Is My Active Toddler Sleeping Enough and Pooping Regularly? - Pediatrics

Dr. Pei Rensheng reply Pediatrics

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Hello:
1.
a) First, let's understand what is meant by "hyperactive children." In academic terms, "hyperactive children" is formally referred to as "Attention Deficit/Hyperactivity Disorder" (ADHD).
The main issues manifest in three areas: difficulty sustaining attention, excessive activity levels, and impulsive behavior.
Clinical manifestations include: inattention, where the child cannot focus on completing a task or game; they are easily distracted by external noises or stimuli; when speaking to them face-to-face, one often feels that "they seem not to be listening." Although they can play with peers of the same age, they tend to prefer dynamic games and often disrupt others, making it difficult for the game to continue.
They struggle to complete static games, pay little attention to details while doing homework or playing, often making careless mistakes, and cannot follow through from start to finish.
For tasks requiring sustained concentration, such as homework, they may avoid or refuse to do them; they often forget where they placed items needed for work or activities, and in severe cases, they may even forget daily routines.

Excessive activity: In preschool age, most comments about them are "lively, active," or "mischievous." They are often seen unable to sit still in a chair, fidgeting, squirming, or getting up from their seats during class.
They run around, jump up and down; they cannot settle down and engage in static activities, and they tend to talk a lot.

Impulsive behavior: They often answer questions before they have finished hearing them, frequently interrupt conversations or activities, and cannot wait patiently in line.
They may suddenly touch others without consent, take others' belongings regardless of potential danger, acting on impulse.
Not every child with ADHD exhibits all of these symptoms.
Some children primarily show inattention, while others may primarily exhibit hyperactivity and impulsivity, and some may display a combination of all three characteristics.
These symptoms must be present before the age of seven and can adversely affect academic performance, work, and interpersonal relationships.

b) Physiological hyperactivity in children aged 1 to 2 years is often due to the onset of walking, leading to a tendency for distraction and high activity levels, which can improve as they grow older.
Your child, being under one year old, likely falls into this category of physiological hyperactivity.

2.
The definition of constipation is having a bowel movement less than once every three days or having to exert significant effort to pass stool, sometimes with blood present.
To address constipation, you can first try massaging the child's abdomen in a clockwise direction (around the navel), and for infants, you can stimulate the anus with a rectal thermometer or a finger.
Ensure adequate hydration and provide high-fiber foods, including prunes, plums, pears, papaya, bananas, and black dates, while reducing high-protein and fatty foods.
Importantly, give the child ample time to use the toilet (try twice daily for ten minutes each time) to facilitate easy bowel movements.
A small stool can be used to allow their feet to touch the ground while sitting (similar to the stance of martial artists).
If the child continues to complain of abdominal pain, hard stools, infrequent bowel movements, or blood in the stool, it is essential to visit a pediatric clinic.
The physician will conduct physical and imaging examinations to rule out non-functional constipation issues (such as megacolon, intestinal obstruction, hypothyroidism, lead poisoning, medication effects, psychological and neuromuscular disorders, etc.) and will actively provide treatment, ensuring consistent follow-up in the clinic for effective management.
Wishing you health and happiness!
Sincerely,
Pei Ren-Sheng

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Reply Date: 2006/09/17