



	Health Resources

Constipation

Definition of Constipation

Pain or crying during the passage of a bowel movement (BM) OR
Unable to pass a BM after straining or pushing > 10 minutes OR
No BM after more than 3 days
(EXCEPTION: If breastfed and > 1 mo. infrequent BMs can be normal)
The following symptoms are NOT constipation: normal grunting, brief straining or pushing for < 10 minutes, large BMs, or BMs passed every 2 or 3 days. Hard or dry BMs are also normal if passed easily
Main cause: high-milk diet, lack of fiber in diet, postponing BMs

See More Appropriate Topic

If doesn’t meet the definition of constipation, either normal or see ABDOMINAL PAIN

Call Your Doctor Now (night or day) If

Your child looks or acts very sick
Persistent abdominal pain > 1 hour (includes persistent crying)
Persistent rectal pain > 1 hour (includes persistent straining)
Vomiting > 3 times in last 2 hours
Breastfed newborn (< 1 month old)
Age < 12 months with recent onset of weak cry, weak suck or weak muscles

Call Your Doctor Within 24 Hours (between 9 and 4) If

You think your child needs to be seen
Age < 2 months
Bleeding from anal fissures (tears)
Leaking stool

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns
Suppository or enema needed recently to relieve pain
Days between BMs > 3 while eating a nonconstipating diet
(EXCEPTION: Normal if breastfed infant > 2 mo. AND BMs are not painful)
Toilet training is in progress
Constipation is a recurrent problem

Parent Care at Home

Mild constipation and you don’t think your child needs to be seen

Home Care Advice for Constipation

Diet for Infants Under 1 Year
- For infants > 1 month old only on breast milk or formula, add fruit juices 1 oz./month of age twice a day. Grape, pear, apple, cherry or prune juice are OK at any age
- For infants > 4 months old, also add baby foods with high fiber content twice a day (peas, beans, apricots, prunes, peaches, pears, plums, spinach)
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 (peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, dates)
- Increase whole grain foods (bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn can be used if > 4 years old.)
- Decrease constipating foods (milk, ice cream, cheese, yogurt, or cooked carrots)
Stop Toilet Training: Temporarily put your child back in diapers or pull-ups.
- Reassure him that the poops won't hurt when they come out.
- Praise him for the release of BMs. Avoid any pressure, punishment or power struggles about holding back BMs, sitting on the potty or resistance to training.
Sitting on the Toilet (if toilet trained): Establish a regular bowel pattern by sitting on the toilet for 10 minutes after meals, especially breakfast.
Call Your Doctor If
- Days between BMs continue > 3 after eating a nonconstipating diet > 1 week
- Your child becomes worse or develops any of the “Call Your Doctor” symptoms