Constipation Follow-Up Guide: What Parents Need to Know

Understanding Constipation

Constipation affects up to 30% of children

Common triggers for constipation include dietary changes, stool withholding, difficulty with toilet training, psychosocial stressors, and a history of painful evacuation

Functional Constipation is the most common type of constipation, characterized by a history of painful/hard bowel movements, large diameter stools, infrequent defecation, fecal incontinence (if toilet trained)  

When to Manage Constipation at Home

✅You can manage your child's constipation at home when:

• Constipation occurs occasionally
• Constipation is a new concern
• Your child’s stools are hard to pass
• Your child is straining or fussy
• Your child is withholding stool while toilet training

How to Treat Constipation at Home

Home remedies for constipation in different situations: 

• Infants < 12 months: 
  
  • Movement and positioning - bicycle legs, gentle abdomen massage, upright time
  • Prune juice - 1oz per month of age (e.g. a 3 month old infant can have 3 ounces prune juice daily), max 4oz daily
  • Formula fed infants often stool at least every 2-3 days
  • Breastfed infants may go several days between stools
  • If > 6 months and on solids: offer sips of water with meals, introduce fiber rich purees (4 Ps - prunes, peas, peaches pears), limit iron fortified cereals
  • Avoid rectal therapies such as suppositories 
• Children > 12 months:
  
  • Diet modification: add fruit juices including pear, prune, peach, pineapple, apple; avoid citrus juices, offer fiber rich fruits and veggies (peas, pears, beans broccoli, figs prunes) at least 3x/ day and whole grains (oatmeal, brown rice) regularly, limit dairy intake, and encourage hydration
• Toilet Training and Constipation: 
  
  • If you notice your child withholding stool while toilet training, pause toilet training and follow the above diet modifications
  • It is very common for children to withhold stool while toilet training - avoid pressure and shaming around stooling

Safe Medications

• For children >12 months: 
• Polyethylene glycol (Miralax): Use for constipation with straining

• Glycerin Suppositories: Use when stool is in the rectum but not passing
  
  • Typically works in 10-30 minutes

When to Contact Poppins

📱Contact us when:

• Constipation lasting more than one week without improvement
• Symptoms worsen or new symptoms develop
• No bowel movement for > 96 hours
• Straining and fussiness while attempting a bowel movement
• You're just not sure and need reassurance

When to Visit Your Pediatrician

🩺 Go to an in-person appointment when:

• Constipation lasts more than one month without improvement
• Infants < 3 months with constipation symptoms
• Constipation doesn't improve with diet adjustments and medications

When to Go to the ER

🚨 Seek emergency care immediately for infants < 1 month with inability to pass a stool and concurrent vomiting.

If your gut tells you something is wrong, don't hesitate to reach out. Need help? Reconnect with our on-demand team of medical staff available 24/7.