To rightly discuss the treatment of constipation, it is important to familiarize the reader with the varying frequency and consistency of bowel movements as the child increases in age. At the first week of life, you can expect about 4 or more bowel movements daily. At 4 months of age through the period of weaning, expect 2 or more bowel movements daily. When diet assumes a more adult pattern or at about 2 years of age, bowel movements are usually once daily. At this point, the stools are more formed. In an older child, bowel movements vary from one movement after each meal to once every other day.

Constipation is suspected when there is a change in the frequency that is usual for the child. This can appear as change in consistency such as harder or bulkier than is usual for the child. It can also present itself as discomfort associated with the effort to move the bowel, stool withholding behavior, or the occasional soiling of the undergarments due to loss of control of the bowel.

Intervention / Common Home Remedies

Find palatable ways of presenting vegetables, fruits, cereals, and fiber rich foods to children. Increase fluid intake to a minimum of 32 ounces daily (about 950 ml) for the toddler.

It is best to avoid or decrease consumption of dairy products. Try encouraging the use of the toilet after meals and discouraging the tendency to rush out of the bathroom. If toilet training is in process, it can be suspended for a little while until constipation is under control.

Call the office for utgent consultation / Same day assessment if

• Infant is younger than 4 months
• The recommended steps above have not been extremely helpful
• If bleeding occurs or discomfort is severe