Severe Constipation in a Child of 3

This is a case of a 3-year old girl who was brought to us by her mother with complaint of severe constipation on June 2^nd,2020. Both the mother and child came to us for the first consultation/treatment together. So, this case below has glimpses/history of the mother as well. It is very difficult to separate out both the cases. Mother’s c/c was of chronic otitis media/discharge along with some other complaints. The case was taken online.

Child’s C/C: She would not pass motions for days at a stretch around 15 – 17 days. The child was a pre-mature baby born at 24 weeks weighing 550 gms at birth (youngest child at that time in India). She was breast fed until 2 years of age.

CASE HISTORY AS GIVEN BY MOTHER:

The pregnancy was quite smooth until the mother went into labour. Two weeks after she was diagnosed with gestational diabetes, the mother went into labour. it was like one kick in the tummy and the next morning she started experiencing pains and had to immediately be rushed to the hospital.

After being checked by the doctor on duty, he said that the patient was in active labour. For one day they stopped the baby from getting delivered but on the second day, the mother developed constipation and had to pass motions. The doctor asked her not to push or pass motions, and that she needed to hold on rather than push the baby out.

As the mother couldn’t hold on further, she was given an enema after which she went into labour.

After Birth:

The baby was delivered by C Section and was thereafter kept in neonatal care for about 80 days. When the baby was brought home, she weighed around 1.9 kgs (at birth 550 gms).

Intially the baby was not putting on much weight, but after Kangaroo Care, she started gaining weight. After 6 months, when solids were introduced, everything went haywire as she would not take food at all. So, the breast feeding had to be continued until 2 years of age.

The child had been on iron drops for the longest time since birth, due to low birth weight, which would make her severely constipated and she would not pass motions for days at a stretch (around 15 – 17 days)

So, the parents had to take her to Biodynamic Cranio Sacro Therapy which helped the child in all aspects of speech, growth and development. After a year when the therapy was over, the parents thought that everything was better but the constipation issue surfaced again and hence they approached for homeopathic treatment, as earlier also the child was on homeopathic treatment.

NATURE/BEHAVIOUR:

Very happy child
Mischievous
Has good sense of humor
Likes Teasing
Doesn’t have much affinity to toys, gets bored very soon
Likes reading books or listening to stories
Intelligent
Affinity to learn languages [Marathi, Tamil, Hindi, English & French]
Completely Dependent on Mother, it’s her choice to be dependent on the mother even when she can do everything on her own.
Loves shopping, likes to wear shoes.
Likes to be tickled
Restless, cannot sit in one place, other than listening to stories
Cautious child, not a risk taker
She will run here and there, doesn’t know to jump yet, only hops
Affinity to music (Humm’s music while playing)
Likes to do pretend play [pretends to be different animals]
Talkative
Good Memory

D: Tell us something about your child’s birth process…??

P: I was supposed to go for a family ritual at a relative’s place in village, but there was something that stopped me from going there, something didn’t feel right in my mind and so I told my husband that I won’t go, so he also stayed back with me.

My MIL was upset with me, on a telephonic conversation between the two of us, there was tension and I was disturbed since then I wanted everyone to understand me, like my husband did, as to why I said NO for travelling to Chennai. But then I didn’t think about it that much. On the day of ritual at my native place, I went into labour. I was checked at the hospital and it found that I had fluid in my lungs, pneumonia kind of, so I was unable to breathe properly. I was on medications for it post-delivery as well

D: So, talk about this a little more, where you thought everyone should have understood you…

P: Ours was an intercaste love marriage. I am a Maharashtrian and my husband is a South Indian. Though everyone in my extended family had accepted me and my mother-in-law also accepted me, but still she did not accept me completely.

I also come from a very traditional Maharashtrian background. I was born and brought up in such an atmosphere where, they (parents) gave me all the rights to do whatever I felt was right, and here when people didn’t quite agree to what I said, was a little difficult for me.

Hence because of that my relationship with my MIL in the initial phase was very bad. Even if she tried her best to mend ways with me, I didn’t want to mend ways with her

But after my child came home, she actually became my strength because she did understand a lot of things. Now we have a better relationship because of my daughter. Because they saw what all we did for our daughter and how much time they spent in the hospital this also and maybe my Ego also went down.

