From the Guidelines
For a 1-month and 10-day-old female infant with constipation, the best initial treatment is to ensure adequate hydration and consider dietary adjustments, with small amounts of prune juice (1-2 ounces) being a recommended option to help soften stools, as suggested by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1.
Key Considerations
- Ensure adequate hydration, as this is crucial for preventing constipation in infants.
- For breastfed infants, continue breastfeeding as normal, as breast milk is easily digestible.
- For formula-fed babies, try switching to a different formula or ensuring proper preparation to rule out any formula-related issues.
- Small amounts of prune juice can be offered once daily to help soften stools, due to its sorbitol content, which can increase the frequency and water content of stools 1.
- Gentle belly massage in a clockwise direction and bicycle leg movements can help stimulate bowel movements.
Additional Measures
- A glycerin suppository may be used occasionally for immediate relief, but should not be used regularly.
- Rectal stimulation with a thermometer tip lubricated with petroleum jelly can sometimes trigger a bowel movement in very young infants.
- Medications like lactulose or polyethylene glycol are rarely needed at this age and should only be used under medical supervision.
Important Notes
- Constipation in very young infants is often temporary and related to developing digestive systems.
- Persistent constipation, especially with symptoms like vomiting, abdominal distension, or blood in stool, requires prompt medical evaluation to rule out more serious conditions.
- The use of fruit juice, such as prune juice, should be done in moderation and as part of a comprehensive approach to managing constipation in infants, as recommended by the Dietary Guidelines for Americans and the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition 1.
From the FDA Drug Label
Lactulose for Oral Solution is indicated for the treatment of constipation. In patients with a history of chronic constipation, lactulose therapy increases the number of bowel movements per day and the number of days on which bowel movements occur. The best treatment for a 1-month and 10-day-old female infant with constipation is lactulose.
- Key points:
- Lactulose is indicated for the treatment of constipation.
- It increases the number of bowel movements per day and the number of days on which bowel movements occur. 2
From the Research
Treatment Options for Constipation in Infants
For a 1-month and 10-day-old female infant with constipation, the following treatment options can be considered:
- Education of the family about constipation and its management 3
- Fecal disimpaction, if necessary 3
- Long-term maintenance therapy with laxatives, such as magnesium hydroxide, lactulose, or polyethylene glycol 3350 3, 4
- Behavioral modification, including dietary changes and increased fluid intake 3, 5, 6
Importance of Fluid Intake
Maintaining adequate fluid intake is crucial in preventing and managing constipation in infants 5.
- Increasing water consumption can help improve constipation, especially if the infant's voluntary fluid consumption is lower than normal 5
- Fluid intake and magnesium sulphate-rich mineral waters may also help improve constipation in healthy infants 5
Guidelines for Management
The North American Society for Pediatric Gastroenterology and Nutrition has formulated clinical practice guidelines for the management of pediatric constipation, including infants less than 1 year of age 7.