1. BOWEL TRAINING:
Sit on the toilet for 10 minutes after a meal with a glass of water. Pick a time of day when the household is not in the “Rush Mode”. Do not insist that the patient has a bowel movement; this is a time to allow the body to relax. If this sitting time is done every day for 1 week, eventually the bowels will be conditioned to relax and pass a stool at that time.
2. DIET for Infants < 1yr of age:
· Infants >1mo of age who are fed breast milk or formula exclusively: add fruit juices* – 1oz./month of age/day.
· Infants >4mo of age: add baby foods with high fiber content 2 times/day, (see food list below).
*Prune, apple and pear juices are beneficial to give because they contain carbohydrates which are poorly absorbed by the body, causing soft stool.
3. DIET for Children >1yr of age:
· Increase fruit juice (apple, pear, prune, cherry grape); citrus juices are usually not very helpful.
· Add fruits,vegetables and whole grain foods which are high in fiber content (see food list below).
· Decrease milk products to 3 servings/day
· Increase water consumption
4. FIBER REQUIREMENTS per age per day:
· 2 -3 yrs = 19 grams
· 4 – 8 yrs = 25 grams
· 9 – 11 yrs: female = 26 grams; male = 31 grams
5. FIBER FOOD SOURCES (if age appropriate):
Other Raw Vegetables
Popcorn (>4yrs of age)
Whole wheat bread
6. Foods to decrease:
MEDICATIONS FOR CONSTIPATION:
Over The Counter:
CITRUCEL (Bulk forming fiber laxative)
Promotes elimination by providing additional bulk (fiber) to the diet. The patient will usually have a bowel movement in 12-72 hours. Your child must have a good liquid intake.
Dose: 1 tsp-1 Tbsp 1-3 times a day as directed by your physician.
Dose: 1 capful in 8 ounce beverage 2-3 times a day over a weekend until fecal excretion is clear. Miralax usually works within a few days. Typical maintenance dosing is 1 capful/8 ounces of any beverage once/day, though the amount may be adjusted to produce a soft stool every day.
Pediatric Nutrition Handbook. 6th edition, AAP, 2009
Instructions for Pediatric Patients. 2nd edition, Dr. Barton Schmitt, 1999