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Infant with chronic constipation and acid reflux. Need help on diet

Hello, my 11 month old has chronic issues with stomach/gas/ constipation . As a baby he was breastfed exclusively and never had regular bowel movements. He was often stiff, cried often, refused to eat and when he did have a Nm it was thick like peanut butter. He has also struggled with bad reflux/spit up. Recently his constipation has gotten so bad we have ended up in the er where he had an enema and was prescribed lactulose (unsuccessful) do then restoralax. He has been pooping much better the last few days but has started throwing up and has major flatulence with a really bad smell. He is no longer breastfed and I feed him lots of fibre foods, low iron formula, diluted apple juice. Any advice? I don t seem to be getting anywhere here...
Asked On : Mon, 5 Nov 2012
Answers:  1 Views:  103
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Pediatrician, Neonatology 's  Response
It seems that your child has some underlying chronic problems.

Please check the following general steps -
1. Let your child drink a lot of fluid / water. Dehydration can cause constipation in many cases.
2. Maintain a good bowel habit. Let your child a lot of time in toilet if he is not passing stool. Retained stool get dried and hardened. It is more difficult and painful to pass a hard stool. The child try to retain that, which actually cause more constipation. Thus the vicious cycle goes on.
3. Decrease the milk (and milk products) from his diet.
4. Please check the defecation posture. Natural defecation posture is squatting. Get your child habituated to defecating in squatting posture, if he is not already doing it. Posture is an established cause behind primary constipation.
5. Give him fiber rich diet (I know you do), and remove Fiber less foods (like banana, milk and dairy products, refined cereals, white bread etc).

If the constipation still persists after the above general measures, please get your son thoroughly examined by pediatrician. The causes could be -

1. Hirschsprung's disease - is most commonly associated cause. The improper movement of muscle in intestine is the cause behind it.
2. Hypothyroidism - Low thyroid hormone slows down the muscle activity in intestine.
3. Cystic fibrosis
4. Coeliac disease.

Hence, I would suggest you to visit a pediatrician as I hope the general steps are already done.(If not, please follow these).

Please post if you have more queries.
Answered: Fri, 9 Nov 2012
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