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from Singapore asked a question

Do I need to bring my toddler to see a doctor if she is on formula milk and has not pooped for 3 days?

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Children’s Health

LO hasn’t pooped for 3 days and is on formula milk – is this ok? Or should I bring her to a paeds? She is on a lactose free formula. Occasionally, she will drink Express Breast Milk (around 3 ounces per day).

DOCTOR’S ANSWER (2)

Thank you Dr Ethan,

Absolutely agree with your comprehensive answer.

To add on:

  1. Breast Milk tends to be the best for children.
  2. There is a difference between foremilk (the first portion) and the hindmilk (the last portions).
  3. If your child is having difficulty passing, you can try giving more foremilk.

Certainly a visit to the PD/GP will be great as well to make sure we are not missing something serious.

Consult Doctor
0 429 views 0 Doctors agree 25 Jan 2018

Dear Shereen,

Welcome to our QnA! Unfortunately, you didn’t mention the age of your toddler/infant. This makes it difficult to provide more tailored information, as the “normal amount of time” between each bowel movement depends upon:

  1. How old they are
  2. What they eat

It’s worth noting in your case (if you recently switched her from breast to formula milk) that formula-fed infants commonly have less frequent stools than breast-fed infants.

By 4 months of age, most formula-fed infants average 2 – 3 bowel movements a day. This also depends on what type of formula you are using.

Even though constipation is typically defined as “less than 3 bowel movements per week”, it’s important to first establish what’s “normal” for him or her.

Eg. if he/she used to go 2 times a day, and hasn’t gone for 3 days now, that would be abnormal.

Conversely, if she used to go 1 time every 2 days, but now goes once every 3 days, it may still be within the range of “normal”, although you should certainly start considering what could be causing the change in bowel habit.

25% of chronic childhood constipation begins when the child is an infant, so it’s important to recognise and treat the problem early, if this has been a recurring issue.

Constipation in infants is most often caused by:

  1. Insufficient fluid in their diet (dehydration)
  2. Dietary changes
  3. Illness

If your infant is older than 4 months old, you can try a simple trick: fruit juice! (If your infant is younger than 4 months old, talk to a doctor about treatment of constipation). It should begin to work within 24 hours.

  1. Infants 4 – 8 months old: Apple, prune, or pear juice (other juices are not as helpful). Give a total of 60 to 120 ml of 100 percent fruit juice per day.
  2. Infants 8 – 12 months old: Give up to 180 mL of fruit juice per day.

If these measures are not effective within 24 hours, consider seeing a doctor. He may prescribe a mild laxative or stool softener.

You should bring your infant to see your doctor ASAP if there is:

  1. Severe stomach pain
  2. Bleeding in stools

Do note that without examining your child, and knowing more pertinent details, I cannot provide any medical advise, and that you should treat the above as general information.

Cheers

Consult Doctor
0 429 views 0 Doctors agree 25 Jan 2018
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