Infant and toddler health What are the signs of infant constipation? And what’s the best way to treat it?

Infant constipation isn’t common. However, your baby might have infant constipation if he or she has:

  • Hard or pellet-like bowel movements
  • Bowel movements that appear difficult to pass, causing your baby to arch his or her back or cry
  • Infrequent or less frequent bowel movements

Causes

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Constipation occurs when the stool remains in the colon for too long. Too much water gets absorbed by the colon, leaving hard, dry stools.

Constipation may be caused by:

  • Ignoring the urge to use the toilet
  • Not eating enough fiber
  • Not drinking enough fluids
  • Switching to solid foods or from breast milk to formula (infants)
  • Changes in situation, such as travel, starting school, or stressful events
  • The most common cause is the milk powder – milk formulas

Home Care

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Lifestyle changes can help your child avoid constipation. These changes can also be used to treat it.

For infants:

  • Give your baby extra water or juice during the day in between feedings. Juice can help bring water to the colon.
  • Over 2 months old: Try 2 to 4 ounces (59  to 118 mL) of fruit juice (grape, pear, apple, cherry, or prune) twice a day.
  • Over 4 months old: If the baby has started to eat solid foods, try baby foods with high-fiber content such as peas, beans, apricots, prunes, peaches, pears, plums, and spinach twice a day.

For children:

  • Drink plenty of fluids each day. Your child’s health care provider can tell you how much.
  • Eat more fruits and vegetables and foods high in fiber, such as whole grains.
  • Avoid certain foods such as cheese, fast food, prepared and processed foods, meat, and ice cream.
  • Stop toilet training if your child becomes constipated. Resume after your child is no longer constipated.
  • Teach older children to use the toilet right after eating a meal.

Stool softeners (such as those containing docusate sodium) may help for older children. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives may help your child have regular bowel movements. Electrolyte solutions like Miralax can also be effective.

Some children may need enemas or prescription laxatives. These methods should be used only if fiber, fluids, and stool softeners do not provide enough relief.

Do NOT give laxatives or enemas to children without first asking your provider.

Also, Medical causes of constipation may include:

  • Diseases of the bowel, such as those that affect the bowel muscles or nerves
  • Other medical conditions that affect the bowel
  • Use of certain medicines

Children may ignore the urge to have a bowel movement because:

  • They are not ready for toilet training
  • They are learning to control their bowel movements
  • They have had previous painful bowel movements and want to avoid them
  • They don’t want to use a school or public toilet

If your newborn seems constipated, contact his or her doctor for advice. But keep in mind that the normal amount of bowel movements an infant passes varies depending on his or her age and what he or she is eating. Infants also have weak abdominal muscles and often strain during bowel movements. Infant constipation is unlikely if your baby passes a soft bowel movement after a few minutes of straining.

Infant constipation often begins when a baby starts eating solid foods. If your baby seems constipated, consider simple dietary changes:

  • Water or fruit juice. Offer your baby a small amount of water or a daily serving of 100 percent apple, prune or pear juice in addition to usual feedings. These juices contain sorbitol, a sweetener that acts like a laxative. Start with 2 to 4 ounces (about 60 to 120 milliliters), and experiment to determine whether your baby needs more or less.
  • Baby food. If your baby is eating solid foods, try pureed peas or prunes, which contain more fiber than other fruits and vegetables. Offer whole wheat, barley or multigrain cereals, which contain more fiber than rice cereal.

If your baby is struggling, it’s been a few days since his or her last bowel movement, and dietary changes haven’t been effective, it might help to place an infant glycerin suppository into your baby’s anus. However, glycerin suppositories are only meant for occasional use. Don’t use mineral oil, stimulant laxatives or enemas to treat infant constipation.

Rarely, infant constipation is caused by an underlying condition, such as Hirschsprung’s disease, hypothyroidism or cystic fibrosis. If infant constipation persists despite dietary changes or is accompanied by other signs or symptoms — such as vomiting or weakness — contact your baby’s doctor.

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