D: So, what, what happens when somebody doesn’t listen to you…??

P: Did you just see my eyebrow going up…?? It is automatic. If somebody doesn’t listen to me, and my daughter has the same thing when she doesn’t want to listen her eyebrow will go up. It’s an automatic response that comes from my father to me, from me to my daughter, we don’t like not being listened to, like not listening to us types.

D: Talk more about this. You don’t like people not listening to you…??

P: Yeah, because I’m basically very bossy by nature. I am being very honest. Everybody tells me this and yaa I am Bossy by nature and I can’t tolerate inefficiency at all. But yes now I have mellowed down.

I did not like people telling me that no, you’re wrong. I did not like people. I thought I made the best decisions I could make with it.

I made the right decisions that’s what I thought. So, I used to get angry and short-tempered basically at that time, but, I did not exercise those emotions. I don’t remember feeling those things when I was pregnant as a person, maybe. Yes, I would like that. Uh, I don’t remember being that kind of a person when I was pregnant.

D: Let’s stay on this point that you’re not being heard or, you know, somebody is not listening to you in that moment. What happens to you…?? What do you feel…??

P: I get this KNOT in my chest, like a very ANGRY KNOT and I feel like saying something really nasty to that person. I tried to remember the nastiest thing that I can say to this person. Downright to being very, very personal. If I’m using a local language, then he is gone.

So, I would say that English stops me from being very Chapri [Local] also. Yeah. So, I get this and then I get very like, shaky, like I get very angry. And, yeah, I, then I would lose, all my reasoning. and I think then everything goes out of the window

D: What do you mean by Shaky…??

P: I can like, you know, like what should I do man, how do I explain to this person, like not physically shaky, but from within. Like what, what can I do that this person will listen to me.

D: What are the physical changes in your body that time…?? Like, what are the sensations in your chest and in your body, in your back…??

P: My hands become sweaty. My legs become cold. I think I sweat, I sweat like crazy but my feet turn cold and my heart becomes balmy and sweaty.

D: So, then you went into labour. I mean, you went to the hospital, to get a regular check-up. And they told you that you’re going into active labour. What was your state of mind at that time…??

P: PANIC. Because I was alone. My husband was in a meeting and that day a new cook had joined us, so I couldn’t even trust her enough to come with me.

And after that, I went to the hospital and they checked me or the lady doctor checked me and I was panicking and I was calling my parents, calling him, I was calling my doctor. Uh, but then they, the nurses told me not to panic so much. They just speed up everything. So, I tried to be calm, but that didn’t help. So, by the time my husband came to the hospital I was in a different state of panic because I didn’t want to lose my child.

The doctors explained me that I could have another child, that I was still young to have another baby, there could be complications after the birth for the baby because there can be complications. The baby might not be normal, So, they gave me all facts that could happen.

“But I told my husband, let anything happen I am going to have this baby. This is the only baby that we are having otherwise we were not having”

So, we went ahead with it, but the doctors still were giving us another options, then the option of not having the baby or having this baby came up. So, till the doctor told me that I had that option, till then I was in panic, but the time the doctor told me to abandon the baby, I was like No. This is the baby I want and I will keep this one only.

So, after that I had calmed down. If I have to have this baby, I need to calm down. Till that point I had just gone in a panic state.

D: So, what was the feeling, mother bearing the child and, you know, you wanted just that baby and not lose the baby at any cost. What, what is that feeling…?? Just explain that…

P: Basically, first I felt very angry at myself. You know that you did the prenatal yoga, you found the best doctor, you went to Surya Hospital all the way to Ghatkopar and all that, but in all that, all you had to do was take care of the baby inside and you couldn’t do it. I still get that feeling at times when I see her weight, which is very low., when I see her not able to jump, when you know, things like, random things I don’t even know now anymore. So, it still comes back, you know, maybe because of that, you were not able to carry her to term.

D: When the doctors give you the option, we didn’t want to go abandon the baby. What was that feeling…??

P: It was like, I don’t know. There’s no feeling this. Like how can you even think of, it’s not even a thought. I feel like I had, I, I don’t even remember now. What does it mean…??

