Current Environment:

Constipation

Constipation may be suspected if there is pain during defecation, an inability to release a stool after 10 minutes of pushing, or 3 or more days have passed without the passage of a stool. Once children are on a regular diet (age 1 year), the normal range for stools is 3 per day to 1 every 2 days. Most constipation is a result of diet changes or waiting too long to use the bathroom.

Symptom Management

Diet for Infants Under 1 Year:

  • For infants over 1 month old only on breast milk or formula, you may add fruit juices 1 ounce per month of age per day (e.g., 3 months old = 3 ounces a day). Limit amount to 4 ounces per day. Pear and apple juice are good choices. After 3 months, you can also use prune juice - no more than 2oz in 24hrs.
  • For infants over 4 months old, also add baby foods with high fiber content twice a day (e.g., peas, beans, apricots, prunes, peaches, pears, plums).
  • If on finger foods, you can add in cereal and small pieces of fresh fruit.

Diet for Children Over 1 Year Old:

  • Increase fruit juice and vegetable juice. (Note: Citrus fruit juices are not helpful)
  • Add fruits and vegetables high in fiber content (e.g., peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, dates) 3 times or more per day.
  • Increase whole grain foods (e.g., Cracklin Oat Bran cereal (tastes like oatmeal cookies), bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread).
  • Popcorn can be used if the child is over 4 years old.
  • Limit milk products to 3 servings per day.
  • Give enough fluids to keep your child well hydrated.

Stop Toilet Training (if Not Trained):

  • Temporarily put your child back in diapers or Pull-Ups.
  • Reassure your child that the poops won’t hurt when they come out.
  • Praise them for the release of stools.
  • Holding back stools is harmful. Use rewards to help your child give up this bad habit.
  • Avoid any pressure, punishment, or power struggles about holding back poops, sitting on the potty, or resistance to training.

Encourage Sitting on the Toilet (if Toilet Trained):

  • Establish a regular bowel pattern by sitting on the toilet about 20 minutes after meals, especially breakfast.
  • How long to sit: About 5 minutes.
  • If you observe your child holding back, take them to sit on the toilet at that time as well.

Warm Water to Relax the Anus (for Young Children):

  • Warmth helps many children relax the anal sphincer and release a stool.
  • Apply a warm, wet cotton ball to the anus. Vibrate it side-to-side for about 10 seconds to help relax the anus.

Flexed Position to Help Stool Release:

  • Hold the knees against the chest to stimulate squatting (the natural position for pushing out a stool).
  • Relax the legs, then press again. Move them like riding a bike.
  • Gently pump on the lower abdomen. This may work even better.
  • If no stool releases within 5 minutes, stop. It will usually work next time your baby is straining.

Expected Course

Improvements in diet usually relieve constipation. Once your child feels better, try to keep them on a high-fiber, non-constipating diet so that it doesn’t happen again. Sitting on the toilet at regular intervals daily may help to prevent recurrences.

When to Call the Office

  • Constipation continues after making dietary changes.
  • Pain or crying with the passage of stools
  • Your child becomes worse.

 

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The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances