Constipation

Infant symptoms

  • Extreme (out of the ordinary) crying, discomfort with passage of stool
  • Unable to pass stool in spite of straining and pushing for more than 10 minutes

Child symptoms

  • Pain with passage of hard, large stools
  • Child unable to pass stool, even though they have discomfort and the urge to have a bowel movement

What is NOT constipation

  • Constipation is not how often bowel movements happen as children can be very different from each other. Rather it is defined by how hard or soft the bowel movements are and any other problems that may be causing (like abdominal pain).
  • Babies younger than 6 months old - often push, strain, grunt, pull up their legs, and get a flushed face when having a stool - this is NOT constipation; it is normal behavior for a baby having a stool while laying down as long as stool appears soft.
  • Hard BM’s may be normal, if no is pain involved

What to do

Infants younger than 2 months

  • Call if baby has vomiting or poor feeding

Infant 2 months to year old

  • Consider juices twice a day
  • If over 4 months old add food with high fiber content (cereals, apricots, prunes, peaches, pears, plums, beans, peas or spinach)

Children 1 year old, and over

  • Increase water intake (offer frequently)
  • Offer juice (prune, apple, pear, cherry, or grape)
  • High fiber fruits and vegetables three times/day examples: apricots, pears, peaches, prunes, figs, and dates peas, beans, broccoli
  • Give more high fiber grain foods, examples: whole wheat bread, graham crackers, oatmeal, bran muffins, brown rice
  • Decrease foods that can be constipating in high amount such as dairy, cheese, and some cooked vegetables.
  • Children who use toilet:
    • Sit on toilet for 10-15 minutes after breakfast or dinner daily
    • Provide books, puzzles, or a toy
    • Praise for success; give positive encouragement

When to call

  • If no improvement after 1 week of using above treatment
  • If toilet trained child has leaking, liquid bowel movements
  • Large and/or painful bowel movements not relieved by diet changes
  • Persistant abdominal pain
  • Have bowel movements accidents when your child was previously potty trained