In this Article I cover one of the more frequent topics raised during visits to the London Pediatric Clinic – Infant Constipation.
What is Constipation?
Most folks believe that constipation refers to the infrequency of bowel movements. Actually, constipation refers to the compactness and the difficulty of passing stools. Although the consistency and number of stools varies with age and between children, no child should struggle and pass hard stools. For example, some breastfed newborns pass yellow seedy stools with every feed. Others may do so weekly, but without issue.
Formula-fed infants may have fewer, firmer and darker stools. Introduction of solid food results in more formed and less frequent stools. Some babies on transitioning to solids may have a bowel movement without difficulty every three or four days, but promoting daily stools is preferable.
So, consider infant constipation if/when your child is straining and struggling to pass hard, dry stools, the passage of which maybe painful, especially if new foods are introduced into the diet.
What should you do if you think your Infant is Constipated?
If you do suspect your infant is constipated, please see his/her physician. Why? There are some very rare potential significant causes, which may be readily ruled out by a good history and physical of a newborn infant. So, before embarking on a treatment, it is important that you see your child’s physician.
Possible solutions your physician may recommend
Your physician may make few suggestions to help your child. Strategies for helping constipated newborns include:
- Warm baths and tummy rub
- Sugar water
- Juice – half or full strength
The recommendation you receive from your physician will reflect her/his training and beliefs. Much of this is style. There is little or no evidence that anyone thing is wrong (or right for that matter).
Some physicians believe that the overuse of suppositories is not the best for any child and is a last resort. Others do not. Similarly, some folks recommend water and/or juice and others believe that they should never be used in newborns or infants.
My Approach to Infant Constipation
I personally have never been a big fan of suppositories or enemas for routine constipation.
If an infant is otherwise well and is constipated, I will first try to ease the passage of hard stools by applying a small amount of water-based lubricant to the infant’s anus. The warm bath and tummy rub will often work, but many parents do not wish to try this approach.
If the simple anal stimulation does not work, then I will recommend 1-2 ounces (30-60ml) of water once a day for 1-2 days. If this also fails, I will recommend a single serving of 1-2 ounces (30-60 ml) of pasteurized pure apple juice with no additives.
The inherent fruit sugars are used as a laxative. This is about the only time any parent will ever hear me recommend juice for anyone.
I recognize that some disagree with my approach. However, it works in my hands and relieves the problem in most infants.
Below are four references on the topic of Infant Constipation from other folks with varying approaches:
1) Mayo Clinic – http://www.mayoclinic.com/health/infant-constipation/AN01089
2) Dr. Sears – www.askdrsears.com/topics/childhood-illnesses/constipation
3) American Academy of Pediatrics – www.healthychildren.org/English/ages…/Infant-Constipation.aspx
4) Better Health Channel – Government of Victoria, Australia- www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Constipation_and_children
5) Featured Image reused from http://www.humptybumptykids.com/constipation-children/