But also, if I don’t have her, I don’t think I should even try again and do this again to myself or to another baby.

So, either you have this, or I don’t you don’t have it. This side or that side. That was a feeling. You have to do it that is all I thought.

D: What was the Fear…?? What was the Panic…??

Panic was key, you know, when the doctor said “NOT TO PUSH”, if you push she’ll have brain damage in there. And it was active labour and it was all going on its own, it was pushing, but what people, she moved out. So, I didn’t know how to stop it.

In fact, I have to do the opposite I had to stop pushing. So, I do the physical, the thought was to stop this. So, I would have to like pull up my vaginal muscles [HG]. I used to close it.

Like Ohh God…!! I should not, I should not. I should not… That was my focus was there that it’s told not be done, so means I have to stop it. That was the whole focus at that time.

D: Like controlling it…??

P: Yeah…!! So, when, initially they didn’t let me touch her because I had a chest infection and they didn’t want an NICU baby to be touched by someone. After 10 days I could touch her. They opened a small window and I could touch her.

Touch her with my pinky finger because what she was just 550 grams. So, I was very scared to touch her, but it was really nice. Like, uh, slowly. It didn’t register at first that she’s my child, but slowly slowly with the touch I felt it. I guess the same time I was also pumping milk all the time.

I had to donate the milk after she took up on my breast. So, I used to be on constant, breastfeeding, more than my medications.

Because with her until Kangaroo Care, I used to only cry because only that much I could touch her. But once Kangaroo Care started, I started feeling happy.

Holding her close to me and the first time I breastfed her, there was a picture taken, she looked at me and she smiled.

No, I think the first time I held her for the Kangaroo Care she looked at me and she smiled for hardly a month-old baby.

She actually had a smile in that picture. So yeah, I felt very happy that day also. So, it improved over time. And when she came home, it was good, I was very happy that she was home.

But I was constantly pumping milk for her day and night. So, I got frustrated, but you know what I was working like a machine. This is what is required at this moment. So, I focused on care. I didn’t focus on feelings at that time. I didn’t want to, because then if I focus on my feelings, I don’t think I would have been able to care that well for her.

Some direct questioning to confirm once we knew what we are looking at:

D: She’s a very cautious child…??

P: Yes, she is and she only knows one thing that she is be more that she’s busy.

She keeps humming. all the time. She has affinity for music also. She keeps on listening to music and she keeps on humming and she humms in different different tunes.

She tries to copy other tunes. So, we know she’s playing.

“And one thing about passing motions she will go to the balcony, she will play there and if we are not around, she will pass there. Then we know that she has gone to do potty now”

D: So, she is shy to do it in front of others…?? Or if you are around…??

P: Yes

D: Is she self-conscious…??

P: I think so. Maybe while doing potty and in front of people like, um, like at home she’s very outgoing. And if people come to the house, she’s very happy to meet them. But when she goes out, even in school they say she is a person who only speaks when you speak to her, she responds only when you give her, you give her a separate attention of who actually pay attention, but she won’t respond or she won’t participate. But at home we wonder if that’s true, because at home all her Masti (fun) is going on all the time.

D: Are you both cleanliness conscious…?? Is it the same for you too or not…??

P: She doesn’t like her hands getting dirty. So, she keeps a napkin when she’s eating. She doesn’t like her hand getting dirty at all.

If her clothes get stained or dirty then she has to change them immediately, that’s very important.

So, whenever she is painting so she will not make it all dirty, she knows what things is to be used and how…

She’s never interested in it and when she’s interested. So, she’ll do a little bit but then she doesn’t make too much mess.

D: Is she very choosy…??

P: Yes, very selective right from what the colour she wants to wear. to the type of toys she likes, she is very particular about what she eats, is very little and very selective, that only vegetable that she wants to eat. Dals she doesn’t like. So, she’s very, very selective and everything.

She will only watch 2 of her favourite cartoons and nothing else

She has a weird taste in music, like for a young child, you would not expect, she likes to hear to classical music.

(weird for a 3-year-old child, isn’t it..??)

