except for the stewed juice. Even wholemeal bread and coarse oatmeal need to be introduced carefully, a little at a time, though these are usually quite safe early in the second year. The value of thorough chewing cannot be too strongly stressed. Foods reduced to pulp by active little teeth very seldom disagree. Water forms much the greater part of fluid essential ofr the elimination of waste products from the body, and so is important in the treatment of constipation. It is often difficult to get children to take an adequate amount of water. Make a point of stressing it at suitable opportunities — say, after a romp, provided the child is not overheated, or on waking, when thirst is natural. It may be given warm cr cold as preferred, or even flavoured with a little fruit juice. As in the case of infants, persistent or severe constipation in children is a serious condition calling for medical advice. Purgative drugs are harmful, and castor oil should never be given for constipation. Although a simple aperient or enema may be necessary occasionally, these things take little

part in the real cure of constipation. The measures on which we may safely pin our faith are: Regularity of habit. Well-balanced diet. Extra fluid in the form of water. Fresh air and exercise, and, with all, much patience and perseverance.