Infant Constipation

• Signs & Symptoms
• What causes it
• About the condition
• Care Tips

Signs & Symptoms

Everyone has a different normal bowel pattern. For example, some children have bowel movements only once every 2-4 days. It is normal for breast-fed babies to have large, soft bowel movements without pain up to 7 days apart. Others have bowel movements 2-4 times daily.

However, a child is constipated whenever his/her pattern slows down noticeably. Sometimes constipation can cause recurrent tummy pain.

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What causes it

Very rarely, disease causes constipation. In this case the problem usually begins in the early weeks of life. In most children, there is no disease but once constipation begins, it tends to continue. Some of the factors that may contribute to the onset of constipation are:

1. Lack of fibre-rich foods (cereals, vegetables, fruits), inadequate fluid intake and an excess of sweet junk food in the diet.
2. Poor bowel habits, problems with toilet training and at times, unwillingness to spend time on the toilet.
3. Small tears (fissures) at the bowel opening (anus), causing pain at the time of bowel movements.
4. Some medications such as iron.
5. Illness (vomiting, fever) in which a lot of fluids have been lost.

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About the condition

Constipation is an abnormal pattern of bowel movements in which stools are passed less frequently than usual and are often harder than usual.

Call your child's doctor if:

• Your child's general health seems to be affected
• Your child has significant tummy pain
• There is blood in the stool
• Your child cannot pass a bowel movement after 4 days despite increasing fluids and fibre (vegetables, cereal, fruits) in diet
• Your child loses some control of his/her bowel actions and begins to soil underclothes.

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Care Tips

How do I prevent constipation?

1. Make sure that your child's diet contains adequate fluids and high-fibre foods that act as natural laxatives (Fruit juices, fruits, particularly prunes, vegetables and salads, cereals).
2. If over 2 months old, give diluted fruit juices, such as prune juice twice a day.
3. If over 4 months old, add strained foods with high fibre content, such as cereals, apricots, prunes, peaches, pears, plums, beans, peas, or spinach twice daily.
4. Decrease consumption of constipating foods, such as milk, ice cream, cheese and cooked carrots.
5. Do not give your baby an enema or suppository (medicine in the rectum) unless advised by your doctor.
6. When your child is old enough (about 2 to 3 years old) help him/her establish regular bowel habits. Have your child spend a few minutes on the toilet or the "potty" once or twice daily immediately after meals. The position should be comfortable with knees up. For a small child using the toilet, a footrest will be necessary so the legs don't hang down and the knees are up in a crouched position. Such a position eases bowel movement.

What should I do?

1. If your child has severe pain during a bowel movement, there may be a tear (fissure) at the bowel opening (anus). Call his or her doctor.
2. If the pain is severe, your child's doctor may use a medicine to soften your child's stool or  apply an ointment around the anus. Occasionally it is necessary to wash out the stool with an enema.
3. Be patient. Improvement may be slow and it can take several weeks of active treatment before your child returns to his or her normal bowel pattern.
4. Always ask your child's doctor before giving a laxative.
5. Do not punish your child if he or she does not have a bowel movement or if he/she soils his/her underclothes.

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