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Constipation in newborns with artificial feeding. Constipation in a child from a mixture - how to help at home When not all remedies are good: about civilized treatment

Constipation and colic is a fairly common phenomenon in children of the first year of life, both breastfed and formula-fed, most often associated with functional immaturity. digestive system child. If during breastfeeding the main measure to eliminate them is the correction of the mother's diet, then with artificial feeding, the mixture should be reviewed or the correct intake of the already consumed one should be checked.

What to do if the child has constipation from the mixture

Before replacing one mixture with another, you must once again carefully read the instructions on the jar and analyze the correct preparation of the mixture. It is possible that the ratio between the mixture powder and the added water is not observed, which leads to a lack of water in the child's body and creates an increased load on the excretory system. Another cause of constipation may be overfeeding the baby with formula.

If everything is normal, then you can try to give the child an additional 100-150 ml of fluid per day. It doesn't have to be boiled water. Instead, children's tea based on medicinal herbs or their extracts, dill water, Plantex, which normalize water balance body, have a mild laxative effect.

Important! Before taking any action, be sure to consult a doctor and exclude the occurrence of constipation due to congenital disorders of the child's gastrointestinal tract.

What mixture is better to choose for constipation

If, nevertheless, all attempts to establish a normal child's stool were in vain, it is necessary to resolve the issue of replacing the mixture. To do this, it must meet most or all of the following criteria.

Suitable for the child's age to meet all nutritional and energy needs. Excess protein and fat inhibits intestinal motility.
The composition of the mixture should be enriched with dietary fiber - prebiotics, the type of which is selected taking into account the tolerance of the child. Prebiotics are polysaccharides (fructooligosaccharides (FOS), galactooligosaccharides (GOS), inulin, and lactulose) that cannot be digested by the small intestine. Once in the large intestine, they serve as an energy source for beneficial bifidus and lactobacilli, stimulating their growth. Lactose, not digested in the small intestine, also has similar properties. The prebiotic properties of the mixture depend on the variety of oligosaccharides and their quantity (approximately 1 g per 100 ml of breast milk). It is best if the mixture contains GOS and FOS at the same time in a ratio of 9: 1 - this is how they have the most pronounced prebiotic effect.
It is good if the mixture contributes to the normalization of the intestinal microflora due to probiotics (lacto- and bifidobacteria). They reduce the likelihood of intestinal infections, suppressing pathogenic microflora, contribute to the proper flow of all microbiological processes. Probiotics can be contained both in sour-milk mixtures and in regular ones. Adapted sour-milk mixtures have proved themselves very well for this purpose, which, while normalizing the work of the intestine, contribute to its colonization with beneficial bacteria.
It has been observed that often hard stools occur in children receiving formulas containing palm oil, therefore, if possible, formulas without palm oil or with ß-palmitate should be chosen.

In the event that for some reason the replacement of the mixture is undesirable, in addition to the existing mixture,

List of formulas from birth to 6 months with probiotics and prebiotics

Name	Protein, g/100 ml	Fat, g/100 ml	Prebiotics g/100 ml	Probiotics
Similac	1,33	3,3 without palm oil	GOS, 0.4	+
Nutrilak immuno bifi	1,5	3,4	GOS and FOS, 0.4	+
Agusha gold	1,42	3,6	GOS and FOS, 0.4	+
Bellakt immunis	1,4	3,5	GOS and FOS, 0.5	+
hipp combo	1,4	3,6	GOS, 0.3	+

List of formulas from birth to 6 months with prebiotics

Name	Protein, g/100 ml	Fat, g/100 ml	Prebiotics, g/100 ml	Probiotics
baby	1,3	3,3	GOS, FOS, 0.8	-
Grandma's basket	1,5	3,5	GOS, FOS, 0.37	-
Baby Premium	1,55	3,6	GOS, FOS, 0.6	-
Unstable prebio	1,41	3,48	GOS, FOS, 0.4	-
Bellakt optimum	1,4	3,5	GOS, FOS, 0.5	-
Samper ND Baby	1,3	3,5	GOS, 0.29	-
Frisolak gold	1,4	3,5	GOS, 0.25	-
Nutrilak Premium	1,4	3,6	GOS, 0.4	-
Humana	1,4	3,2	GOS, 0.5	-

