Constipation
Definition of Constipation
- Pain or crying during the passage of a bowel movement (BM) OR
- Unable to pass a BM after straining or pushing > 10 minutes OR
- No BM after more than 3 days (EXCEPTION: If breastfed and > 1 month old, infrequent BMs can be normal)
- The following symptoms are NOT constipation: normal grunting, brief straining or pushing for < 10 minutes, large BMs, or BMs passed every 2 or 3 days. Hard or dry BMs are also normal if passed easily
- Main cause: high-milk diet, lack of fiber in diet, postponing BMs
See More Appropriate Topic
- If doesn’t meet the definition of constipation, either normal or see Abdominal Pain
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Persistent abdominal pain > 1 hour (includes persistent crying)
- Persistent rectal pain > 1 hour (includes persistent straining)
- Vomiting > 3 times in last 2 hours
- Breastfed newborn (< 1 month old)
- Age < 12 months with recent onset of weak cry, weak suck or weak muscles
Call Your Doctor Within 24 Hours (between 9 and 4) If
- You think your child needs to be seen
- Age < 2 months
- Bleeding from anal fissures (tears in the skin)
- Leaking stool
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Suppository or enema needed frequently to relieve pain
- Days between BMs > 3 while eating a nonconstipating diet (EXCEPTION: Normal if breastfed infant is older then 2 months AND BMs are not painful)
- Toilet training is in progress
- Constipation is a recurrent problem
Parent Care at Home If
- Mild constipation and you don’t think your child needs to be seen
Home Care Advice for Constipation
- Diet for Infants Under 1 Year
- For infants older then 1 month old that only eat breast milk or formula, add 1 oz (per month of age) of fruit juices twice a day. Grape, pear, apple, cherry or prune juice are OK at any age
- For infants older then 4 months old, also add baby foods with high fiber content twice a day (peas, beans, apricots, prunes, peaches, pears, plums, or spinach)
- Diet for Children Over 1 Year Old
- Increase fruit juice (apple, pear, cherry, grape, prune) (Note: citrus fruit juices are not helpful)
- Add fruits and vegetables high in fiber content (peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, or dates)
- Increase whole grain foods (bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn can be used if > 4 years old.)
- Decrease constipating foods (milk, ice cream, cheese, yogurt, or cooked carrots)
- Stop Toilet Training: Temporarily put your child back in diapers or pull-ups.
- Reassure him that the poops won’t hurt when they come out
- Praise him for the release of BMs. Avoid any pressure, punishment or power struggles about holding back BMs, sitting on the potty or resistance to training
- Sitting on the Toilet (if toilet trained): Establish a regular bowel pattern by sitting on the toilet for 10 minutes after meals, especially breakfast.
- Call Your Doctor If
- More then 3 days pass between BMs despite eating a nonconstipating diet for more than 1 week
- Your child becomes worse or develops any of the “Call Your Doctor” symptoms