Constipation
Posted on Aug 3, 2009 Symptoms of constipation include pain or crying during a bowel movement, straining or pushing longer than 10 minutes, or 3 or more days without a bowel movement. Causes can include high milk or cheese diet, low fiber diet, stool holding, or slow gastrointestinal transit time (which is a genetic condition). It can be normal for young infants to strain or grunt and ther face may become red while pushing during a bowel movement. Large BMs can be normal and is related to the amount of food consumed and may not indicate consipation. Hard or dry BMs can be normal if passed easily without straining and increasing fiber in the diet can help soften stools. Once children are on a regular diet after age 1, the normal range for BM frequency is 3 times per day to once every two days. Treatment in children over age 1 is to increase fiber in the diet by including more fruits and vegetables. Also increase whole grain foods such as bran flakes, bran muffins, oatmeal, graham crackers, brown rice and whole wheat bread. Popcorn can be tried if the child is older than 4 years old. Be aware that bananas and applesauce can be constipating. Encourage a regular bowel pattern by sitting the child on the toilet for 10 minutes after meals, especially breakfast. You can have your child sit in warm water to help them relax their bottom. Babies can be helped by holding the knees against the chest to stimulate squatting. You should call our office if constipation continues after making the recommended dietary changes, your child becomes worse, your child is having abdominal pain, your child is vomiting, blood is present in or on the stool, your child is acting weak, or if there is significant bleeding from a anal tear. Note that it is normal for infants who are breastfed and are older than one month of age to begin to have infrequent BMs every 4-7 days.
SOURCE PEDIATRIC TELEPHONE PROTOCOLS/ SCHMITT 12TH EDITION
