Original Article
Prevalence, symptoms and outcome of constipation in infants and toddlers

https://doi.org/10.1016/j.jpeds.2004.10.046Get rights and content

Objective

To determine the prevalence of constipation in children ≤2 years, describe the symptoms of constipation, and review how often specific interventions were effective.

Study design

Retrospective chart review.

Results

Of 4,157 children <2 years of age, 185 children had constipation. The prevalence rate for constipation in the first year of life was 2.9%, and in the second year of life, the rate was 10.1%. Functional constipation was the cause in 97% of the children. Boys and girls were affected with equal frequency. Constipation was caused by an underlying organic disease in 1.6% of cases, and 97% of the children had functional constipation. Dietary changes and corn syrup were the initial treatment suggestions for 116 children; 93% of these children underwent follow-up examinations, and the constipation resolved in 25% of the children. Of 100 children treated with milk of magnesia or polyethylene glycol 3350 without electrolytes, 93 children underwent follow-up examinations, and the constipation was resolved with treatment in 92% of the children.

Conclusions

Dietary changes, corn syrup, or both resolved constipation in 25% of children, and laxatives resolved constipation in 92% of children. Both milk of magnesia and polyethylene glycol were efficient and safe in infants and toddlers.

Section snippets

Subjects

Between January 2000 and July 2003, a 42-month period, 4,157 children between 0 and 24 months were seen in our general pediatric clinics for health maintenance and acute care visits. This interval was chosen because it allowed follow-up examination of all children. The study was approved by the Institutional Human Research Review Committee.

A computer search using “0 to 24 months” and “constipation,” defined by the ICD codes 564.0, 564.1, 564.2, 564.09 as search terms, identified 215 children, 0

Prevalence of Constipation

A total of 185 of the 4,157 infants and toddlers had constipation. The prevalence rate for constipation for children ≤2 years of age was 4.45%. The age distribution of these 4,157 children and the prevalence rate by age is given in the Figure. The prevalence rate for constipation in children in the first year of life was 2.9% and was significantly lower than in the second year of life (10.1%; P <.001). The ratio of constipated boys to girls was 1.1:1.

Infant Dyschezia

Ten otherwise healthy infants younger than 6

Discussion

We found that the prevalence rate for constipation in children ≤2 years of age who attended the general pediatric clinics was 4.5%. The prevalence rate in the first year of life was 2.9%, and in the second year of life it was 10.1%. The ratio of constipated boys to girls was 1.1 : 1. Most of the infants and toddlers who were constipated (97%) had functional constipation. Constipation should not be defined by symptom duration of >2 weeks or by frequency of BMs only, but rather by hard stool

References (16)

  • J.M. Bishop et al.

    Natural history of cow milk allergy: clinical outcome

    J Pediatr

    (1990)
  • W.L. Nyhan

    Stool frequency of normal infants in the first week of life

    Pediatrics

    (1952)
  • J.N. Lemoh et al.

    Frequency and weight of normal stools in infancy

    Arch Dis Child

    (1979)
  • L.T. Weaver et al.

    The bowel habit of young children

    Arch Dis Child

    (1984)
  • M. Fontana et al.

    Bowel frequency in healthy children

    Acta Paediatr Scand

    (1989)
  • R.M. Issenman et al.

    Are chronic digestive complaints the result of abnormal dietary patterns?

    Am J Dis Child

    (1987)
  • S.S. Baker et al.

    Constipation in infants and children: evaluation and treatment

    J Ped Gastro Nutr

    (1999)
  • A. Rasquin-Weber et al.

    Childhood functional gastrointestinal disorders

    Gut

    (1999)
There are more references available in the full text version of this article.

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Dr. Loening-Baucke has received research funding and consulting fees from Braintree Laboratories.

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