Although rarely seen in breast fed babies, it is not abnormal for breast
fed babies to have bowel movements as infrequently as one in seven days.
Treat breast fed infants for constipation only if the child appears to have
pain and cries during the bowel movement. The indications for treatment
in bottle fed babies or young children include:
- Painful passage. Pain during bowel movement is abnormal and in
some cases trauma to the anal canal can lead to anal fissure. This is confirmed
by finding bright red blood around anus or on toilet paper.
- Inability to pass stools. Children who feel the need to have
a bowel movement and are unable to do so. The exception is infants less
that 12 months of age who grunt push, or strain, and become flushed in the
face during bowel movements. This is normal behavior as long as the episode
is not accompanied by pain.
- Infrequent movements, going more than four days for young children.
If bowel movements are accompanied by much pain, abdominal bloating and
crying it is important to refer for skilled diagnosis to rule out conditions
such as Hirschsprungs disease, impaction, etc..
It is inappropriate to use laxative remedies with children unless absolutely
necessary, as constipation almost always responds to dietary changes. For
babies over six months of age you may add strained apricots, prunes, pears
to the diet. For older children try:
- Increase intake of water.
- Increase fruits and vegetables particularly raw foods with peels such
as figs, raisins, pears, apricots, beans, celery, cucumber, lettuce, apples.
- Increase fibre by using whole grain cereals or making bran muffins.
- Decrease constipating foods, e.g. dairy products, white rice, bananas,
cooked carrots, white flour.
- Use Psyllium seed preparations in children over two years of age.
- Flavored cod liver oil.