Pharmamum’s Ultimate Guide: Constipation for first time mums
As a change of pace I want to discuss a common health concern amongst mothers with newborns. This health concern requires prompt management and needs to be addressed, otherwise it can lead to a lot of pain and be very distressing. Often, we concentrate on our baby’s health and at the back of our mind, think ‘I’ll deal with my issues later.’ We need to keep ourselves healthy in order to look after our babies.
Constipation is very common once we have given birth. Whilst we are getting used to managing our baby’s health as well as our own health, there are many reasons constipation can occur and not only in breast feeding mothers. If we allow constipation to continue, it can lead to potential straining, pelvic floor issues and potential tears around the anus called ‘anal fissures’. Anal fissures are common within the first 6 months of giving birth and can be prevented if we manage constipation effectively.
Why is constipation such a problem?
Constipation can occur initially once we give birth. We often dread our first bowel motion after birth due to a number of factors:
- Pain medication given during labor which may slow down our gut processing speed.
- Tears/stitches in the region
- A change in hormone levels
All these factors increase the risk of constipation mainly by slowing down the pathway to passing a bowel motion.
Constipation can occur whilst breastfeeding due to a lot of fluid transferring to baby. When we become dehydrated, our bodies first draw on the fluid from the bowel, causing our bowel motions to dry up and become firm. Hence, it is extremely important to drink plenty of water whilst breastfeeding. If you notice every time you sit down to breastfeed, you feel thirsty, this is because your body is signalling you to replace the lost fluid that your baby is consuming. Whilst breastfeeding the progesterone levels are high and this hormone is also known to slow the bowel motility and hence allow more opportunity for the body to absorb fluid from the bowel motions.
Time: When we are so focussed on our babies, we become time poor and often forget to drink enough water. It is very common to have a headache in the early days, and that reason is often due to dehydration and not finding the time to replenish our fluid. Try and carry a bottle of water wherever you go and also have a large glass of water next to your bed over night. I found I had to have a large glass of water with me every time I breastfed, otherwise I felt uncomfortably thirsty.
Fibre: Same applies with eating, we often eat whatever is quickest and easiest in those early days, but it is really important to eat well and have a nutritious diet. Our bodies need fibre to pass through our digestive system, as well as protein rich food and ‘good fats’ to also ensure good quality breast milk.
Iron supplements- Your doctor may have you either continuing on an iron supplement from pregnancy or you may require an iron supplement after giving birth if a lot of blood loss occurred. Your obstetrician and local GP will let you know whether you need to take an iron supplement and many iron supplements can cause constipation. There are many brands of iron that have an improved formulation to prevent constipation and ensure the iron is absorbed and not excreted in the bowel motions. An easy test to know if the majority is passing out through our bowel motions is if the colour of our stools are almost black. I am fan of Ethical nutrients Iron Max, Spatone, or Bioceutical Iron sustain. These formulations are easy to absorb and won’t cause the side effect of constipation.
So what can I do to help relieve constipation?
Water: is one of the most important factors in preventing constipation. Minimise fluids that are dehydrating ie coffee, tea, other caffeinated drinks eg. Coke, pepsi max etc.
Fibre: Try and eat fibrous foods, ie plenty of fruit and vegetable, cereals, wholemeal bread or pasta. However it may be worth supplementing with a fibre supplement eg. Metamucil, Benefibre, Fybogel which are all safe whilst breastfeeding.
Gentle exercise: Light walking can get the bowels moving and make it easier to pass a motion.
Medication: Stool softeners (eg coloxyl tablets )and osmotic laxatives (eg Lactulose) are safe to use at the recommended doses while breastfeeding until the bowel motions are soft. Stimulant laxatives are not recommended such as senna (eg. Senokot) or bisacodyl (eg.Dulcolax). They may pass into the breast milk and cause diarrhoea in your baby. Ensuring the stools passed are soft will prevent painful bowel motions. Painful bowel motions can lead to tears around the anus causing an anal fissure. If you find when making a bowel motion, there is extreme sharp pain and you break out in a sweat when making a bowel motion, you most likely have a tear in the anus. It is important to see your doctor and get it diagnosed, and your local GP will recommend a cream which aids in the pain relief and will assist in wound healing. The medication applied is different to creams used for hemorrhoids. Hemorrhoid creams will not treat an anal fissure.
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also if you tried a remedy that worked well for your children that was or wasn’t mentioned above, let me know. I hope this information does help.
Disclaimer – The material on this blog is only to be used for informational purposes only. As each individual situation is unique, you should use proper discretion, in consultation with a health care practitioner, before applying the methods, medicines, techniques or otherwise described herein. The author and publisher expressly disclaim responsibility for any adverse effects that may result from the use or application of the information contained herein.