symptoms in infants and children
children s health issues
Constipation in Children
Treatment of constipation depends on the cause. Fororganic constipation,the causative disorder, drug, or toxin is treated, corrected, or removed. Forfunctional constipation,measures include Changing the diet Modifying behavior Sometimes using stool softeners or laxatives Dietary changes for infants include giving them 1 to 4 ounces (30 to 120 milliliters [mL]) of prune, pear, or apple juice each day. For infants younger than 2 months, 1 teaspoon (5 mL) of light corn syrup can be added to their formula in the morning and evening. Older infants and children should increase their consumption of fruits, vegetables, and high-fiber cereals and decrease consumption of constipating foods, such as milk and cheese. Behavioral modification can help older children. Measures include Encouraging children who are toilet trained to sit on the toilet for 5 to 10 minutes after meals and encouraging them when they make progress (for example, noting progress on a wall chart) Giving children who are being toilet trained a break from toilet training until constipation resolves Sitting on the toilet after a meal can help because eating a meal triggers a reflex to have a BM. Frequently, children ignore the signals from this reflex and put off having a BM. This technique uses the reflex to help retrain the digestive tract, establish a toilet routine, and encourage more regular BMs. If constipation does not respond to behavioral modification and changes in diet, doctors may recommend certain drugs that help soften stool (stool softeners) and/or increase the spontaneous movement of the digestive tract (laxatives). Such drugs includepolyethylene glycol,lactulose,mineral oil, milk of magnesia (magnesium hydroxide),senna, andbisacodyl. Many of these drugs are now available over the counter. However, doses should be based on the age and body weight of the child as well as the severity of constipation. Thus, parents should consult a doctor regarding the appropriate dose and number of doses per day before using these treatments. The goal of treatment is the passage of one soft stool per day. If children have a fecal impaction, options include gentle enemas and agents (such asmineral oilorpolyethylene glycol) taken by mouth with large amounts of fluid. If these treatments are ineffective, children may need to be hospitalized to have the impaction removed. Infants do not usually require any of these treatments. Typically, aglycerinsuppository is adequate. To maintain regular BMs, doctors may recommend that children use fiber supplements (such aspsyllium), which may be obtained without a prescription. For these supplements to be effective, children must drink 32 to 64 ounces (about 1 to 2 liters) of water a day. 