Infant constipation question, please help!?

Question

My 7 week old son is constipated due to the thicker formula we feed him for his reflux. He hasn't pooped in almost 4 days now and I know he has to because he strains red and is trying so very hard to push out. I have tried diluted prune juice and the thermomiter trick...even tried my little pinky to stimulate his a**s. Nothing has worked. He loves it when I rub his belly but still will not p**p. I found child (2-11 years) glycerine suppositories and have read you can cut them in half vertically and insert them halfway in their bottom. Has anyone else done this?? The doctor told us about prune juice but that isnt working and I don't know if he can wait until Monday to get more "advice" from these military doctors.

Answer 1

Just to add, in the UK and elsewhere you get infant size glycerine suppositories which are only a 1 gram dose, so you don't have to cut them in half.  If you can't get them at your local pharmacy there'll be an online source.  I "grew up with" them and so I've always reached for them if my little 'un couldn't do some sh'it for 3 or 4 days.

Answer 2

Have you tried breastfeeding?

Answer 3

I've heard cut them in half horizontally?  

Be very cautious they are very strong (personally as an adult I use a half an infant one when I had some problems after birth).  However because of the way glycerin suppositories work they are relatively safe and won't cause dehydration.

BTW thickened feeds doesn't work:

http://www.kellymom.com/babyconcerns/ref...

What about thickened feeds?

Baby cereal, added to thicken breastmilk or formula, has been used as a treatment for GER for many years, but its use is controversial.

Does it work? Thickened feeds can reduce spitting up, but studies have not shown a decrease in reflux index scores (i.e., the “silent reflux” is still present). Per Donna Secker, MS, RD in Gastroesophageal Reflux Disease PDF, "The effect of thickened feedings may be more cosmetic (decreased regurgitation and increased postprandial sleeping) than beneficial." Thickened feeds have been associated with increased coughing after feedings, and may also decrease gastric emptying time and increase reflux episodes and aspiration. Note that rice cereal will not effectively thicken breastmilk due to the amylase (an enzyme that digests carbohydrates) naturally present in the breastmilk.

Is it healthy for baby? If you do thicken feeds, monitor baby’s intake since baby may take in less milk overall and thus decrease overall nutrient intake. There are a number of reasons to avoid introducing cereal and other solids early. There is evidence that the introduction of rice or gluten-containing cereals before 3 months of age increases baby's risk for type I diabetes. In addition, babies with GERD are more likely to need all their defenses against allergies, respiratory infections and ear infections – but studies show that early introduction of solids increases baby’s risk for all of these conditions.

http://mrw.interscience.wiley.com/cochra...

Plain language summary

There is no current evidence from randomised trials to show that adding feed thickeners to milk for newborn infants is effective in treating gastro-oesophageal reflux.

Many newborn babies (in the first four weeks of life) suffer from gastro-oesophageal reflux, especially if they are born premature. Thickening the milk feed is a simple manoeuvre and commonly used as first line treatment for gastro-oesophageal reflux. Thickening the feeds can be used with or without other treatments such as positioning babies on their stomach or side, and using medications that suppress acid in the stomach or cause food to move more rapidly through the stomach. No randomised controlled studies of sufficient quality were found in this review. Therefore, there is no current evidence to support or refute the use of feed thickeners in treating newborn babies with gastro-oesophageal reflux.

http://www.llli.org/llleaderweb/LV/LVFeb...

Thickened feedings are suggested by many doctors. However, thickened feedings do not always work (Bailey et al 1987), can interfere with breastfeeding, and may increase the risk of food allergies. Some studies have shown that thickened feeds can have an adverse effect on growth in some babies and increase the risk of respiratory involvement (Orenstein et al 1992). Because thickened feeds remain in the stomach longer, they may actually cause more reflux. For these reasons, mothers should consider their options very carefully before deciding to use thickened feeds. If a mother does want to try this, she can use her expressed milk thickened with cereal and offer it with a spoon before regular feedings at the breast. Surgery on the LES is a rarely used treatment except in the most extreme and unresponsive cases.

Studies have shown that formula-fed babies are more likely to exhibit symptoms of GERD than are breastfed infants. Weaning from the breast should not be regarded as a good solution for GERD. Non-thriving babies should be evaluated for underlying illness. In most cases, GERD can be handled through proper breastfeeding management, positioning, mother’s diet, and education. When these steps do not bring about relief, more extensive testing and other treatment options may need to be explored.

http://www.medscape.com/viewarticle/4706...

Thickened Feeds

Thickening feeds with rice cereal (one tablespoon per 2 to 4 ounces of formula) is associated with a decrease in the number of vomiting episodes, but does not improve reflux index scores (Rudolph et al., 2001). Jiang, Ewigman, and Danis (2001) report that thickened formula may reduce the frequency of regurgitation and total volume of emesis. It may also reduce time spent crying and increase time spent sleeping.

Rice cereal used as a thickener increases the caloric density of formula and may cause constipation. Thickened formulas also require enlarged nipple holes to feed, potentially resulting in greater ingestion of air or formula, which can favor regurgitation. Because rice cereal- thickened feedings have 150% of the caloric density of un-thickened fe

Answer 4

my daugther had a problem going due to her being so small. the doctor would get her to go by the pinky trick but she was getting it out of her. and then she would go for a day and then stop. finally she told us to use the suppositories. i put one in and the next thing i knew. she pushed it out and out came some ****.. so those should work.

Answer 5

I would keep trying the prune juice of pear juice. I had the same thing happen with my daughter and it lasted about a week. I know it is scary but sometimes they just get backed up. Keep trying the anal stimulation and warm bathes really do help too. If he still hasn't pooped in a weeks time then I would go back to the doctors again and ask about the suppositories. Good luck!

Answer 6

the best thing you can do is take him off thickened formula and don't feed him any thing except breastmilk or formula until he is at least 6 months old and able to digest it

adding anything to breastmilk or formula does nothing to help reflux pain, it simply saves you laundry, your baby still hurts when he eats

as you have found it also causes constipation, & it causes nutritional defiency

in addition it causes a variety of illness like diabetes allergies etc some taking 30-40 years to show up

I recommend a trip to a dietition or nutritionist (not a pedi) if you are having feeding related problems (after all you wouldn't see a heart specialist for brain surgery)

Answer 7

Last time i went to "Babies R US"  they had some for "Little Tummies"  That was just for constipated and gassy babies.  Maybe that could help.  It's for infants. I hope your baby feels better.  

Answer 8

i think ur child is too small for prune juice. as i remember my Dr asked me to avoid prune juice as it pass thru breast milk and cause diarrhea to the baby. my baby got constipated when she was 1 week old and she also tear when she passed the stool finally. i think u should consult with Dr as constipation is common in formula fed babies.you can also try to give your baby your breasmilk.

good luck!

Answer 9

My sister's infant had the same problems and she was able to give him a mix of water and apple juice, yes at an earlier age, for constipation.  It worked great and he was able to p**p.  I would be careful at your babies age about giving a suppository.  Too much could be a bad thing for an infant.  The bigger problem may be the formula, that's what caused my nephews problem and they had to switch his.

Answer 10

I have used the glycerine suppositories...my son's ped. told us that whenever it gets to 4 days that he is unable to use the bathroom to use it. but I found the infant glycerin suppositories at CVS Pharmacy. My doctor also said to cut it and use the smaller ends. He also said it is okay to use, but not to use more than once maybe twice a month because then your child will rely on the suppositories to use the potty.