Is Your NICU Baby Constantly Grunting and Groaning? It Might Be Infant Dyschezia.
Imagine a tiny baby laying in her bassinet. She seems like she is asleep, but she is constantly wriggling and grunting (some parents even say they sound like a little goat). She frequently turns red in her face and bears down like she is trying to poop. Sometimes she might even cry out like she is in pain.
Witnessing these symptoms can be incredibly distressing for parents. Especially after a NICU experience where they witnessed their child struggle, many parents want to do anything and everything possible to prevent any further discomfort for their baby once home.
While these symptoms can certainly be a sign of a more serious problem like true constipation or severe GERD, it is more often a condition called Infant Dyschezia (pronounced “dis-key-zee-ah”).
Also known as “grunting baby syndrome”, infant dyschezia is characterized by apparent discomfort with passing stool (aka baby poop), but when the baby does poop it is a normal consistency (aka soft and not hard pellets) and normal frequency (several time a day to up to a week for breastfed babies or 3-5 days for formula fed babies).
So, the baby isn’t constipated, but is just having a seemingly hard time pooping.
Why? Is it a bad thing?
Let’s explore!
You might remember in the NICU that you learned about the “suck-swallow-breath” reflex and that NICU babies, especially preemies, often have a hard time coordinating their systems to be able to safely coordinate their feeding patterns. They often suck and suck and suck and suck and then forget to swallow or try to swallow and breath at the same time causing lots of coughing and sputtering and sometimes even a brady/desat episode.
We know that this is a skill that NICU babies learn over time and that with practice, support and time to mature, their systems catch up and they learn how to suck, swallow and breathe in a safe and rhythmic pattern.
Well, the same immature patterns that happen in their upper GI system (mouth, throat and belly) are also happening in their lower GI system (belly and bottom)!
In order to successfully poop, the body has to do two things:
1.) Release the anal sphincter (to let the poop out)
2.) And bear down to create an increase in pressure (to push the poop out)
Babies with infant dsychezia have a hard time coordinating both of these things at the same time. They might bear down without releasing their sphincter (and turning red in the face) or release their sphincter but forgot to bear down (the tiny smear poops you see).
And what are some ways to increase abdominal pressure?
Grunting. Groaning. Crying. Bearing down.
(Try grunting and crying out yourself — you will feel the pressure in your tummy change just like it does in a baby!)
So, they aren’t necessarily uncomfortable or in pain – they most likely are just super smart and know that they need to practice pooping! And just like the suck-swallow-breathe skills they need to feed, the ability to have a coordinated (and less noisy) poop comes with time as their GI systems and neural pathways continue to grow and mature (usually by 2-3 months corrected gestational age).
Want to learn more about understanding tummy troubles in NICU babies and ways to help support and manage their symptoms? I would love to see you in my upcoming workshop, “Is That Normal? Troubleshooting Tummy Troubles in NICU Babies” on June 27th, 2024 from 1100-12:30 EST!
By the end of the live workshop (replay available on demand), you will:
🩷Understand the basics of reflux vs. colic vs. constipation vs. GERD
🩷Learn 5 small tweaks you can do to help keep your baby comfortable
🩷Overview of best practices for managing tummy issues in NICU babies
🩷Gain 5 questions to ask your pediatrician to get the most out of your visit and have your concerns heard
🩷Be able to get your questions answered in a Live Q&A