List of formulas from birth to 6 months with probiotics

Name	Appearance	Protein, g/100 ml	Fat g/100 ml	Prebiotics	Probiotics
Nan Premium		1,24	3,6	-	+
Celia expert		1,44	3,7	-	+

List of goat milk formulas with probiotics and/or prebiotics

Name	Protein, g/100 ml	Fat, g/100 ml	Prebiotics, g/100 ml	Probiotics
Cabrita Gold 1	1,5	3,3 β-palmitate, Palm oil	GOS and FOS, 0.4	+
Nanny 1 with prebiotics	1,4	3,6 without palm oil	Inulin, GOS, 0.5	+
Mamako 1	1,35	3,4 without palm oil	GOS 0.32	+
md mil goat 1	1,4	3,5	GOS, 0.17	+

Medicinal mixtures for constipation

If conventional mixtures do not help, the child may be assigned one of the specialized (therapeutic) mixtures. These are mixtures containing lactulose and locust bean gum.

Lactulose is an isomer of lactose that is not broken down by lactase in the intestine and enters the lower intestine unchanged, where it is consumed by beneficial microflora. As a result, a number of low molecular weight acids (acetic, lactic, propionic) are released, which contribute to bowel emptying by increasing its peristalsis and increasing the amount of water through excess osmotic pressure. In the name of such mixtures, one can often find the prefix "bifidus", although they do not contain bifidobacteria as such. This is due to the ability of lactulose to influence their growth and development. Depending on the situation, lactulose-containing formulas can be used as the only formula consumed or in the amount of 1/2 - 1/3 of the required volume at each time regular formula is fed. The duration of treatment depends on the achievement of a stable therapeutic effect.

List of mixtures with lactulose

Name	Appearance	Protein, g/100 ml	Fat, g/100 ml	Lactulose g/100 ml
Samper bifidus		1,3	3,5	0,9
Humana bifidus		1,4	3,5	0,9

Mixtures for constipation with lactase deficiency and food allergies

Separately, it must be said about constipation, which is not a consequence of the immaturity of the child's digestive system, but is caused by other reasons that require the use of not just adapted mixtures, but mixtures that, due to the characteristics of their composition, have a preventive, therapeutic or other effect.

"Lock" form - the absence of independent stool in the presence of liquid feces and other characteristic symptoms. Depending on the type of feeding of the child (natural or artificial), therapeutic or are recommended for use;
Allergies caused by food products, in particular intolerance to cow's milk protein, in which, depending on the situation, goat's milk-based mixtures are used.

Mixtures for colic

Colic quite often bothers infants aged 2-5 months and can be caused by different:

physiological immaturity of the digestive system;
intestinal motility disorders;
excessive gas formation;
lactose intolerance and allergy to cow's milk proteins.

Depending on the causes of colic, various mixtures are used. If colic is caused by lactase deficiency or intolerance to cow's milk protein, then it is necessary to prescribe therapeutic mixtures, the same as those used for constipation caused by these diseases.

In infants, the digestive system is poorly developed - especially in those who are artificially fed. The result is a violation of the stool. Most often, constipation occurs. Sometimes the body copes with them on its own, but often additional help is required.

In infants who are fed with mixtures, the stool becomes rare. The consistency of the feces themselves also changes. When a child is breastfed, stools occur up to several times a day, and during formula feeding, it can be reduced to one. This happens due to an increase in the production of enzymes: food is broken down almost in full, and the introduction of any complementary foods increases the body's need for enzymes.

You need to take action if:

stool irregular, not every day;
the stool is too thick, hard and dark in color;
the baby is worried about abdominal pain;
sleep is disturbed, appetite disappears;
the child pushes hard, blushes, groans;
tummy hard, swollen.

In most cases, constipation in children during the first months of life is associated with underdevelopment of the gastric and intestinal tract.

It is especially pronounced in premature babies. With artificial feeding, the problem is further exacerbated.

Causes

Other causes of stool disorders include the following:

The stool is broken during the transition from breast milk to formula, so you need to fight with all your might so that the milk does not disappear.

Do not do enemas and abuse laxative suppositories. The walls of the intestines begin to work poorly, peristalsis is disturbed, constipation returns again.

