From the Guidelines
For an 11-month-old infant with constipation, the most effective treatment is to offer small amounts of diluted prune or apple juice (1-2 ounces) to help soften stools, as recommended by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1. This approach takes advantage of the sorbitol and other carbohydrates contained in some juices, such as prune, pear, and apple juices, to help increase the frequency and water content of stools. In addition to juice, increasing fluid intake, especially water, and offering high-fiber foods like pureed prunes, pears, or peaches can also help alleviate constipation. Ensuring the baby is getting adequate physical activity by encouraging crawling or assisted walking is also beneficial. For immediate relief, a warm bath to relax the abdominal muscles or gentle tummy massage in a clockwise direction can be tried. If these measures don't work within a day or two, consulting a pediatrician is recommended, as they may suggest an infant glycerin suppository (not for regular use) or Pedia-Lax liquid glycerin suppositories. It's essential to note that constipation in babies often occurs during diet transitions, especially when introducing solid foods or cow's milk, as their digestive systems are still developing, and pediatricians play a central role in guiding parents on healthy dietary choices, including the appropriate use of fruit juice 1.
From the FDA Drug Label
Pediatric: ...the recommended initial daily oral dose in infants is 2. 5 mL to 10 mL in divided doses. As with adults, the subjective goal in proper treatment is to produce 2 or 3 soft stools daily. The treatment for constipation in an 11-month-old infant is lactulose (PO) with a recommended initial daily oral dose of 2.5 mL to 10 mL in divided doses. The goal is to produce 2 or 3 soft stools daily 2.
From the Research
Treatment for Constipation in Infants
The treatment for constipation in an 11-month-old infant is primarily focused on relieving the constipation and preventing future episodes.
- For infants over 6 months, polyethylene glycol (PEG) is an effective treatment option 3, 4, 5, 6.
- Lactulose/lactitol-based medications are also authorized and effective for infants under 6 months, but for an 11-month-old, PEG would be more suitable 3.
- In cases of fecal impaction, a high dose of PEG or repeated phosphate enemas may be used for fecal disimpaction 3.
- Dietary changes and education on bowel habits are also important components of treatment 3, 5, 6, 7.
- Maintenance medications, such as PEG powder, may be required for several months to prevent relapse 5.
- It is essential to rule out any underlying organic causes of constipation, such as Hirschsprung's disease or hypothyroidism, before initiating treatment 5, 6.