Infant Constipation

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

Everyone has a different normal bowel pattern. For example, some children have bowel movements only once every 2 to 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 to 4 times daily.

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

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

• 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).
• If over 2 months old, give diluted fruit juices, such as prune juice twice a day.
• 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.
• Decrease consumption of constipating foods, such as milk, ice cream, cheese and cooked carrots.
• Do not give your baby an enema or suppository (medicine in the rectum) unless advised by your doctor.
• 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.

• 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.
• 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.
• 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.
• Always ask your child's doctor before giving a laxative.
• Do not punish your child if he or she does not have a bowel movement or if he/she soils his/her underclothes.