Constipation

Constipation

Constipation is described as the infrequent passage of dry, hardened stools. The child may experience some pain when they need to empty their bowels.

Babies

The frequency of stools differs between babies, whether breast or bottle-fed:- some pass several motions a day or after every feed, others may pass only one, or none at all on some days. It‘s not necessarily the frequency but the type of motion that is important.

Causes of constipation in babies

There are a range of common causes that include the following:

Too little fluid intake (particularly in warm environments. e.g. centrally heated houses)
Over concentrated formula feeds.
Medical gastrointestinal problems.
Any change in the diet, e.g. moving from a ‘milk only’ diet to solids can change defaecation patterns.

Tips for Babies

If the baby has not started weaning, make sure they are getting enough fluids. Mothers can give water, but remember water should be boiled and cooled until at least 6 months of age
(Solely breast fed babies normally don’t need additional fluids until they have commenced weaning.)

Total daily recommended fluid intake for infants per kg of body weight^†

Age                   ml/kg
0-3 months        150
4-6 months        130
7-9 months        120
10-12 months    110
1-3 years            95

^†Shaw V and Lawson M. Clinical Paediatric Dietetics. Second edition. Blackwell Science, 2001

Make sure the mother is preparing bottle feeds according to manufacturers instructions, ensuring nothing extra is added to the feed.

If weaning has already begun, pureed fruits and vegetables such as apples, apricots, bananas and prunes can also help.

Toddlers

When toddlers are constipated they are likely to have hard, small, pellet-like stools, straining and very infrequent bowel movements. If a toddler has not had a bowel movement for more than 3 days, he may be constipated. Constipation in toddlers usually lasts for just a few days but may sometimes be a long-term problem.

Causes in toddlers

There is a range of common causes that include the following:

A high intake of protein and fat.
Not drinking enough fluids.
Being inactive.
The child being anxious or nervous when straining.
Not going to the toilet when needed.

Tips for Toddlers

Toddlers should be taught good toilet habits, in particular going when needed.

Encourage the toddler to be active during the day.

Include some high-fibre foods (whole-grain cereals, wholemeal bread, fruit & vegetables) as part of a balanced diet. However, its not advisable to give only wholegrain foods, as they are filling and could lead to a deficiency in calorie intake.

Make sure toddlers drink lots of fluids every day. The recommended fluid intake for a child between 1-3 years is 95 ml/kg per day.

Ensure the toddler eats regular meals to help improve his bowel movements – at least three main meals a day with drinks and snacks in between.

If mothers are concerned about their child’s bowel movements or if the constipation persists, encourage them to speak to their health professional. Laxatives should never be used without medical advice.

IMPORTANT NOTICE: Breast feeding is best for babies. Infant milks are intended to replace breast milk when mothers do not breast feed. Good maternal nutrition is important for the preparation and maintenance of breast feeding. Introducing partial bottle feeding may have a negative effect on breast feeding and reversing a decision not to breast feed is difficult. You should always seek the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist on the need for and proper method of use of infant milks and on all matters of infant feeding. Infant milk should always be prepared and used as directed. Unnecessary or improper use of infant milk may present a health hazard. Social and financial implications should be considered when selecting a method of infant feeding.

This information is intended for use only by residents of the UK and ROI