Care Advice
What You Should Know about Constipation:
- Constipation is common in children.
- Most often, it's from a change in diet. It can also be caused by waiting too long to stool.
- Passing a stool should be pleasant and free of pain.
- Any child with pain during stool passage or lots of straining needs treatment. At the very least, they need changes in diet.
- Here is some care advice that should help.
Normal Stools:
- Normal range: 3 per day to 1 every 2 days. Once children are on a regular diet, their stool pattern is like adults.
- Kids who go every 3 days often drift into longer times. Then symptoms start.
- Kids who go every 4 and 5 days almost always have pain with passage. They also have lots of straining.
Diet for Infants Under 1 Year Old:
- Age over 1 month old only on breast milk or formula, add fruit juice.
- Amount. Give 1 ounce (30 mL) per month of age per day. Limit amount to 4 ounces (120 mL).
- Pear and apple juice are good choices. After 3 months, can use prune (plum) juice. Reason for fruit juice: approved for babies in treating a symptom.
- If on baby foods, add those high in fiber. Do this twice a day. Examples are peas, beans, apricots, prunes, peaches, pears, or plums.
- If on finger foods, add cereals and small pieces of fresh fruit.
Diet for Children Over 1 Year Old:
- Increase fruit juice (apple, pear, cherry, grape, prune). Note: citrus fruit juices are not helpful.
- Add fruits and vegetables high in fiber content. Examples are peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, or dates. Offer these foods 3 or more times per day.
- Increase whole grain foods. Examples are bran flakes or muffins, graham crackers, and oatmeal. Brown rice and whole wheat bread are also helpful. Popcorn can be used if over 4 years old.
- Limit milk products (milk, ice cream, cheese, yogurt) to 3 servings per day.
- Fluids. Give enough fluids to stay well-hydrated. Reason: keep the stool soft.
Stop Toilet Training:
- Your child may be starting to hold back stools. Talk to your doctor about a treatment plan.
- Put your child back in diapers or pull-ups for a short time.
- Tell him that the poops won't hurt if he helps them come out every day.
- Praise him for passing poops into a diaper.
- Holding back stools is harmful. Use rewards to help your child give up this bad habit.
- Avoid any pressure or punishment. Also, never force your child to sit on the potty against his will. Reason: it will cause a power struggle.
- Treats and hugs always work better.
Encourage Sitting on the Toilet (if toilet trained):
- Set up a normal stool routine, if your child agrees to sitting.
- Have your child sit on the toilet for 5 minutes after meals.
- This is especially important after breakfast.
- If you see your child holding back a stool, also take to the toilet for a sit (if cooperates).
- During sits, stay with your child and be a coach. Just focus on helping the poop come out.
- Do not distract your child. Do not allow your child to play with video devices, games or books during sits.
- Once he passes a normal size stool, he doesn't need to sit anymore that day.
Warm Water to Relax the Anus:
- Warmth helps many children relax the anus and release a stool.
- For straining too long, have your child sit in warm water.
- You can also put a warm wet cotton ball on the anus. Vibrate it side to side for about 10 seconds to help relax the anus.
Flexed Position to Help Stool Release for Babies:
- Help your baby by holding the knees against the chest. This is like squatting for your baby. This is the natural position for pushing out a stool. It's hard to have a stool lying down.
- Gently pump on the lower belly with your fingers. If no stool release in a few minutes, stop.
- Gently pumping the left side of the belly also helps.
Squatting Position to Help Stool Release for Older Children:
- The squatting position gives faster stool release and less straining.
- Squatting means that the knees are above the hips.
- For most children who sit on the toilet, a foot stool is needed.
- It is an important part of treating constipation.
Stool Softeners (Age Over 1 Year Old):
- If a change in diet doesn't help, you can add a stool softener. Must be over 1 year of age.
- Use a stool softener (such as Miralax). It is available without a prescription. Give 1-3 teaspoons (5-15 mL) powder each day with dinner.
- Mix each 1 teaspoon (5 mL) of Miralax powder to 2 ounces (30 mL) of water.
- Fiber products (such as Benefiber) are also helpful. Give 1 teaspoon (5 mL) twice a day. Mix it in 2 ounces (60 mL) of water or fruit juice.
- Stool softeners and fiber should produce regular soft stools in 1 to 3 days.
- Discuss dosage and how long to use with your doctor.
What to Expect:
- Most often, changes in diet helps constipation.
- After your child is better, be sure to keep him on high fiber foods.
- Also, have your child sit on the toilet at the same time each day.
- These tips will help to prevent the symptoms from coming back.
Call Your Doctor If:
- Constipation lasts more than 1 week after making changes to diet
- You think your child needs to be seen
- Your child becomes worse
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.