Summary of Constipation Treatments for Children

Agent

Action

Advantages

Disadvantages

Switch of formula or mother’s diet

·    Prevents constipation by eliminating allergens

·    Prevention, not just treating symptoms

·    Takes time and some sleuthing to find the right diet

Lower-iron formula for formula-fed

·    Reduces constipation from iron

·    If it works, elimination of cause

·    Concerns over anemia but not well-founded

Physical measures

·    Help move stool through

·    No chemical or sugar ingestion

·    None, generally harmless

Glycerin suppositories

·    Attract water into rectum

·    Ease passage of stool

·    Quick results

·    Appropriate for young infants

·    Concerns over dependency with frequent use

Saline (phosphate) enema (Fleet)

·    Adds and attracts water into lower colon

·    Stimulates movement

·    Quick results

·    Risk of phosphate overdose

·    Muscles can weaken with long-term daily enema use

Homemade salt enema

·    Adds and attracts water into lower colon

·    Stimulates colon by expansion

·    Quick results

·    Considered quite safe when properly used

·    Muscles can weaken with long-term daily enema use

Milk and molasses enema

·    Attracts water

·    Causes gas formation to push stool out

·    Quick results

·    Highly effective

·    Natural ingredients

·    Can be quite uncomfortable

Senna (Senokot) enema

·    Stimulates intestinal movements

·    Quick results

·    Generally not recommended under age 2

Senna products oral

·    Stimulates intestinal movements

·    Natural herb

·    Often need attendant softener

Bisacodyl (Dulcolax) oral, suppository, or enema

·    Stimulates intestinal movements

·    Commonly prescribed

·    May cause nutritional or fluid imbalances with long-term use

Docusate (Colace) oral

·    Softens stool

·    Commonly prescribed

·    Effectiveness not well-established

Prunes, pears

·    Add fiber and special water-attracting sugars

·    Natural

·    Regular usage is fine

·    Not before solid food age

Prune or pear juice

·    Adds fluid and special water-attracting sugars

·    Easy acceptance

·    Not before solid food age

·    Cause insulin surges

·    Cause tooth decay

Fiber powders and supplements

·    Add bulk

·    Maintain water in intestines

·    Food for healthy flora

·    Long-term use fine

·    Slow to act

·    Difficult acceptance

High fruit and vegetable consumption

·    Adds fiber and special normalizing sugars (both also found in breastmilk)

·    Promotion of gut and general health

·    Natural prevention

·    Only toddlers and older can eat enough

·    Not strong enough for urgent impaction

Probiotic foods and supplements

·    Provide healthy flora

·    Flora support

·    Promotion of gut and general health

·    Mild and slow effect

·    Require additional mode of treatment

Magnesium products (Natural Calm, Milk of Magnesia) oral

·    Attract water into intestines

·    Gentle

·    Simple

·    Valuable nutrient

·    Slight risk of overdose

Mineral oiloral or enema

·    Lubricates

·    Time-proven remedy

·    Reduce some vitamin absorption

Castor oil oral

·    Lubricates

·    Stimulates movement

·    Time-proven remedy

·    Can cause strong sensations

Palm, cod liver, or flax seed oil oral

·    Lubricates

·    Is anti-inflammatory

·    Nutritious

·    Small doses okay under 6 months

·    Difficult administration

Simple sugars, corn syrup

·    Draw water into intestines

·    Easily accepted

·    Okay under 6 months

·    Empty calories

·    Cause insulin surges

·    Cause tooth decay

Lactulose sugar

·    Holds water in intestines

·    Causes gas formation to push stool

·    Not absorbed as sugar

·    Not cause insulin surges

·    Feed healthy flora

·    Easily accepted

·    Prescription only, despite excellent safety record

Sorbitol sugar

·    Holds water in intestines

·    Causes gas formation to push stool

·    Not cause insulin surges

·    Feed healthy flora

·    Fight tooth decay

·    Easily accepted

·    Adds sugar calories

Polyethylene glycol (PEG) oral (Miralax)

·    Maintains water in the stool

·    Frequently chosen by pediatricians

·    Damages healthy flora

·    Increasing serious concerns over safety