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Fecal Impaction (Infant/Toddler)

If a child becomes constipated, stool often hardens in the rectum. New stool continues to develop in the rectum and colon but is unable to pass the blockage. The child is then unable to pass stool, passes only small, pea-sized stool, or has uncontrolled watery diarrhea. This condition is called fecal impaction. Constipation in an infant may be due to a reaction to formula or to something in the breastfeeding mother’s diet. Infants given cow’s milk often become constipated. It may also occur when an infant is started on solid food. A toddler may react to toilet training or a painful elimination by purposely holding in stool. This can lead to constipation and impaction.

Fecal impaction can cause a distended (swollen) abdomen and discomfort. The child may pass tiny stools or have uncontrolled diarrhea, with watery stool passing around the hardened stool (called encopresis). Rectal bleeding can occur.

To treat the impaction, a stool softener may be given. In some cases, a glycerin suppository, enema, or irrigation is used to loosen hard stool, which is then removed. Once the acute impaction is treated, steps are taken to regain healthy elimination. If old enough, the child may be started on a combined laxative and behavior modification plan to help regulate elimination. Be patient. It can take several months for the child to regain healthy bowel habits.

Home Care:

Medications: The doctor may prescribe medications to soften stool and promote bowel movements. Follow the doctor’s instructions for giving this medication to your child. Talk to the doctor about whether to manually eliminate hardened stool or give a suppository or enema. If your infant is formula-fed, the doctor may recommend switching to a different type of formula. Follow the doctor’s instructions.

General Care:

  1. Do not give cow’s milk to children less than 1 year of age. Cow’s milk affects the intestine and reduces the absorption of iron, which is necessary for growth.

  2. Children on solid foods should eat more fiber, which is found in whole grains, fruits, and vegetables. Ensure that your child drinks plenty of liquids.

  3. Avoid toilet training younger children until the elimination problem is resolved.

  4. A toilet-trained child may have bowel retraining. This process can help your child have normal bowel movements again. Your child sits on the toilet for a short time after meals. This helps the body reconnect eating with having bowel movements. Your child’s doctor can discuss bowel retraining with you.

Follow Up

as advised by the doctor or our staff.

Get Prompt Medical Attention

if any of the following occur:

  • Fever greater than 100.4°F (38°C)

  • Continuing constipation, swollen abdomen or diarrhea

  • Vomiting

  • Bloody stools

  • No appetite; refusal to eat


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