Gastroenterology Book

Constipation

http://www.fpnotebook.com/

Constipation in InfantsAka: Constipation in Newborns, Neonatal Constipation

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  1. See Also
    1. Constipation in Children
    2. Constipation Causes in Children
    3. Pediatric Constipation Dietary Management
  2. Etiology
    1. Functional Causes
      1. Constipation has functional cause in >95% of infants
      2. More common in formula fed than breast fed infants
    2. Organic causes (most often present as newborns)
      1. Constipation Causes in Infants
  3. Examination
    1. See Newborn Abdominal Exam
    2. See Newborn Neurologic Exam
  4. Evaluation
    1. See Pediatric Constipation for History and Diagnostics
    2. See Pediatric Constipation for Red Flags
  5. Management: Constipation in under age 1 year
    1. Disimpaction
      1. Glycerin suppository (preferred)
      2. Enema with normal saline or Mineral Oil (refractory)
        1. Dose: 6 ml/kg up to 135 ml
        2. May repeat every 12-24 hours for 3 doses
    2. Maintenance: Dietary Management
      1. Baby under 4 months
        1. Apple, pear, or prune juice one ounce daily to bid
        2. Maximize fluid intake (breast milk or formula)
      2. Baby over 4 months: High fiber strained foods bid
        1. Cereals
        2. Fruits: Apricots, Prunes, Peaches, Pears, Plums
        3. Vegetables: Beans, Peas, Spinach
      3. Avoid constipating fruits
        1. Bananas
        2. Rice
        3. Apples

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