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Child exposed to crack in utero is constipated

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My daughter is three and a half. She has just been placed with me for adoption. She was exposed to high amounts of crack in utero. She routinely is constipated unless I let her drink a jug of juice daily. The autism clinic in hamilton ontario told me to give her miralax. A little watery stool but she's not had a proper bowel movement in four days. I suspect sexual abuse while in foster care so manual disimpacting will be traumatic. Is there anything else I can try before the er.


Category: Gastroenterologist, Medical

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Additional reply. For Dr.Kini's reply please see previous post.

Hello,

Thank you for asking your query at DoctorSpring.

Constipation is a common problem throughout childhood and often accepted as a normal variation that will resolve as children get older. A child is supposed to be constipated occasionally and this NOT related to child’s prenatal exposure to crack. Studies have shown no relationship between constipation and cocaine. You need not be worried in this regard.

A home approach is most of the times enough for managing constipation.

1. First of all make sure her toilet training is adequate. (I assume toilet training has been started already. If not please let me know)
2. Make sure she is comfortable in going to toilet. Withholding bowel evacuation can set on vicious cycle of constipation! This should be avoided at any cost. As Dr. Kini has said any fissure or anal problems which can cause pain (there by causing the child withhold the bowel movements) should be ruled out
3. Fibre , Fibre and more fibre - Eat more fruit, vegetables, cereal, and other foods with fiber .
4. Drink some prune juice, apple juice, or pear juice
5. Drink at least 32 ounces of water and drinks that aren’t milk each day
6. Avoid milk, yogurt, cheese, and ice cream till the constipation is resovled.
7. Sit on the toilet for 5 or 10 minutes after meals, if he or she is toilet trained. Offer rewards just for sitting there.
Among these the most important thing is fibre. Children’s diets are often low in fibre. But you need to increase the intake (atleast 20gms/day ). You can get information on high fibre based diets for children online. Orelse I can share some educational materials if you need. Please let me know.

Please feel free to ask followup questions.
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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