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      Time of passage of First Stool in Newborns in a Tertiary Health Facility in Southern Nigeria

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          Abstract

          Introduction:

          The first stool passed by the newborn, the meconium, is different from the ordinary stool both in its nature and its implication. Delayed or non-passage of the meconium may represent a number of clinical conditions. In this study, we sought to identify what should be considered delayed passage of meconium in our babies.

          Aims and Objectives:

          To investigate the timing of passage of first stool in Nigerian neonates and whether it is influenced by gender, birth weight, maternal age, and parity.

          Materials and Methods:

          A proforma was designed to obtain the following data: Maternal age, parity, mode of delivery, Apgar score at 1 min, birth weight, gender, and interval between delivery and passage of first stool among normal newborn babies delivered at the obstetrics department of our center in August and September 2010.

          Results:

          One hundred babies out of 393 delivered during the period of the study were included in the study. There were 63 (63%) males and 37 (37%) females. The interval between delivery and passage of meconium ranged from 0.5 to 54 h; mean, 16.2 (SD = 10.57). This was not influenced by gender, weight, maternal age, and parity.

          Conclusion:

          Non-passage of meconium beyond 48 h of life could be considered delayed. We therefore, recommend that clinicians should re-evaluate newborns, for hitherto unrecognized conditions, if after 48 h they have not passed first stool.

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          Most cited references18

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          Factors associated with defecation patterns in 0-24-month-old children.

          To identify the normal defecation patterns and the factors affecting these patterns in the first two years of life, a questionnaire was given to the parents of 1,021 children who were followed in a well-child clinic. The time of first meconium passage, presence of colic symptoms, frequency, color, and consistency of stools were recorded.Mann Whitney U, Wilcoxon, chi-square, and correlation tests were used in the statistical analyses. The median number of defecations per day was six in the first month of life. This decreased to once in the second month and almost all cases remained so until the end of the 24th month. At the second month of age, 39.3% of infants passed stools less than once a day. This pattern of rare defecation was seen until the end of 6 months, when supplemental foods were started. Stool frequency was higher in exclusively breast-fed infants (p = 0.0001). Infants who had colic symptoms in the first 2 months had less frequent defecation during the first 2 years of life (p = 0.0001). In addition to confirming the previously observed defecation patterns of 0-2-year-old infants, this study provides the relationship between colic symptoms and stool frequency, and showed that the second month of life was unique in the sense that the frequency of stooling decreased to half of the previous month and 39.3% of these infants defecated less than once a day.
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            Failure to pass meconium: diagnosing neonatal intestinal obstruction.

            Timely passage of the first stool is a hallmark of the well-being of the newborn infant. Failure of a full-term newborn to pass meconium in the first 24 hours may signal intestinal obstruction. Lower intestinal obstruction may be associated with disorders such as Hirschsprung's disease, anorectal malformations, meconium plug syndrome, small left colon syndrome, hypoganglionosis, neuronal intestinal dysplasia and megacystis-microcolon-intestinal hypoperistalsis syndrome. Radiologic studies are usually required to make the diagnosis. In addition, specific tests such as pelvic magnetic resonance imaging, anorectal manometry and rectal biopsy are helpful in the evaluation of newborns with failure to pass meconium.
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              Times of first void and first stool in 500 newborns.

              D Clark (1977)
              The times of the first stool and the first void were recorded for 500 infants. The population studied was defined in terms of gestational age, maternal premedication, and mode of delivery. The results are presented in tabular form by time segments with term, preterm, and postterm infants treated separately.
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                Author and article information

                Journal
                Niger J Surg
                Niger J Surg
                NJS
                Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society
                Medknow Publications & Media Pvt Ltd (India )
                1117-6806
                2278-7100
                Jan-Jun 2013
                : 19
                : 1
                : 20-22
                Affiliations
                [1]Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
                [1 ]Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
                Author notes
                Address for correspondence: Dr. Philemon E Okoro, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. E-mail: phileokoro@ 123456yahoo.com
                Article
                NJS-19-20
                10.4103/1117-6806.111503
                3762039
                24027413
                40abf5a9-26e2-484e-87aa-9e90a3e2fa31
                Copyright: © Nigerian Journal of Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Original Article

                first stool,meconium,nigerian newborns,timing
                first stool, meconium, nigerian newborns, timing

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