From the Guidelines
Water is okay for constipated infants, but it should not be the primary solution, and parents should consult with their pediatrician for appropriate advice. For constipated infants, especially those under 6 months of age, water is not typically recommended as the first line of treatment, but it can be used in small amounts to help with hydration 1. According to the American Academy of Pediatrics, human milk and/or infant formula is sufficient for infants to satisfy fluid requirements, and low-fat/nonfat milk and water are sufficient for older children 1.
When considering treatment for constipation in infants, it's essential to prioritize their nutritional and hydration needs. The American Academy of Pediatrics recommends that juice should not be introduced into the diet of infants before 12 months of age unless clinically indicated 1. However, for constipated infants over 4 months, small amounts of apple, pear, or prune juice (1-2 ounces) may be considered, or parents can speak with their pediatrician about glycerin suppositories or infant-specific laxatives if needed.
Some key points to consider when dealing with constipated infants include:
- Breastfed babies may benefit from more frequent nursing to help with constipation
- Formula-fed infants might benefit from trying a different formula after consulting with their doctor
- Constipation in infants is often temporary and related to dietary changes, but persistent issues warrant medical attention
- Excessive juice consumption can be associated with malnutrition, diarrhea, and other health issues, so it's crucial to follow the recommended guidelines 1.
It's also important to note that water alone may not be effective in treating constipation in infants, as it does not address the underlying issue of stool consistency. Therefore, parents should consult with their pediatrician to determine the best course of treatment for their constipated infant.
From the Research
Constipation in Infants
- Constipation is a common problem in infants and children, with approximately 95% of cases being functional in nature without any obvious cause 2.
- Factors that promote constipation include reduced physical activity and inadequate dietary intake of fibers, carbohydrates, and fluids 3.
Role of Water in Constipation
- Fluid losses and fluid restriction can increase constipation, making it important to maintain euhydration as a prevention of constipation 3.
- Increasing water intake may be effective in improving constipation in children, especially when voluntary fluid consumption is lower-than-normal for the child's age and activity level 3.
- Hyperosmotic mineral water is not a recommended treatment for established constipation in infants and children 4.
Treatment of Constipation in Infants
- Treatment of functional constipation in infants involves disimpaction using oral or rectal medication, followed by a maintenance program that may include medications such as lactulose, polyethylene glycol powder, and sorbitol 5, 4.
- Education of the family and the child is instrumental in improving functional constipation, and adding fiber to the diet may also improve constipation 5.
- Lactulose/lactitol-based medications are authorized and effective for infants under 6 months, while polyethylene-glycol is recommended for infants over 6 months 4.