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Infant becoming stubborn and angry. Has constipation despite taking cremaffin and duphalac. What to do?

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Answered by

Pediatrician, Critical Care
Practicing since : 2001
Answered : 208 Questions
Hi Dr,
My son is 14 months old and we have started noticing some changes in him. He is becoming stubborn and whatever he wants he wants. Basically he started crawling properly since January and now he moves wants to crawl on his own. It's like if we don't put him on floor he starts getting annoyed, angry and cranky. Due to this we have started noticing changes in his nature (stubborn, angry and cranky if we don't listen to him)

We give him all sorts of food and also added fiber food as dr suggested us. He is very much constipated. He passes his stool every 2nd day that also his mother basically make him lie down and helps him to pass stool. As he passes gas we come to know that he wanna pass stool but finds its very difficult to do so and is very cranky till the time he does not passes his stool. His dr told us to give him duphalac 7.5 ml bedtime but was not helpful and then she added another medication called cremaffin 5 ml after breakfast but still not helpful. He still passes stools ever alternate day and is in pain and gets cranky as his stools are very hard.

Posted Sun, 7 Apr 2013 in Child Health
Answered by Dr. Tejas Shah 7 hours later
Good Morning

I will be glad to offer you my suggestions.

Behavioral changes are very common from 1-5 years of age. It is part of normal developmental process. However, the symptoms you've mentioned (i.e. getting angry, being stubborn etc) could be related to multiple factors. His reactions are due to his frustration. He wants to do a particular thing, and if we try to prevent him, he gets frustrated.

Also, this is age when he wants to cruise holding furniture, walk on his own and explore things. He probably would not like to sit at one place.

Have you got another child in the house? Are there elderly people in the house?

Best course of action in this situation would be:
To pay less direct attention when he is getting angry or being stubborn. It is important to keep an indirect eye on him to make sure he is safe enough and not doing any activity which can hurt him. Try to pad furniture with sharp edges or keep them away if that's possible.

For e.g. many infants like to sleep on the floor in anger. If we immediately pay attention to him to pick him up and fulfill his wishes, it will become a habit. He would learn that by acting in that particular way, he would get what he wants.

In this situation, if it is safe, let him lie on the floor. In couple of minutes, if nobody is paying attention or fulfilling his wishes, he would slowly stop that behavior.

Regarding Constipation, I would like to know couple of things to understand the problem better.

1. When did he start having constipation? Is it present since birth?
2. Has he got any vomiting or urine problems?
3. Is he been gaining weight properly?
4. What do you feel about his development so far - for things like sitting, cruising, babbling etc at correct time?
5. When did he pass stool after his birth? Was it within first 48 hours or later?

Please do revert back to me with the answers and will take it forwards.

Dr Tejas Shah
Above answer was peer-reviewed by
Follow-up: Infant becoming stubborn and angry. Has constipation despite taking cremaffin and duphalac. What to do? 2 hours later
Good Morning Dr.

Thank you for your revert back. It's like what we feel is that he wants to play and if we take him to our room he gets enjoyed and cranky and then we are force to allow him to play.
Sometimes like we make him sleep forcibly but he starts crying and doesn't wants to stay in the room and as we take I'm out and keep him on the floor he is ver happy.

Actually we expecting our second baby in may and thus it's becomes difficult for my wife.

He never lies on the floor and throw tantrums. If he cry and we keep him on the floor he is very happy. We wants to crawl across the whole house and wants to play.

No we don't have any other child in our home. My brother and his family just recently visited us and they have a 2 years old son. He is very playful, cheerful but at times very mischievous and stubborn. They stayed with us for 2 months and my son really enjoyed his company.

We stay in joint family. Got my dad, mom, granny and few servants. My servants play with my son and he enjoys their company the most. He is very happy when they playing and never cry, but in case if its late and you take him in the room them he crys.

Regarding constipation

No he never has this problem before. This started just 2 months before
No he does not have any urine or vomiting problem
Yes as per his dr he is gaining weight properly. Last month when he was 13 months his weight was 9.250 kgs.
Regarding his development we find everything to be fine. He was born in 36 weeks and was weighing 2.5 kgs. He likes to watch songs and enjoy dancing on it. Likes to play wit his iPad and watch poetry and songs on it. He know how to shake hands, give flying kiss, say bye bye. He crawls and goes and sit where his toys are placed and play with them.

He was on his mother milk till 9 months and when dr suggested us not to breastfeed him as my wife is pregnant so we switched him on to XXXXXXX lactogen 2. When he completed his 1 year we switched him to lactogen 3. I and my wife were just discussing that we feel is it due to lagtogen? We are not sure but just had a thought. Milk is his weekness. He can't sleep without milk and when he is tired or cranky we give him milk and he settles down, goes to sleep or becomes fresh. We want to shift him to cows milk but we feel that if we travel out and he wants milk then it's gonna be difficult to provide him milk so we prefer using powder milk.

I hope this give you an idea about everything.


Answered by Dr. Tejas Shah 1 hour later
Sorry, I typed and somehow my response got deleted and typing again now.

I feel there is some element of separation anxiety in your son, having enjoyed company of a child of his age for a period of 2 months.

I would request all family members to be consistent in relation to dealing with his tantrum. Good behavior should be rewarded and bad behavior should not be encouraged/paid attention to. If he throws tantrum and it is safe, do not pay any attention for 5-10 minutes. Once his behavior is normal, try to deal with it as if you didn't notice it at all. Patience and Consistency is very essential in this situation.

Crawling around house, wanting to play all the time etc is related to his developmental age when they want to explore the world around them. Try taking him to play outside, may be infant groups and he would feel happy about playing with kids of his age.

Things may get slightly difficult when your wife has baby, because her attention would be diverted away from your son. Either yourself or grand-dad or mum should take increase responsibility in his day-to-day activities like feeding/bathing/playing etc.

Things will settle down, it is matter of time, patience and consistency in adult behavior in dealing with this tantrum.

Regarding his constipation, I hope he has enough water intake. You can try other formula milk (like Nan from Nestle, Nestum rice etc) and see if it works. They all differ slightly in their composition about type of protein and hence one formula may cause constipation and other doesn't. I hope he takes soup/vegetables etc, which are XXXXXXX in fibers. He can also be tried on packaged milk like Amul etc as he may like a different taste as compared to Lactogen and constipation can get better.

You can try anti-colic medications for worrisome abdominal pain.

As he is gaining weight adequately, there does not seem to be anything serious medical issue.

Once you've tried different milk formula or packaged milk, continuing with current anti-constipation medications -- if things don't improve, you need to seek opinion from Pediatric Surgeon.

Wishing you all the best for the baby and hope things settle down with your son.

Please don't hesitate to come back to me if you have any further queries.

Dr Tejas Shah

Above answer was peer-reviewed by
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