Examination of the child

In addition to an external examination, the pediatrician may prescribe a number of additional procedures:

Experimenting, like our grandmothers, with soap is not worth it. It dries the intestinal mucosa, disrupts peristalsis and can be harmful to health. It is better to use special laxative suppositories designed for a small child. You should first consult with your pediatrician about the dosage. Perhaps the doctor, when examining the child, decides to prescribe other drugs.

Those mothers who, for some reason, cannot breastfeed, have to buy mixtures.
And not always the first time it is possible to choose a mixture that is ideal for the child's body.
Rules for the introduction of complementary foods
The introduction of complementary foods should be appropriate for the age of the baby and its condition.
It is better to start the first introductions of complementary foods older than four months of age.
With an exacerbation of allergic diseases, the introduction of any complementary foods is prohibited.
At the time of teething, the introduction of complementary foods is also not recommended.
If you have a cold.

Complementary foods should not contain several products at the same time, and portions should be made small.

The main reason why constipation occurs with artificial feeding is a violation of the child's diet.

Regular and painless bowel movements in a baby indicate normal digestion. The regular stool of a child is an individual norm and can mean bowel movements both twice a day and once every two days. The popular statement that the chair should be strictly once a day is not suitable for babies - their digestive system is still unstable.

Parents' excitement

Parents should be concerned when:

it is difficult for the child to empty the intestines;
the process of defecation causes pain;
the chair is dense and separated by sausage or lumps;
stool frequency more than two days.

The guideline for the correctness of the process is the condition of the child - if the stool is rare, but painless, the baby is good mood and plays, grows well, the problem of constipation exists only in the minds of loving parents.

Features of the chair in infants

stool retention for a day or more;
separation of dense, hard and dry feces;
defecation requiring effort;
sensation of incomplete bowel emptying.

Having found a rare stool in a baby, mothers begin to worry, often in vain. The chair is formed by food, and the approach to assessing its regularity in a baby who consumes almost perfect food is breast milk or an adapted formula should be different. Dr. Komarovsky constantly draws the attention of parents of babies to the fact that:

the more suitable the infant formula and breast milk, the better they are digested;
with good digestibility, there is a minimum of waste that is excreted from the body in the form of feces.

Bowel cleansing in a child depends on the age and type of feeding:

the first bowel movement most often occurs after the first intake of food in the body, the stool is very dark in color, odorless, has a paste consistency;
during the first days of life, stools occur no more than 2-3 times a day and depend on feeding - breast milk forms a yellow semi-liquid stool with the smell of milk, milk mixtures are denser masses with a characteristic odor;
up to three months of age, painless stools once or more per day are considered the norm for a bottle-fed child;
as the digestive system matures in children, the number of bowel movements decreases and is up to two times a day at the age of 6 months. The stool should be soft and not have a sour or putrid odor.
After six months, the chair should be regular, no more than twice a day. Its appearance changes after the child begins to receive more varied food. The child's stool darkens, becomes denser, has a specific smell.

In most cases, a bottle-fed child should have a stool at least once a day. The reference point will be the well-being of the child, normal weight gain, the absence of pain during bowel movements. All consultations on this subject to worried parents should be carried out with the attending pediatrician and follow his recommendations.

Constipation, types and causes

The problem with delayed bowel movements will first manifest itself in the behavior of the child. An attentive mother will pay attention to such symptoms:

moodiness and frequent crying;
poor appetite;
restless sleep;
hard swollen tummy;
separation of gases with the smell of rot;
too tight stool;
pulling the legs to the stomach;
redness of the face, frequent attempts to push;
screaming and crying when emptying.

Constipation in a formula-fed child can be manifested by the reverse retraction of already appeared feces into the anus.

Parents should pay attention to the structure of the stool and the presence of blood in it, consult a doctor to identify the cause of constipation and eliminate it.

The main cause of problems with stools is the imperfection of the digestive system of a child up to a year old, its immaturity - digestive enzymes will begin to be produced as they grow older. Against this background, violations of the process of digestion of food and bowel movements will inevitably be present.

Types of constipation

Depending on the cause of constipation in newborns with artificial feeding, it can be divided into:

physiological, which is caused by congenital disorders in the structure of the intestine and can manifest itself as the baby grows older;
functional, the cause of which is various disorders in the activity of the digestive tract of the newborn.

Congenital pathologies in intestinal disorders include too long sigmoid loop, fusion or congenital absence of the anus, impaired innervation of the colon (Hirschsprung disease).

