Constipation
What is constipation?
Constipation is not really just how often a child goes to the toilet, but
describes a more significant problem passing a stool, causing pain and discomfort
or having regular tummy pain and bloating. Some children may go to the toilet
only 1-2 times a week and others every day. If this is a child’s normal
pattern, and passing a stool is not associated with discomfort, there is
no reason for concern.
Breast fed babies
Breast fed babies do not get constipated. They can have frequent bowel actions
in the early days and at times may go for up to 10 days without having a
bowel action. Both are normal. If you are concerned contact your nearest
MCH nurse or GP.
What causes constipation?
Constipation is a common childhood problem. The causes of a child’s constipation
may not always be clear, but may include poor diet and physical activity
combined with irregular toileting practices.
How is constipated treated?
It is important to have an infant or young child examined by a medical doctor
if constipation is a long-term problem, as it is possible that medication
may be required. The longer the child remains constipated, the worse it
may become, and the longer it may take to treat.
Is diet important?
A healthy diet including wholegrain or whole meal breads and cereals with
plenty of fruits and vegetables and water to drink is helpful, even when
medication is needed in older children. All children will also need a toileting
schedule to help establish a regular routine.
Can an infant be constipated?
True constipation in infants is rare and should always be checked by a medical
doctor. If you believe an infant is constipated then it is important to
check for the following:
● If the baby is bottle fed, ensure the formula
is made up correctly.
● In warm weather bottle fed infants will require
extra fluid such as cooled, boiled water between formula feeds. Breastfed
infants will require more frequent feeds.
● Ensure the use of solid foods is age appropriate.
Be aware that excessive use of legumes and high fibre cereals is inappropriate
in young infants.
What can I do to prevent or manage constipation in my child?
Important ways to help prevent or manage constipation in young children
may include:
● Increase in fluid intake (preferably water) if
this is a problem. To start, try to increase water by 1-2 glasses per day
● Encourage physical activity,
● Increase fibre intake slowly, substituting whole
meal or wholegrain breads and cereals for some refined products,
● Include fruits and vegetables daily,
● Avoid the use of unprocessed bran in young children,
● ‘Habit training’- or a toileting routine. This
may need some motivation and encouragement, so the use of a star chart and
rewards may help your child to go to and sit on the toilet to help them
get used to passing a stool at a similar time each day when they are most
comfortable.
● A medical assessment in children with longer-term
constipation for advice about appropriate laxative treatment.
Can I change my baby’s diet to manage constipation?
In general, recommendations to increase fibre from wholegrain cereals and
large quantities of fruit and vegetables and water may not be appropriate
when treating an infant with constipation. Usual recommendations for introduction
of solid foods should be followed for infants less than 1 year of age. Treatment
for constipation in infants should be discussed with an experience health
practitioner. Adding one teaspoon on brown sugar to 30mls of cooled boiled
water and given once and repeated only if necessary.
In addition the following are not recommended:
● Prune juice: contains a natural bowel irritant
and is not recommended for infants under 9 months of age, even when diluted.
● The introduction of solids before 4 – 6 months
of age is not recommended as a treatment for constipation.
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