SPG Guide to constipation

What is a normal “poop” vs. constipation?

• Normal bowel movements range in frequency from several per day to once every 5-7 days. A bowel movement may be large and hard and still considered normal.
• Normal babies have bowel movements associated with grunting, red faces, legs drawn up to their abdomens.
• Constipation is infrequent and/or painful bowel movements in a child with an urge and the inability to pass a bm despite straining.

**When was your child’s first BM after birth? If your baby passed their 1st meconium >36 hours of life inform your pediatrician.

Why does my child have constipation? Many children with chronic constipation are caused by a painful bowel movement. The children then have voluntary stool holding to avoid painful defecation. This results in the rectum stretching and a decreased urge to poop. The stools subsequently get larger and harder which worsens the painful stool passage. This cycle may eventually lead to accidents.

Constipation-causes:

Older children - Stool holding at school

• Diets low in fiber
• Diets of excessive milk products
• Waiting too long to go to the bathroom
• Small tears/rashes causing pain
• Babies: Transitioning between breast milk to formula or changing formulas
• Toddlers:
  1. Toilet training
  2. After a bad diaper rash

  TREATMENT

  The Foods

  • Babies less than 4 months: Dilute 1 oz of water with 1 oz of prune or white grape juice once daily.
  • Babies 4-12 months: Apricots, prunes, peaches, plums, pears, peas and spinach. Avoid rice cereal and bananas. Give juice as above.
  • Toddlers >12 months: Fruits, vegetables, and juices as listed above as well as figs, raisins, cauliflower, broccoli and cabbage. Caution: avoid choking hazards in children less than 3 years.
  • High fiber foods: multi-grain cheerios, whole wheat bread, multi-grain waffles, bran cereal/muffins, mini-wheats, brown rice. More water. Less cheese, apples, bananas, white rice.
  • The Potty During potty training encourage a schedule to try to sit on the potty after meals with a footstool under their feet.

    **If your child resists-stop toilet training for bowel movements and put him/her back in diapers.

    Do not use suppositories, laxatives or enemas without the advice of your pediatrician. Do not take rectal temperatures or attempt any rectal stimulation.

    If constipation continues despite diet and toileting recommendations contact your SPG pediatrician.