Treatment Options for Infant Constipation

Dietary Interventions

• Fruit juices containing sorbitol, such as prune, pear, and apple juices, can help increase stool frequency and water content in infants with constipation, as recommended by the American Academy of Pediatrics 1, 2
• For breastfed infants with constipation, the American Academy of Family Physicians recommends continuing breastfeeding on demand while potentially implementing a maternal exclusion diet, restricting milk and eggs, for 2-4 weeks 3
• For formula-fed infants, the Centers for Disease Control and Prevention suggests considering switching to lactose-free or lactose-reduced formulas if symptoms persist 4, 5
• The Centers for Disease Control and Prevention also recommends administering full-strength formulas immediately upon rehydration in bottle-fed infants with constipation 4
• For older infants who have started solid foods, the Centers for Disease Control and Prevention advises avoiding foods high in simple sugars and fats 6

Medication Options

Treatment Algorithm

• The Centers for Disease Control and Prevention recommends a first-line approach of trying dietary modifications, including continuing breastfeeding and considering maternal dietary changes for breastfed infants, considering lactose-free formulas for formula-fed infants, and adding fruits and vegetables while avoiding simple sugars for infants on solids 3, 4, 6
• The American Academy of Pediatrics suggests trying fruit juices with sorbitol, such as prune, pear, and apple juices, in appropriate amounts (10 mL/kg body weight) as a first-line dietary intervention 1, 2

Red Flags Requiring Further Investigation

• The Centers for Disease Control and Prevention identifies delayed passage of meconium (>48 hours after birth) as a red flag requiring further investigation 6
• The American Academy of Family Physicians and the Centers for Disease Control and Prevention list failure to thrive, abdominal distension, bloody stools, vomiting, and abnormal neurological findings as red flags that may indicate serious organic causes requiring specialist evaluation 3, 4