Why does my 8-month-old daughter has trouble sleeping and constipation?

Question

Hi doctor,

My daughter was born in the 37th week of pregnancy; her weight was 9.04 lbs. In the 3rd or 4th week, we observed she was having trouble sleeping, and we got her checked by the children's neuro therapist, who ordered an ultrasound test. The test showed a cyst in one of her brains, and the doctor prescribed Phenibut, Citicoline, and Hopantenic acid for 14 days. The sleeplessness at night has subsided so far, but she has constipation, gassy stomach, and her bowel movement is delayed for 4 to 5 days. We had to use a glycerin suppository to force her to poop twice. Our subsequent meeting with the pediatrician was three days ago, and he prescribed a double dose of Phenibut and some medicine with active bacteria in it. I would like to know her exact condition and if her neurological condition is linked to bowel movements.

Thank you.

Answer 1

Hi,

Welcome to Icliniq.com.

According to all the provided details and reports (attachment removed to protect the patient's identity), there are some changes in the brain cells where the brain looks to be not getting sufficient oxygen, or there might be some lack of oxygen at the time of delivery or thereafter. Regarding cysts, they simply require regular follow-up. Looking at the baby, she looks quiet well and comfortable.

There are too many medications for such a small baby. Phenibut suppresses brain activity as well as causes sleep, and Hopantenic acid is also a brain activity suppressant. I will go only with Phenibut. Citicoline takes care of some chemical substances in the brain. I suggest continuing these drugs for a week and I would prefer not to increase the dose of Phenibut if the baby is otherwise comfortable.

Regarding constipation, there are many possible reasons, and it may be related to brain conditions and even due to drugs. The most important thing is to rule out other common conditions first.

Is she on breastfeeding or formula feeds? Formula feeds do give rise to some constipation.
Is your daughter accepting feeds well?
Gaining weight normally?
Does she vomit quite frequently? Looking at the birth weight and current weight, she is not gaining any weight.
1. Concentrating first on feeding, and I suggest to be breastfeeding if you have sufficient milk secretion. Feed the baby frequently.
2. Continue Vitamin D.
3. Give Bifolak Neo (probiotic) for two days more and stop.
4. Use pediatric glycerin suppository only if the baby is not passing a motion for more than 48 hours.
5. With the next follow-up, get done a brain MRI (magnetic resonance imaging) brain to look at the brain tissue properly.
6. Connect with me after one week.

I suggest;

Answer 2

Hi,

Welcome back to Icliniq.com.

I got confused as the birth weight was mentioned as 9.04 lbs. No problem, then just continue the feeds. At this stage, USG (ultrasonography) may not give you much information, Once you discontinue medications which are brain suppressants, and thereafter constipation persists, then only go for any abdominal investigation. Tap water is not recommended if your baby is breastfeeding properly and gaining weight.