Constipation in infants can be caused by insufficient intestinal motility, which is provoked by congenital disorders nervous system child, rickets, malfunction of the thyroid gland.

Delayed bowel movements can be:

one-time, or acute, caused by a specific cause, after its elimination, quickly return to normal;
permanent, or chronic, which is manifested by long-term problems with bowel movements.

Problems with stools that occur systematically indicate improper treatment of acute constipation or the existence of problems with the baby's diet.

Causes of the condition

Constipation in a newborn with artificial feeding is most often caused by the following reasons:

improper selection of a mixture for nutrition;
abrupt transition to a new mixture;
frequent feeding with different mixtures;
a small amount of drinking water;
trying to feed too early;
treated with antibiotics;
violation of the intestinal flora;
psychological trauma.

Quite often, children are born with physiological immaturity - during intrauterine development, for various reasons, the innervation of the intestinal wall has not formed in them. As a result, a monthly child suffers from stagnation of food in the intestines, which is not yet able to contract in a timely manner and transport the food gruel to the anus. In a two-month-old child, such a violation disappears on its own.

Violations in the selection of mixtures

Most often, constipation in children develops due to the fact that the formula for feeding the baby is not chosen correctly. If feeding with mother's milk is not possible, then the mixture that is offered to the child should be as close as possible to human milk.

According to the degree of similarity, milk mixtures are divided into three categories:

highly adapted;
little adapted;
limited adaptation.

High adaptation formulas are labeled with the number 1 and are most reminiscent of breast milk in composition. They are recommended for feeding children up to six months. There are formulas specially designed for feeding children with various disorders - premature babies, those with allergies to certain components of conventional formulas, etc.

From six months, you can switch to mixtures of low adaptation, and after a year - to limitedly adapted ones.

In pharmacies, mixtures of various manufacturers are presented, their cost is quite high. Selection recommendations are given by the pediatrician, but with a possible choice, the mixture should:

well tolerated by the child, do not cause digestive disorders, allergies;
produced by a company with a good reputation and reviews;
be constantly available (on sale);
ensure weight gain and development of the child.

If a child is offered a mixture with a large amount of fatty acids and components that the child’s body cannot digest due to age, sleepless nights are provided to parents.

The mixture must be diluted and prepared strictly according to the instructions on the package; too thick food with a reduced amount of liquid will cause flatulence and constipation.

Switching to a new mixture

The transfer of the baby to a new mixture should be carried out only in case of severe necessity - if it causes intolerance or does not meet the needs of the child (he has stopped gaining weight). If the child is full, he is not worried about digestive disorders (gas, stool disorders) - nothing should be changed in the diet.

When a one-time disorder of the stool is noted, one should analyze the causes of the phenomenon, and not rush to change the mixture or reduce its amount - perhaps there is an oversight in the violation of the cooking process, or there is a disease. If the phenomenon does not go away, the baby should be shown to the doctor, and act on his recommendations.

If you still need to transfer, it is best to do this gradually, over several days, first feeding the baby, and then completely replacing feeding with a new mixture. It is considered optimal to switch to a new mixture within a week.

Constipation that occurs when switching to a new food is often called false - this reaction of the body to a change in food passes after adaptation. A similar reaction may occur when changing periods of feeding, when the usual conditions return, the violations disappear.

Drinking disorders

The presence of dense feces indicates a lack of water in the child's body. A. Komarovsky, in his appeals to parents, notes that for normal bowel movements, the child must receive enough water. Pediatricians believe that breastfeeding fully meets the child's needs for water, and it is not necessary to give it to infants up to 6 months in addition, an exception is made in case of illness, high temperature in the room.

To prevent constipation in newborns who are fed with artificial mixtures, they need to offer water between feedings. It is important that it is pure drinking water, not decoctions or teas.

If the baby refuses water, he does not need to be forced to drink, but it is necessary to offer a drink without fail.

An important trace element on which the activity of the intestine depends is potassium, its sources are raisins and prunes. Komarovsky recommends giving babies a decoction of raisins or prunes to prevent constipation.

Violation of the rules of feeding

Modern pediatrics has a different point of view on complementary foods than the school of Soviet children's doctors, which recommended starting feeding an infant from 2 months. This was due to many reasons, one of which is the lack of nutritional value of breast milk substitutes.

