How to manage constipation in an 11-month-old infant?

Managing Constipation in an 11-Month-Old Infant

For an 11-month-old with constipation, increase fluid intake, consider fruit juices containing sorbitol (like prune, pear, or apple juice), and ensure adequate dietary fiber through age-appropriate foods. 1

First-Line Interventions

• Increase fluid intake to help soften stools and improve bowel movements 1
• For infants still on formula, continue full-strength formula feeding; if using lactose-containing formula and true lactose intolerance is suspected, consider temporary switch to lactose-free formula 1
• For breastfed infants, continue breastfeeding on demand as this should not be discontinued 2
• Introduce fruit juices containing sorbitol and other carbohydrates that can help increase stool frequency and water content:
  • Prune juice, pear juice, or apple juice in small amounts (10 mL/kg body weight) 1
  • Limit juice to small therapeutic amounts as excessive juice consumption can cause other gastrointestinal issues 1

Dietary Modifications

• If the infant is eating solid foods, increase dietary fiber through:
  • Age-appropriate fruits (especially those containing sorbitol like prunes, pears, and apples) 1
  • Vegetables and whole grains as tolerated 3
• Avoid foods high in simple sugars and fats, which can worsen constipation 1
• Ensure the diet provides adequate energy and nutrient requirements while addressing constipation 1

When to Consider Medication

• If dietary measures are insufficient, consider:
  • Glycerin suppository for immediate relief 1
  • For persistent constipation, osmotic laxatives like polyethylene glycol may be considered under medical supervision 4

Important Considerations

• Rule out organic causes of constipation before assuming functional constipation, especially if there are red flags such as delayed passage of meconium, failure to thrive, or abnormal physical examination findings 4
• Constipation in infants may lead to complications including anal fissures, which can create a painful cycle of stool withholding 5
• Avoid prolonged use of stimulant laxatives in infants without medical supervision 1
• For formula-fed infants with persistent constipation, formulas enriched with high β-palmitate and increased magnesium content may be considered to soften stools 2

Follow-up and Monitoring

• Monitor for adequate stool frequency (goal is one non-forced bowel movement every 1-2 days) 1
• Assess for signs of discomfort, straining, or hard stools 4
• If constipation persists despite these measures, or if there are concerns about growth or development, consult with a pediatrician for further evaluation 5

Remember that functional constipation is common in infants and typically responds well to dietary interventions, but persistent problems warrant medical evaluation to rule out underlying conditions 4, 6.