Constipation is a common trouble in infants, both breastfed and bottle-fed. Without being immediately injurious to the child's health, it is the source of much discomfort, and may induce a permanent weakening of the bowel and of the digestive functions. The most common cause of constipation is some fault in the quality or quantity of the food, and as a first step in the treatment the dietetic habits must be carefully inquired into and regulated. In the case of breast-fed babies this will also include an investigation into the mother's habits and dietary. Very often in the case of young infants the drinking of some plain water or barley-water between feeds may serve to relieve constipation. In the case of bottle-fed babies a little extra fat may be added to the diet in the shape of a teaspoonful of cream or olive oil thrice daily, which has a lubricant action on the bowel contents. In other cases some additional sugar in the shape of malt extract will prove effective. The juice of grapes or oranges, a tablespoonful diluted with water, and given in divided doses, will often relieve constipation. After the age of six months some farinaceous food in the shape of oatmeal or barley gruel may have a beneficial stimulating effect on the bowel wall.
In older children the prolongation of a soft, pappy diet after the teeth have been cut, and the use of too refined foods, are apt to be followed by constipation. Intestinal peristalsis is weakened when there is no solid residue in the bowel to call it into action. The fluid, non-irritating contents of the small intestine fail to stimulate the colon, and accumulate there as soft masses, which tend in time to become inspissated. Hence it will be found useful in many cases of constipation to order foods which contain some irritating particles, such as porridge, whole-meal bread, figs, etc., or which contain a considerable amount of indigestible residue, such as salads, green vegetables, tomatoes, and raw apples. Care must be taken that these substances, vegetables and fruits, are not given in excess, as the digestion may be impaired in the attempt to relieve constipation. Many growing children are constipated because they do not drink enough water. They never complain of thirst and so no fluid is given them save at meal times. Frequently at meals very little fluid is taken. In such cases from a pint to a pint and a half of water should be drunk daily between meals, commencing with a cupful of cold water on rising. Fresh fruits such as oranges and grapes may be regarded as fluids, and the organic acids in them lend an additional aperient action. Fats and oils have a lubricating effect in the intestine, and prevent the inspissation of faeces, so that plenty of beef or mutton fat, salad oil, and nuts may relieve constipation, especially when the motions are hard and dry.