Now this problem is gone, high-quality adapted mixtures allow you to introduce complementary foods when the child is ready for it. The criterion is the appearance of at least one tooth and the age of at least 6 months. All attempts to feed the child with food that he cannot digest will end in constipation, bloating and calling a doctor.

Psychological causes of constipation

Constipation during artificial feeding can be caused by psychological reasons. The child may find it hard to endure separation from his mother, which will affect his appetite and, accordingly, the process of bowel movement. After reunion, episodic constipation goes away.

Another psychological reason is the child's unpleasant experience when emptying - a cold pot, bad smell from it, can cause the child's desire to endure the urge to the last, which provokes constipation. Komarovsky draws the attention of parents to the fact that the habit of regular emptying can only be developed by creating comfortable conditions for the baby.

Often the cause of untimely emptying is overfeeding the child or forced feeding. Constipation in this case is a subconscious protest reaction of the baby.

Treatment and prevention

Parents of toddlers should know what to do if a child has constipation and how to treat it. All ways of helping with this condition can be divided into several groups. This:

massage and laying on the baby's tummy before feeding;
selection of a suitable mixture for feeding;
treatment with lactulose preparations;
the use of enemas and other mechanical methods of irritation of the rectum.

Massage

A light massage will help stimulate the baby's bowels and improve the release of gases, soothe him. To perform massage movements, you do not need to have special knowledge, they are simple and effective. First, lay the baby on the back and perform the following steps:

With warm, warm palms, stroke the tummy around the navel in circular motions for a minute;
Holding the baby's feet and ankles in warm palms, bend and unbend the legs in turn at the knees, easily pressing the thigh to the tummy. You need to do such movements 5-7 times;
Do the same as in the previous paragraph, only with two legs at the same time;
To continue the massage, the baby must be turned over on the tummy on a hard, flat surface or placed on the mother's lap. With warm palms, run along the spine in the direction from the shoulder blades to the buttocks with light pressure. Carry out such movements at least 5-7 times.

Laxatives

If you need to urgently help the baby, you can use medications. Komarovsky for recommends lactulose syrup, which is sold in all pharmacies under various commercial names (). These are not synthetic drugs, their use will not harm the child. You need to start giving syrup with small doses, as it causes increased gas formation.

Mechanical methods

Young parents often hear from grandmothers and mothers about "folk" methods of treating constipation - mechanical irritation of the rectum or mercury thermometer. Why can't this be done. These methods are quite barbaric, in addition, they form a habit from which it is very difficult to wean a baby. Constipation can cause cracks in anus. What should parents do in this case? Can help or sea buckthorn suppositories, which will relieve pain and speed up healing.

In this article:

A mixture of constipation for newborns often becomes a real salvation in a situation where the child's digestive process is disturbed. And this in infants today, unfortunately, is not uncommon. After all, the baby's body systems are not yet fully formed. And if for some reason the possibility breastfeeding is excluded, you need to be very careful in choosing a mixture that replaces mother's milk.

Some children still have dairy intolerance. And in such cases, mixes with either a low lactose content or no lactose at all are suitable. The first group includes:

"Similak low lactose";
"Unstable low-lactose";
"Bellakt NL";
Humana LP.

To the second:

"Nan";
"Bellakt";
"Nutrilak";
"Nutrilon Premium";
"Grandmother's Lukoshko".

It is necessary to purchase options on the packages of which indicate that there is no lactose here.

For food allergies

Sometimes infants are diagnosed with protein intolerance. Speech in this case It's about food allergies. In such situations, just a mixture of anti-constipation will not work. Its hypoallergenic options are required. Such, for example, as "Hipp GA2", "Phenyl Free", "Humana GA2", "Nutrilon amino acids", "Nutrilak soy" and others.

Depending on the type of allergy and general health, one or another diet is prescribed. Insofar as we are talking about newborns, the issue should be approached as carefully as possible. It is unacceptable to introduce baby food on your own, without consulting a doctor.

How to choose a mixture

When choosing a mixture for constipation for babies, you need to focus on several factors. First, carefully study the information on the packaging to make sure that this product is suitable for the child.

Secondly, look at the date of manufacture and the allowable shelf life. You should not buy a mixture if it expires in the current or even next month. The fresher the produce, the better.

