Constipation in infants

Constipation is an abnormal pattern of bowel movements in which stools are passed less frequently than usual and are often harder than usual. Everyone has a different normal pattern. For example, some children have bowel movements only once every 2-4 days. It is normal for breast-fed babies to have large, soft bowel movements without pain up to 7 days apart. Others have bowel movements 2-4 times daily. However, a child is constipated whenever his/her pattern slows down noticeably.

Causes
Very rarely, disease causes constipation. In this case the problem usually begins in the early weeks of life. In most children, there is no disease but once constipation begins, it tends to continue. Some of the factors that may contribute to the onset of constipation are:

1. Formula.
Babies who breastfeed exclusively are rarely constipated. If your baby is on formula, it's possible that something in her formula is making her constipated. Ask your baby's doctor about switching brands.

2. The introduction of solids.
Don't be surprised if your baby becomes mildly constipated as she steps up to solid food. That's often because rice cereal, usually the first food given during this transition period, is low in fiber.

3. Dehydration.
If your baby isn't getting enough fluid, she'll become dehydrated and her system will respond by absorbing more fluid from whatever she eats or drinks — and from the waste in her bowels, as well. The result is hard, dry bowel movements that are difficult to pass.

Prevention
1. Make sure that your child's diet contains adequate fluids and high-fibre foods that act as natural laxatives (Fruit juices, fruits, particularly prunes, vegetables and salads, cereals).

2. If over 2 months old, give diluted fruit juices, such as prune juice twice a day.

3. If over 4 months old, add strained foods with high fibre content, such as cereals, apricots, prunes, peaches, pears, plums, beans, peas, or spinach twice daily.

4. Decrease consumption of constipating foods, such as milk, ice cream, cheese and cooked carrots.

5. Do not give your baby an enema or suppository (medicine in the rectum) unless advised by your doctor.

6. When your child is old enough (about 2 to 3 years old) help him/her establish regular bowel habits. Have your child spend a few minutes on the toilet or the "potty" once or twice daily immediately after meals. The position should be comfortable with knees up. For a small child using the toilet a footrest will be necessary so the legs don't hang down and the knees are up in a crouched position. Such a position eases bowel movement.

Sources:
1. Baby Center
2. NUH Kids