From the Guidelines
The best treatment for constipation in a 16-month-old child is to start by increasing the child's water intake and adding more fiber-rich foods to their diet, such as fruits (especially prunes, pears, and apples), vegetables, and whole grains, as recommended by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1.
To manage constipation in a 16-month-old, consider the following steps:
- Increase water intake to help soften stools and make them easier to pass.
- Add fiber-rich foods to the diet, such as fruits (especially prunes, pears, and apples), vegetables, and whole grains, which can help increase the frequency and water content of stools.
- Limit constipating foods like bananas, rice, applesauce, and dairy products.
- If dietary changes aren't sufficient, over-the-counter options like small amounts of prune or pear juice (2-4 ounces daily) can help, as they contain sorbitol and other carbohydrates that can increase the frequency and water content of stools 1.
- For more persistent constipation, a mild osmotic laxative such as Miralax (polyethylene glycol 3350) might be recommended by a pediatrician, typically starting at 1/2 to 1 teaspoon daily mixed in 4-8 ounces of liquid.
- Regular physical activity also promotes bowel movements and can help prevent constipation.
It's essential to monitor the child's condition and consult a pediatrician if constipation persists beyond two weeks, is accompanied by pain, blood in stool, vomiting, or weight loss, as these may indicate a more serious condition requiring medical attention 1.
From the FDA Drug Label
Use • relieves occasional constipation (irregularity) • generally produces a bowel movement in 1 to 3 days The best treatment for constipation in a 16-month-old child is polyethylene glycol (PO), as it relieves occasional constipation and generally produces a bowel movement in 1 to 3 days 2.
- Key points:
- Relieves constipation
- Produces a bowel movement in 1 to 3 days However, it is essential to consult a pediatrician before administering any medication to a child.
From the Research
Treatment Options for Constipation in 16-Month-Old Children
- Polyethylene glycol (PEG) is considered a safe and effective treatment for constipation in children younger than 18 months, with a mean effective maintenance dose of 0.78 g/kg/day 3.
- Non-pharmacological treatment involves education, demystification, lifestyle advice, and toilet training, while pharmacological treatment consists of disimpaction, maintenance treatment, and eventually weaning if possible 4.
- For children with functional constipation, management includes education and demystification, disimpaction followed by maintenance therapy with oral laxatives, dietary counselling, and toilet training 5.
Pharmacological Treatment
- Polyethylene glycol is considered as the first choice of laxative for both disimpaction and maintenance treatment 4, 6.
- Osmotic laxatives, such as polyethylene glycol, produce the best results for constipation in children 7.
- Stimulant laxatives, lubricants, and enemas are available as alternative pharmacological treatment options 4.
Considerations for Treatment
- Children with functional constipation need a thorough history and physical exam to rule out the presence of any 'red flags' but do not require laboratory investigations 5.
- Treatment options differ between infants and children, and disimpaction and maintenance regimens for common laxatives should be considered 5.