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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: HIV- AIDS Specialist
 20 Doctors Online

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. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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