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.
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