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Diet modification for an infant with constipation - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Constipation
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
User :   Hello,I have an inquiry for a pediatric doctor. My 16 month old, over the past week, has had small, sticky stools for the last week, as if a larger stool is coming out in bits instead of all at once. He strains each time and there is very little produced. This morning I found a medium sized stool in his diaper that had dry white chunks in it and his diaper had white powdery-like marks on it. I do not use baby powder and there is nothing he has eaten out of the ordinary with the exception of increased cow's milk. He was sensitive to dairy and I have been introducing it gradually, using mainly goat's milk. This past week I've used only cow's milk. Could this be an intestinal allergic reaction to the increased cow's milk, or is it something else? I am looking for a succinct answer before I take him to his doctor. Please advise.
Doctor :   Hi
Doctor :   yes, I am
User :   Great, I'll wait for you to read my query.
User :   Some additional information: he is still nursing.
Doctor :   can you let me know if he is feeding well ?
Doctor :   or having any symptoms like irritability, vomiting, ?
User :   He is nursing with the same gusto, but he is not eating as much solid food as he was over the past month. He is a "picky" eater, and has been refusing to eat unless he attempts to feed himself, and therefore doesn't eat as much as when I was able to feed him. For instance, I would be able to feed him about 6 tablespoons of cream of wheat in the morning, but lately he has only had about 2 tablespoons. It is the same with all meals. Some nights all he will eat is more cream of wheat, and not much.
User :   He has been irritable occasionally. He is also teething (has no teeth yet). But, no vomiting.
Doctor :   does he drink any fluids , fruit juices, and soups ?
User :   He prefers water, and I have been giving him Smart Water in a bottle or sippy cup, which he will drink about 2.5 fl oz at at time, about 3 times a day. He does not drink much juice, though I do offer it to him. He prefers apple-white grape juice. He won't drink much orange juice. He will eat soup but mainly the chunks, like carrots.
Doctor :   ok
Doctor :   it seems that all his symptoms could be due to reduced fluid intake
User :   Yesterday he was very irritable.
User :   How should I increase his desire to drink more fluids? Which fluids do you suggest?
Doctor :   constipation and hard stools can cause abdominal pain
Doctor :   and pain on defecation
User :   Yes, he has pain on defecation.
Doctor :   so he will have to be fed soups and more juices
Doctor :   he will have to be rewarded when he drinks in the form of more playtime or emotionallly
User :   Ok, I can do that...can you suggest the kind of soup and the type of juice that would be best for him?
Doctor :   chicken broth soup, vegetable soup, and any fruit juice will help
Doctor :   there is no specific juice that is needed
User :   Great, I'll prepare those. When should he expect relief once started?
Doctor :   within a weeks time, his constipation should improve
User :   Wonderful. Anything else I should keep an eye out for based on his symptoms?
Doctor :   make sure he does not have any pain when defecation
Doctor :   if he cries out , then he might have any impacted stools
User :   What then if he has impacted stools?
Doctor :   he might need finger evacuation with the little finger
User :   Ok. Hopefully it will not get to that point.
Doctor :   yes
Doctor :   it was just a point to me mentioned
User :   absolutely. How do I do that?
Doctor :   use the little finger to mobilose the stools that are impacted

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