One day she watched an entire concert of Zakir Hussain on You tube

She doesn’t like all those upbeat songs. She likes Soft music, slow songs. The fastest song that she likes is “Lakdi ki Kaathi”

She likes song which is not fast, it must have tune, so she likes to listen to good music. It has to be a very good song (refined taste)

Then we realized, she only listens to good music

She will not dance on the latest new songs but instead will dance on Rajasthani folk songs.

She doesn’t like all those cheap songs and if I am (mother) dancing on it, she will even stop me from dancing

D: You said that she is very dependent on you…??

P: She is totally dependent on me for everything in a sense that it’s her choice to be dependent. She can do it on her own, she can take out her panties, she can take out her pj’s and put it in the basket, she shows me that once in 15 days but she doesn’t want to do it.

She doesn’t want to be independent. I’ve tried really hard to make her independent, do things on their own.

But she doesn’t want to, she doesn’t want to pick up her things. She doesn’t want to be organized,

D: So, is that similar to you or opposite to you…??

P: I think never would have stopped my mother from dancing.

D: Is she a very physical person, who likes being kissed or cuddled or hugged…??

P: She is very physical. She likes cuddling. She likes to, even when we sleep, she will push herself into us. And with my husband equally with him and me, she likes to kiss a lot on the lips, on the cheeks, but only with the me and my husband, not with anybody else.

D: How is she with distant family members…??

P: No, she doesn’t cuddle or hug or go to kiss them and even they don’t try to do it with her. She keeps her boundaries (territorial)

D: Cravings…??

P: She likes sweets a lot, but we give her only homemade sweets.

She also likes chocolates, but we don’t give her much.

Milk she doesn’t ask much, very rarely

D: Taste…??

P: She doesn’t like any spicy food or even sour taste

She prefers having bland food

Like the colour of the food should be white, with Coriander, like nothing should be there in the rice like Dal or Sambhar.

She eats plain because that’s what she eats and fruits. She likes fruits. She, most of the fruit she will eat. So yeah, I don’t know what else I can tell that’s like, as in she likes to wear shoes, she loves foods. Then we could go out. She used to love shopping.

Case Analysis:

Themes of Animal Kingdom:

Mother’s history during Pregnancy:
- Issue of survival
- Victim and aggressor: feels victimized by people, illness. People are doing this to me
- Hierarchy: superior, inferior, they are above me, dominating me, overpower me.
In the child:
- Territorial
- Boundaries
- Likes to Tease Others
- Bossy

Once you come to the Animal Kingdom, it is then important to identify whether this is a Vertebrate or an Invertebrate. The question you ask yourself is “How developed is this Case”

In this case the child is very developed, very refined (in taste, in intelligence, in her needs). She is evolved and thinks about her and her surroundings/family.

This confirms a VERTEBRATE ANIMAL

This narrows down our search further.

If we look at Dr. Mahesh Gandhi’s Animal Chart and understand this case along with Sensation Method, with the Personal Evolution Method we further see the below themes:

Themes of nutrition line (fussy in food, constipation, relationship with mother, kangaroo care, premature child)
Themes of toddler age (constipation is control- anal stage)
And themes of pre-school/School Age (initiative/industry)

This brings us down to Mammals. Once you are thinking of a mammal remedy (Lac or Non-Lac) – it’s important to identify whether this is a Prey Animal or Predator Animal. This can be really helpful in finding the simillimum.

Being conscious of one’s space/boundary/being territorial confirms a predator.

Lac Felinum:

Cats have always been connected with dignity, royalty, grace and power
Like all felines, cats too have great leaping ability, acrobatic skills and sudden, short bursts of speed.
Sense of independence:
- Patients who insist on doing all their work on their own with a feeling as if “I can do it and I don’t need you to do anything for me”.
- They have no vested interest in the pack and are quite independent. They are self-sufficient
- Parents of Lac Felinum children often say that these children would come to them on their own accord i.e. when they want to be caressed and may resent being fondled otherwise.
- This child is dependent on her mother, but this dependence is not because she cannot manage things herself. She chooses to be dependent on her mother. There is a choice in this to let mother do her things for her. It is a voluntary dependence.
- In her dependence there is no “neediness” like a Lac Can. In her dependence there is a choice and lack of neediness. She is a queen who demands attention and care.
Conflict of Lac Felinum:
- Needing family and wanting to be free. Only animal who decided to be domesticated.

