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Tummy Troubles

Tummy Troubles

What is Tummy Troubles?

Gastrointestinal problems like constipation, diarrhea, colic, and regurgitation are more common than you think. Get useful information from our experts on the signs and how to manage these symptoms.

Gastrointestinal problems

What is it?

Constipation is diagnosed as a delay or difficulty in pooping that causes distress to the child.

What are the signs?

Difficulty or raredefection (<1 per 7 days in breastfed and <1 per 3 days in formula fed) lasting for at least 2 weeks.

What can I do?

  • Gently massaging your child's tummy may have a relaxing effect that may help.
  • If your child is above 6 months old, try to introduce fruits like papaya and prune puree.
  • Your doctor might recommend probiotics which can help to soften child's poop to enable smooth passage out of the body.
  • Switch to a specialized formula designed to help ease bowel movements. Speak to your doctor for advice.
Gastrointestinal problems

What is it?

Diarrhoea is when the child passes very runny, liquidy stools, sometimes at an increased frequency or more volume than normal. There may be mucus in the stool. It can occur due to reasons like teething, a virus or antibiotics and also in reaction to changes in the mother's diet if she is breastfeeding.

What are the signs?

Changes in the stool is observed, such as more stools all of a sudden; possibly more than one stool per feeding or really watery stools. Do note that it is common for breastfed children to poo up to 6-7 times a day, as quickly as immediately after a feed. It should not be mixed up with symptoms of diarrhoea.

What can I do?

  • See your doctor if your child has loose watery stools for 24 hours, or if diarrhoea is accompanied by dehydration, vomiting, fever or blood in stool.
  • Be sure to talk to your doctor about the amount of fluids your child needs, how to make sure he gets them, when to give them and how to watch for dehydration.
  • There might be a need to temporarily switch to a reduced lactose diet, including using a lactose free formula. Please seek advice from your doctor.
Gastrointestinal problems

What is it?

Colic is most often described as episodes of irritability, fussing and/or crying in healthy children. These episodes last at least 3 hours a day, at least three days a week. Colic begins in the first 4 months of life and peaks at around 6 weeks. Healthcare professionals are still unsure of causes for colic, but it typically starts and ends for no apparent reason.

What are the signs?

Non-stop, inconsolable crying, especially in the late afternoon or evening.

What can I do?

  • Pay attention to your child's hunger cues. Feed him only when he appears hungry, not just because he is crying.
  • Extra feeds can make his tummy upset, which may cause more crying.
  • Try soothing techniques such as rocking, massage, or a warm bath.
  • Choose a specialized formula designed with partially hydrolyzed proteins, lactobacillus reuteri and reduced lactose. Please seek doctor’s advice.
Gastrointestinal problems

What is it?

Regurgitation (also known as spit up) is when the contents of your child's stomach flow involuntarily out of his mouth due to immature digestive system to keep the milk down. Although regurgitation can occur at any age, the peak is usually around 4 months.

What are the signs?

Regurgitation, or spitting up, often after a feed. Some children show signs of being uncomfortable due to heartburn, while others are “happy spitters” and are not affected by it.

What can I do?

  • Avoid overfeeding.
  • Try burping your child more often and in different positions. Prop him up on your shoulder or sit him on your lap to let gravity out with digestion.
  • After a feed, make sure there is nothing pressed on his tummy.
  • Avoid strapping him to a car seat or chair immediately after a feed.
  • Choose a specialized formula thickened with added starch. With increase in viscosity, it helps to reduce spit-up. Please seek doctor’s advice.

Nutrition Q&A on Tummy Discomforts

qa-1

Will a lactose-free diet help eliminate gastro discomfort in children?

It can be helpful if the gastro discomfort is due to lactose intolerance. Lactose intolerance is a digestive problem where the body is unable to digest lactose (a type of milk sugar), so lactose stays in the digestive system where it's fermented by bacteria. This leads to the production of gases and watery stools. There is some evidence that a reduced lactose diet can help children with lactose intolerance.

qa-2

Does soy or goat milk formula help in relieving diarrhoea? Any recommendations of their usage?

It will be difficult to make a recommendation for soy or goat milk formula as a treatment for diarrhoea. It really depends on the cause of the diarrhoea. If the diarrhoea is due to lactose intolerance, then Lactose-Free milk and soy milk (which does not contain lactose) will be helpful. Goat's milk, which also contains lactose, will not be helpful if the diarrhoea is due to lactose intolerance.

qa-3

Infantile colic (inconsolable crying) not only affects bottle-fed children, but also breastfed children. How can probiotics help to relief the symptoms on breastfed children?

Studies have shown that the amount of fussing and crying in early infancy can be interconnected to the development of the gut flora. Use of probiotics may help alleviate the symptoms of colic. Certain probiotics, like Lactobacillus reuteri when added to the diet has been found to reduce the symptoms of infantile colic in breastfed children. However, the effects of probiotics are both strain and clinical condition-specific, and it cannot be generalised.

Reviewed by Dr Marion Aw

Associate Professor, Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore.
Head & Senior Consultant, Division of Pediatric Gastroenterology, Hepatology, Liver Transplantation and Nutrition. Department
of Pediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital Singapore.

Good bacteria in the gut promotes healthy stomach.

Tummy Troubles Magnifier

What is Lactobacillus Reuteri?

Lactobacillus Reuteri can be naturally found in the human body. It is one of the well-researched probiotics and has been used in management of certain functional gastrointestinal conditions. Please consult your doctor for medical advices.

Lactobacillus Reuteri, a beneficial bacteria (also known as probiotics), is able to promote a healthy balanced gut flora in the child's digestive system. There are studies to show that it supports the gut health. The reported beneficial effects include:

  • Softened stools
  • Shorten the duration of diarrhoea
  • Decrease amounth of spit ups
  • Lessen crying time of colicky babies

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