Constipation Consultation - The Singing Pediatrician
Constipation Consultation Explanation and Explication
A few handy tips from an actual pediatrician for your infant or toddler who may (or may not) have constipation. Please share with your friends and get ready for some loose stools!
There were a lot of words in that song (click here if you’d like to see the lyrics). Here are some additional thoughts. . .
Babies
Breastfed babies can go 7-10 days without a stool, formula fed babies up to 5-7 days. They can turn red and strain to poop – but that’s usually just because they’re learning how to open their bottom and squeeze their tummy to poop. It’s not that easy if you’ve never done it before! The poop can also come in all kinds of colors – brown, green, yellow or some combination of the three. Anyway, if the poop is not hard, it’s not constipation!
If it is hard, I recommend trying 2-4 ounces of pure fruit juice (not diluted) per day to try to soften the stool. The undigested sugars in the juice help water get absorbed into the stool to soften it. Consider the juice a medicine – in general kids should drink minimal amounts of juice. It has lots of sugar, but minimal nutritional benefit. Older infants can also try pureed fruits – like prunes or pears – to soften the stools.
Some people use dark Karo syrup for this same purpose – that’s controversial (both due to a theoretical safety risk and questions about its effectiveness). I’m not going to suggest a dose of that though, because it’s not something I generally recommend.
If the juice doesn’t work, see your doctor – they can try some Miralax or Lactulose (they work similarly – undigested substances from the medicine draw water into the stool to soften it – side effects are usually limited to gassiness as none of the medicine should actually be absorbed).
Older Kids
They should poop at least every 1-2 days and have soft stools every time. The first thing I’d try with a kid who is having hard stools, straining or stooling less than every 2-3 days would be increasing the fiber in the diet. Here is a list of fiber containing foods – many similar lists are on the internet. Over the counter fiber supplements such as Metamucil, Benefiber or Citrucel can also be helpful if dietary modification isn’t enough (you could also try the fiber gummies if you’d like – yum?). Make sure that they are not having more than around 18-24 ounces of milk per day (around 3 cups). Excessive dairy intake can result in constipation as well.
If your child remains constipated despite an appropriate dairy and fiber intake, that’s when you should probably talk to your doctor about laxatives. Besides Miralax and Lactulose (my go-to solutions), other interventions that can be effective include mineral oil, flax seed oil, sorbitol syrup and milk of magnesia. Beware – if allowed to become chronic, constipation can take weeks to months of treatment to retrain the bowels to stool normally – so if your child has problems with constipation, I’d start working on a solution as soon as you can!
Below are the lyrics and chords for your next campground sing-a-long!
Chorus:
C F
before you call the ambulance
G Am
please give me a chance
F Am
to tell you what to do
F E
for your baby's number two
Verse 1:
Am F
constipation simply means
G E
poop like rocks or little beans
Am F
if it's not hard like a brick
G
it's not constipation
If he strains, don't you pout,
he's just learning to get it out
it's hard to poop while lying down!
it's not constipation
F G
some kids poop with every feed
E Am
others go just once a week
F G
be happy that the diaper's clean
E
it's still not constipation
Verse 2:
doc, you say, that's well and good
but Sally's stools are blocks of wood
what can I to smooth things out
with constipation?
a few ounces of pure fruit juice
may be the thing to get it loose
miralax or lactulose can cause a blowout
infants can try fruit puree
toddlers, fiber every day
but keep the milk to a cup a meal
and eat your veggies