Thirdly, it is necessary to take into account the age of the baby. Typically, the manufacturer labels formulas for children from birth to six months with the number 1.

As for the price, it is not always possible to focus on it. It happens that fairly cheap mixtures are better than very expensive ones. The main thing is that baby food is ideal for a particular baby.

Breastfeeding rules

To achieve the maximum effect, you need to follow certain rules for feeding a newborn. It is very important.

The new mixture should be introduced gradually. At first, give quite a bit, then supplement with the usual product. Increase the dose every day.
It is impossible to mix a medicinal mixture and a regular one in one bottle.
For the purpose of prevention, the mixture is usually given for two to three weeks, and then they switch to their usual diet.
If a child has a disease that provokes constipation, treatment with a mixture can last up to one and a half, and up to two years.
In cases where no pathologies have been diagnosed, but digestive problems do occur, it is not necessary and even undesirable to completely transfer the baby to the therapeutic mixture. It simply supplements the main diet.

The result from the use of constipation mixtures is unlikely to appear after one or two feedings. Usually the first signs of improvement make themselves felt in about a week. If these are not observed, an additional consultation with a doctor is necessary. Perhaps the mixture was chosen incorrectly.

So, we considered this way of dealing with constipation in newborns, as a special diet. The method is very effective and quickly enough to solve the problem. The main thing is to take into account all the nuances and choose a mixture that will ideally suit the baby. There are many options, and each of them has its own characteristics. The doctor will help you decide on which brand to stop.

Leave your feedback on mixtures for constipation in the comments.

Useful video about constipation in newborns and nutrition during this period

Pediatricians consider artificial feeding as an attack on metabolic processes, since the baby's body is physiologically tuned to assimilate exclusively mother's milk.

A mixture for a newborn should be prescribed only by a doctor, taking into account the developmental characteristics of the baby, the tendency to allergies and weight fluctuations.

You need to understand that it is not easy to organize ideal artificial feeding, often there are problems with bowel movements even with properly selected nutrition. If constipation occurs from the mixture, what should I do?

Causes of constipation in children receiving formula

too concentrated mixture;
illiterate preparation of the mixture;
insufficient drinking regime;
wrong mix.

If the first three points are excluded, and constipation continues, the mixture will have to be changed.

Wrong mixture

It is considered normal when a baby who is bottle-fed, in addition to constipation, has episodic colic, regurgitation, rash, and bloating. This indicates that the components of the mixture are well absorbed by the baby's body.

At the same time, the stool should be strong, have a pale yellow tint and a characteristic smell with a bowel movement frequency of at least 1 time per 24 hours. Alarming symptoms: persistent constipation, weight loss, excessive flatulence, green frothy stools, severe allergic reaction.

With such manifestations, urgent measures must be taken.

What to do

With the help of a pediatrician, choose a dose of medicine for the baby to eliminate constipation without changing the mixture.
Choose a baby mixture for constipation individually.

Overview of mixtures

NAN Comfort from Nestle. Designed for feeding children from the first days of life, reduces constipation and colic, strengthens the immune system, contains lipids, proteins, bifidobacteria, live probiotic cultures. The mixture of NAN is easily digestible, promotes soft and painless defecation, ensuring the normal development and growth of the baby. If a child has constipation from the NAN Comfort mixture, Nutrilon is worth a try.
Nutrilon. The Nutrilon mixture prevents and eliminates regurgitation, constipation, colic and quickly normalizes the intestinal microflora. The composition of the mixture includes prebiotic fibers, selenium, carotene, vitamins, vegetable oils and vital micronutrients that aid regular bowel movements with light and soft stools. A big plus of this mixture is that constipation from the Nutrilon mixture is extremely rare.
Humana bifidus. Contains lactulose and has fewer essential minerals and proteins. Doctors advise introducing the Humana bifidus mixture into the baby's diet carefully, combining it with feeding with standard mixtures, gradually increasing the dose until regular bowel movements are achieved.
Sour-milk mixtures(NAN fermented milk, Agusha k / m). The laxative effect of fermented milk mixtures is due to the presence of fermented protein molecules, live lactic acid bacteria and substances that enhance intestinal motility.
Anti-reflux mixtures(Humana AR, Hipp Antireflux). They include gum - a thickener with a pronounced laxative effect. Such mixtures contain prebiotics and are easily digested without lingering in the intestines and stomach.