From the Guidelines
For a 1-month-old infant with constipation, the most effective treatment is to ensure proper hydration by offering additional breast milk or formula, and consider the use of prune juice, as recommended by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1. When treating constipation in a 1-month-old infant, it is essential to prioritize methods that are safe and gentle.
Initial Steps
- Ensure proper hydration by offering additional breast milk or formula, as dehydration can exacerbate constipation.
- If the baby is formula-fed, check that the formula is being prepared correctly, as improper mixing can cause constipation.
- Gentle belly massage in a clockwise direction and moving the baby's legs in a bicycling motion can help stimulate bowel movements.
- A warm bath may also relax the abdominal muscles.
Medical Intervention
- For immediate relief, you can try a glycerin suppository specifically made for infants (cut in half for a 1-month-old), but use this only occasionally 1.
- Consider the use of prune juice, as it contains sorbitol and other carbohydrates that can help increase the frequency and water content of stools, as suggested by the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1.
Important Considerations
- Do not give any oral laxatives, fiber supplements, or adult constipation remedies without pediatrician approval.
- If the baby seems uncomfortable, a rectal temperature check can sometimes stimulate a bowel movement.
- It's crucial to understand that infant bowel patterns vary widely - some breastfed babies may go several days without a bowel movement yet not be constipated.
- Signs of true constipation include hard, dry stools, straining, and discomfort.
- Contact your pediatrician if constipation persists beyond a few days, if there's blood in the stool, if the baby refuses feeding, or shows signs of distress.
From the FDA Drug Label
Pediatric: ...the recommended initial daily oral dose in infants is 2. 5 mL to 10 mL in divided doses. For a 1-month-old infant with constipation, the treatment is lactulose with a recommended initial daily oral dose of 2.5 mL to 10 mL in divided doses 2.
- The dose may need to be adjusted to produce 2 or 3 soft stools daily.
- If the initial dose causes diarrhea, the dose should be reduced immediately.
- If diarrhea persists, lactulose should be discontinued.
From the Research
Treatment for Constipation in Infants
- For infants under 6 months, lactulose/lactitol-based medications are authorized and effective 3
- For infants over 6 months, polyethylene-glycol (PEG) can be used 3, 4
- Treatment options may include disimpaction using oral or rectal medication, followed by a maintenance program 5, 6
- Education of the family and, when possible, the child is instrumental in improving functional constipation 6
Considerations for 1-Month-Old Infants
- At 1 month old, infants are likely to require lactulose/lactitol-based medications if treatment is necessary 3
- It is essential to rule out any underlying organic causes of constipation, such as Hirschsprung's disease, through a thorough history and physical examination 7, 5, 6
- Parents should be reassured that although this disorder is not life-threatening, several months to years of supportive intervention may be required for effective treatment 5