Management of constipation in infants

Normal bowel habits in infants can vary significantly from one stool in 10 days to 10 stools per day. Constipation frequently occurs during the introduction of solid foodsThe Royal Children's Hospital Melbourne (RCH), 2020. Treatment for nonpainful stools without blood in thriving infants is not warranted.

In infants with constipation, seek advice from a paediatrician or paediatric gastroenterologist if:

  • the infant is not thriving
  • there is a delay in the passage of meconium for longer than 48 hours
  • blood or mucus is present in the stools
  • the abdomen is distended
  • perianal or lower spine examination is abnormal.

For the management of constipation in neonates, a suitable regimen is:

poloxamer 10% liquid 0.3 mL orally, three times daily. Can be mixed with formula or fruit juice. poloxamer

For the management of constipation in infants older than 1 month, suitable regimens include:

1lactulose 2.5 mL orally, twice daily. If needed, mix with other drinks to improve taste lactulose

OR

1macrogol 3350; for example: macrogol 3350

Movicol Junior (6.563 g per sachet, with electrolytes) half a sachet in 30 mL or 1 sachet in 60 mL of water orally, daily

OR

1poloxamer 10% liquid poloxamer

child younger than 6 months: 0.3 mL orally, three times daily

child 6 to 12 months: 0.5 mL orally, three times daily.

For infants who do not respond to oral laxative therapy, rectal therapy using a single dose of a glycerol suppository may be required.