Constipation

Question:

My child hasn't had a bowel movement in two days and the stool was hard when it is passed.  Could he be constipated?

Definition:

We consider constipation to be when child is having infrequent bowel movements, when it is painful to pass stool, and/or when there is an inability to pass stool after prolong straining.  The normal bowel frequency is highly variable.  Frequently a child will go up to 4 days without a bowel movement.

Treatment:

Infants (younger than 1 year of age):

Add 1 teaspoon of dark karo syrup to bottle at least twice a day may provide relief.  If your infant is breast-fed and you pump breast milk you may add dark karo syrup accordingly.  The next step if infant is older than 4 months is to add baby food with a high fiber content (cereals, peas, peaches, pears, prunes).  You can also offer two ounces of fruit juice.

Children (older than 1 year of age):

 Encourage fruits and vegetable at least three times a day and increase water intake. Fruits that are high in fiber (prunes, peaches, pears, apples, beans, peas, broccoli) are particularly helpful.  Add a daily source of bran to the diet (bran muffins, shredded wheat, graham crackers, oatmeal, high-fiber cookies, brown rice, whole wheat bread, popcorn if child is older than 4 years old).  Moreover, a decrease in more constipating foods such as milk, ice cream, cheese, yogurt may be helpful.  If changes in diet do not seem to improve constipation, you can add 1 teaspoon clear (generic) mineral oil to fluid once a day.

*** We do NOT recommend rectal stimulation unless authorized by our office

When to Call:

  1. Newborn:  if no bowel movement in 4-5 days
  2. Infant or child:  if no bowel movement in 7 days
  3. If there is blood in the stool or tarry black stools
  4. If home care doesn't seem to be working