pediatrics
Constipation in Children
Introduction
Constipation is responsible for up to 5% of pediatric office visits. It is defined as delay or difficulty in defecation. Normal frequency and consistency of stool varies with children's age, and diet; there is also considerable variation from child to child. Most (90%) normal neonates pass meconium within the first 24 hours of life. During the first week of life, infants pass an average of 4 to 8 stools/day; breastfed infants typically have more stools than formula-fed infants. During the first few months of life, breastfed infants pass a mean of 3 stools/day, versus about 2 stools/day for formula-fed infants. By age 2 years, the number of bowel movements decreases to slightly < 2/day. After age 4 years, it is slightly > 1/day. In general, signs of effort (eg, straining) in a young infant do not signify constipation. Infants only gradually develop the muscles to assist a bowel movement. 