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Children's Hospital at Dartmouth Hitchcock (CHad)
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Bowel Management During Infancy

Ideally, a bowel management program should begin in infancy. During infancy, the goals of a bowel program are to maintain normal stool consistency (soft and easy to push) and to have an average number of stools per day. Routine emptying of the bowel and prevention of constipation will help keep the colon from becoming stretched out of shape and will help to keep the sphincter muscles working properly.

Developmental issues

There is a wide variation in stool patterns in infants. Breast fed infants initially have as many as six to twelve stools a day, later one to six stools a day. Formula fed infants initially may have one to eight stools a day, but by six to twelve months they generally have one to three stools a day. Constant smearing of stool on the diaper as well as hard ball shaped stool may be the first signs of constipation.

The role of diet in bowel management

When you introduce solid foods or change from breast milk to formula, you will notice changes in your child's stools. You can prevent or treat constipation in infants by:

  • Being sure your infant is getting plenty of fluids such as water and fruit juices. Offer prune juice, one to two ounces per day, straight or diluted with an equal amount of water or apple juice.
  • Offering high fiber foods that are natural stool softeners as you introduce solid foods. For the infant, use oatmeal or barley baby cereals (not rice). Offer wheat grain breads rather than white bread.
  • Offering most pureed fruits (not bananas) such as pureed prunes, 1/2 to 1 jar daily.
  • Offering Fruit-Eze: A fruit paste made of raisins, dates, prunes and prune juice that provides a highly concentrated source of fiber. It can be eaten alone, added to cereal or yogurt, or as a spread on bread or toast. Store in the refrigerator. Use 1 teaspoon a day and adjust as needed. The company will provide information and samples. You can get these samples by calling: (800) 743-1941
  • Offering Homemade Fruit and Fiber Spread. It is similar to Fruit-Eze but the consistency is not as smooth. Blend the following in a blender for two minutes:
    • 1/3 cup raisins
    • 6 prunes
    • 1/2 orange (peeled)
    • 1/2 unpeeled apple
    • 2 TBSP prune juice
    • 2 TBSP orange juice

Store in the refrigerator. Use 1 teaspoon a day and adjust as needed.

If your baby does develop small, hard stools or does not have a daily bowel movement, you may need to give a stool softening agent such as Maltsupex or psyllium powder. If your baby goes two days without a bowel movement, call your health care provider for suggestions about treatment.


Page reviewed on: Aug 16, 2004

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