CONSTIPATION

Constipation = HARD, FORMED, CLAY-LIKE poops, associated with painful or difficult passage. If poops are infrequent but soft, this is NOT constipation; it is obstipation. A baby may poop as many as 5 to 8 times a day or as little as every 3 days. It is normal for a baby to turn red and grunt while they are pooping.

TREATMENT IN INFANTS/TODDLERS

(0 to 18 months of age)

  • Offer 1 to 2 ounces of water (or preferably electrolyte solutions like ‘Pedialyte’ or ‘Ceralyte’)or white grape juice or prune juice in between normal feeds once or twice daily. Do not significantly decrease the amount of usual feedings
  • ½ to 1 tsp of karo syrup to every other bottle. For breastfed babies: mix ½ to 1 tsp in 1 to 2 ounces of water 2 to 3 times/day.
  • White grape juice or prune juice daily in between feeds.
  • In babies > 4 mos. old: oatmeal cereal tends to soften the stools. Rice cereal makes stools firmer.

* See list of foods to increase/avoid

TREATMENT IN TODDLERS/PRE-SCHOOLERS

(18 mos. to 3 ½ years old)

May be a toilet training issue: (may want to discuss with MD/NP)

  • Do not force child to sit on potty!
  • Offer diaper to poop
  • Ask child where they would prefer to poop
  • It is not uncommon for children to hold their poops for days to resist potty training.
    • Encourage child to drink lots of fluids other than milk.
    • Maple syrup or karo syrup (1tsp to 1 tbsp 2 to 3 times/day) Ask MD/NP re: other stool softeners.
    • Mineral oil 1tsp to 1 tbsp 2 times/day (may titrate up or down after speaking with MD/NP)for maximum 5-10 days.

* See list of foods to increase/avoid

PRE-SCHOOLERS/SCHOOL-AGED KIDS

(ages 3 ½ and up)

  • Encourage child to drink plenty of fluids other then milk
  • Mineral oil 1 tsp to 1 tbsp 2 times/day (may titrate up or down after speaking with MD/NP) for a maximum of 5-10 days.
  • May need to speak with MD/NP re: additional stool softeners
  • No laxatives.

* See list of foods to increase/avoid

Foods to Increase

Foods to Avoid or Decrease

  • Fruits and Veggies: 5 to 6 servings per day recommended; raw and unpeeled best
  • Prunes, figs, dates , peaches, pears, apricots, raisins, grapes , leafy green veggies, cauliflower, cabbage , broccoli, potato skins, beans, peas
  • Grains: bran is a high fiber food and acts as a natural stool softener.
  • Whole grain breads, muffins, waffles, wheat and oat bran, whole grain cereals (shredded wheat, bran flakes, oatmeal), brown rice, granola, popcorn (only for children > 4 yrs due to choking risk)
  • It is important to decrease the intake of constipating foods:
    • Dairy products (milk & cheese!!)
    • Cooked carrots
    • Potatoes
    • White rice
    • Bananas
    • Apples
    • Peanut butter
    • Chocolate
  • MAXIMUM milk intake = 24 ounces per day

Last updated: February 2007


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