Other Features of Lac Felinum:

Anal Qualities:

Perfectionist (Also comes from mammal’s self-critical behavior)
Very particular about their choices, cleanliness.
Controlling- dominating
Cats spend about one quarter of their lives cleaning themselves

Air Qualities:

Freedom
Self-willed
Averse to external regulations

Our Clinical Experiences with Lac Felinum from several cases which confirmed the remedy in this case:

Cats can be very particular about the place they do their business. Reason – shy/territorial behavior/hygiene
Cats in general are very shy toileters and will often only pee or poop in their litter box if it is placed in a quiet, secluded area, away from family members and other animals.
Constipation in children, very shy or reluctant to pass motions.
Will Only pass stools when you are not looking
Hidden Haughtiness/Very subtle & sophisticated

REPERTORY:

If you look in the Rectum Chapter you will see Lac Felinum is a very important remedy in Constipation:

PRESCRIPTION:

Lac Felinum 1M – June 2^nd,2020. Once in a week for initial month followed by more infrequent doses.

FOLLOW UPS:

15 Days:

Appetite improved
Energy levels have gone up quite a bit
Motions are good.
Does pass stools on alternate days

2 Months:

Constipation: She doesn’t pass every day, but motions are not constipated anymore
She is confident enough to pass stools and that has improved drastically
She has started using the pot now and does not do it in her pants now
She informs us that parents that she has to go
Her height and weight have increased
Her activity and energy levels have gone up
Her speech has also improved
She sleeps well now
She is playing whole day and attends school as well
Overall, she is around 60% better

4 Months:

She has considerably continued to improve
In between she had episodes for a week where she would streak in her pants
Now after the SOS powder she has settled and back to doing it in the toilet seat.
Her energy levels are good
She is playful and active all day
She still doesn’t take naps in the afternoon
She is 80% better apart from the streaking episode

6 Months:

She is now not constipated at all.
She passes motions daily and also informs us.
The streaking episode didn’t come up again after giving the SOS.
She is much better now
There has been an upscale improvement in her physically regarding her appetite, activity levels.
Her milestones are fine now.
Her motor skills are improving.
Earlier she didn’t used to touch squishy things.
Now she is exploring textures.
Earlier she didn’t used to touch gooie things. Now she has started doing it.
She had a growth spurt 1 or 2 weeks back. She didn’t want to eat that time.
Speech is clear. Grammatically correct English
She has now taken up on doing a lot of puzzles (24 piece).
Her activity level is there a lot but not like hyperactivity.
She is around overall 90 – 95% better.

11 Months:

She continues to do well.
No constipation.
Good energy and development.

She is still under our care and gets a dose seldomly as and when needed. This we believe is the advantage of integrating classical and contemporary methods in homeopathy. This case is a great demonstration of several things – that sensation method can be used in child cases, the utility of the Animal Chart and how repertory /materia medica should be used to anchor our prescriptions.

If you would like to learn the basics of this contemporary homeopathy where all principles age old and modern seamlessly integrate and there is a clear road map to come to a simillimum, we invite you to join our upcoming course:

Homeopathy Musings and Mentors are excited to present a unique opportunity to learn and experience a practical integration of contemporary methods in Homeopathy from their 20+ years of clinical experience.

The course is spread across 12 days in Jun & July 2021 and will cover the basics of teachings by Dr. Sankaran, Scholten, Dr. Gandhi and Yakir. The schedule is conveniently designed as two-days per week and is structured to seamlessly cover all the essential elements for NextGen homeopaths who are beginners in contemporary methods in Homeopathy.

HIGHLIGHTS OF THE COURSE:

Sankaran’s sensation, levels of experience, the other song, case taking and posology
Understanding Kingdoms
In – depth of Miasm
Gandhi’s Personal Evolution
Introduction to Scholten’s Mineral Chart, Yakir’s Plant Chart & Dr. Gandhi’s Animal Chart
Nosodes & Sarcodes
Integrating classical homeopathy & these contemporary methods integrate
Case Examples
Practical Implementation in practice.

Additional Value Adds: