NICU
Constipation in Infants
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Constipation in Infants
, Constipation in Newborns, Neonatal Constipation
See Also
Constipation in Children
Constipation Causes in Children
Pediatric Constipation Dietary Management
Precautions
Most presentations for "
Constipation
" are not
Constipation
Decreased stool frequency is not
Constipation
(1 stool every 7-10 days)
Crying or altered
Skin Color
ation while stooling in young infants is common and normal
True
Constipation
is uncommon in newborns and requires evaluation
See
Constipation Causes in Infants
Etiology
Functional Causes
Constipation
has functional cause in >95% of infants
More common in formula fed than
Breast
fed infants
Organic causes (most often present as newborns)
Constipation Causes in Infants
Evaluate for
Hirschsprung Disease
if first meconium >24 hours after delivery
Hirschsprung Disease
is an emergency in
Infant with Vomiting
or
Abdominal Distention
Examination
See
Newborn Abdominal Exam
See
Newborn Neurologic Exam
Evaluation
See
Pediatric Constipation
for History and Diagnostics
See
Pediatric Constipation
for Red Flags
Management
Constipation
in under age 1 year
See
Pediatric Constipation Management
Exclude serious organic cause
See
Constipation Causes in Infants
See
Pediatric Constipation
for Red Flags
Initial dietary trial
Fruit juice (e.g. prune juice)
Adequate fluid intake (
Breast Milk
or formula)
Disimpaction: Medications
Glycerin
suppository (preferred)
Polyethylene glycol
(
Miralax
or Golytely)
Enema with
Normal Saline
or
Mineral Oil
(refractory)
Dose: 6 ml/kg up to 135 ml
May repeat every 12-24 hours for 3 doses
Maintenance: Medications
Polyethylene glycol
(
Miralax
)
Lactulose
Sorbitol
(e.g. prune juice)
Maintenance: Dietary Management
Baby under 4 months
Apple, pear, or prune juice one ounce daily to twice daily
Maximize fluid intake (
Breast Milk
or formula)
Baby over 4 months: High fiber strained foods bid
Cereals
Fruits:
Apri
cots, Prunes, Peaches, Pears, Plums
Vegetables: Beans, Peas, Spinach
Avoid constipating fruits
Bananas
Rice
Apples
References
Claudius in Majoewsky (2013) EM:Rap 13(1): 8
Nurko (2014) Am Fam Physician 90(2): 82-90 [PubMed]
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