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Sonja Brownlee, MD.
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Last Updated 7/2011
The information contained on this web site is not a substitute for direct examination and treatment by a physician. If any of this material is unclear or confusing, or if you have additional questions or concerns, please call the office at 778-6762.
Disclaimer:Sonja Brownlee,M.D. cannot endorse all links presented on the website as they may link to unrelated third-party websites.
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Constipation
Definition:
Your child is constipated if s/he is passing hard stools.
- These may be little pellets or one large mass.
- It can cause pain and may even cause some bleeding.
- It can also cause bowel movements to occur less frequently.
- Some children may have episodes of abdominal pain that are relieved after having a large bowel movement.
- Some children will soil their underwear between bowel movements.
Call the office if your child is constipated and:
-- is less than 2 months old
-- is in a lot of pain
-- cannot pass a bowel movement (BM)
-- has not passed a BM for much longer than is his/her usual pattern
-- is soiling (having BMs or smears of stool in his/her underwear)
-- has bled with BMs three or more times
-- it is a recurrent problem
Normal bowel movements and the treatment of constipation vary by age. Notice that some of the following age categories overlap. This is because children, and the way they are fed, vary widely. Click on the following for information concerning normal stools, constipation, and dietary guidelines:
Newborns (0-2 months of age)
Normal Stool:
- For the first few days after birth, newborns usually pass thick dark tarry stools. Once this meconium is cleared, and your newborn is feeding well, s/he will most likely stool with every feeding, sometimes 2 or 3 times per feeding.
- The color is usually mustard yellow or yellow-green.
- The consistency is liquid & curdy to mushy. A normal bowel movement (BM) is always messy, requiring you to wipe your baby’s bottom clean.
- Your newborn may have a mild diaper rash about the anus for the 1st week or two because newborn stools tend to be acidic and newborn skin is very sensitive. Use water rather than wipes to cleanse, and then coat the skin with diaper ointment to protect.
- By 1 month, stools thicken somewhat and should decrease in frequency (It can be normal to have one BM per week, especially with breast fed infants, as long as that BM is soft and messy).
Straining: Some newborns will strain, grunt, and turn red in the face during their BMs. As long as their BMs are liquid or mushy, not hard, they are not constipated.
Some newborns may strain, yet not be able to pass a BM. They may also cry or be upset. These newborns may actually need some help in learning how to pass a BM. Their involuntary bowel muscles are pushing, but their voluntary anal sphincter is tightening. Moisten or lubricate a rectal thermometer and gently insert it, about an inch, while your baby is straining. This will open the anal sphincter and allow gas or stool to pass. After a few times of doing this, your baby will learn how to have a BM. The rectal thermometer will not hurt your baby – the stool s/he passes is larger and more forceful.
Constipation:
Definition: passing hard little pellet stools or hard formed BMs which do not mush or mess, but fall out of the diaper, when changed, with minimal smearing.
Causes:
- It is often caused by a change in feedings from breast milk to formula or from one formula to another.
- It can also be caused by dehydration due to infrequent feedings, not feeding enough, or your baby spits up a lot. Before starting treatment of constipation in a newborn, CALL YOUR DOCTOR. It can be a sign of illness.
Treatment (per your Doctor’s recommendation):
- give an extra 2 ounces of water per day. Corn Syrup can be added to the water: 1 tsp. corn syrup per 1 oz. water. Do not use honey. If this does not work, your Doctor may tell you to give 2 ounces per day of ½ strength apple juice, white grape juice, or even prune juice.
- It may take a day or two to soften the stool. Once BMs are softened (messy), you can slowly decrease the amount of extra water or ½ strength juice given each day.
- If your newborn continues to be constipated or is in pain, call your Doctor.
1-6 month old Infants (nursing or formula only; not yet on baby food)
Normal Stool:
- Frequency can vary from 1-4 times per 24 hours to once every week.
- Consistency is liquid with curds to mushy. A normal BM is always messy, requiring you to wipe your baby’s bottom clean.
- Color can vary from mustard yellow to green to brownish.
- Some babies may still strain, grunt or turn red in the face during BMs. This is OK if they are not crying or upset and their BM is not hard. You should not have to use a rectal thermometer at this age.
Constipation:
Definition: passing hard little pellet stools or hard formed BMs which do not mush or mess, but fall out of the diaper, when changed, with minimal smearing.
Causes:
- It is often caused by changing feedings from breast milk to formula, or from one formula to another, or by adding rice cereal to the formula in a misguided attempt to get your baby to sleep longer at night.
- It can be caused by travel or a change in routine.
- It can also be caused by dehydration due to infrequent feedings, not feeding enough, decreased feeding due to a mild illness such as a cold, or your baby spits up a lot. Before starting treatment of constipation, CALL YOUR DOCTOR. It can be a sign of illness.
Treatment (per your Doctor’s recommendation):
- give an extra 4 ounces of water per day. Corn Syrup can be added to the water: 1 tsp. corn syrup per 1 oz. water. Do not use honey. If this does not work, your Doctor may tell you to give 4 ounces per day of ½ strength apple juice, white grape juice, or even prune juice.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or ½ strength juice given each day.
- If your baby continues to be constipated or is in pain, call your Doctor.
4-7 month old Infants (baby food has been added to their diet)
Normal Stool:
- As baby foods are added to the diet, stools will become more solid. They will also have varied and stronger odors. Color varies depending on the food: yellowish, greenish, various shades of brown.
- Frequency can vary from 1-3 times per 24 hours to once every 3-5 days depending on how much solid food your baby is fed.
- Consistency is mushy, but more variable depending on what baby is eating.
- Loose stools may result from too much fruit juice, adding new foods to the diet too quickly, too wide a variety of fruits & vegetables, too much of certain fruits or vegetables, or an allergic reaction.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
Constipation:
Definition: passing hard little pellet stools or hard formed BMs which do not mush or mess, but fall out of the diaper, when changed, with minimal smearing.
Causes:
- It can be caused by adding baby foods.
- Constipating foods: Rice cereal, strained bananas, apples, pears, or carrots are more likely to cause hard stools.
- Higher fiber foods: Oatmeal, peaches, apricots, plums, and prunes tend to cause soft stools.
- It can be caused by travel or a change in routine.
- It can also be caused by dehydration due to infrequent feedings, not feeding enough, decreased feeding due to a mild illness such as a cold, or your baby spits up a lot. Consult your Doctor if you suspect one of these causes.
Treatment: adjust your baby’s diet:
- Decrease the use of rice cereal, strained bananas, apples, pears, and carrots (low fiber foods).
- Increase the use of oatmeal, mixed cereal, peaches, apricots, plums, prunes, green veggies, squash, sweet potatoes (high fiber foods).
Additional treatment: (per your Doctor’s recommendation):
- give an extra 4-6 ounces of water per day. Corn Syrup can be added to the water: 1 tsp. corn syrup per 1 oz. water. Do not use honey. Or use ½ strength baby fruit juice: apple, white grape, or prune juice.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or juice and slowly adjust the types and amounts of baby foods.
- Click here for more information about feeding your baby: 4-5 Months, 6-7 Months
- If your baby continues to be constipated or is in pain, call your Doctor.
8-12 month old Infants (finger foods and table foods have been added to their diet)
Normal Stool:
- Baby’s stools can vary in color, consistency, and odor depending on what is eaten.
- Undigested particles of food may occasionally appear in the stool.
- Frequency can vary from 1-3 times per 24 hours to once every 3 days. However, most 8-12 month old babies will have at least one BM per day.
- Loose stools may result from too much fruit juice, adding new foods to the diet too quickly, too wide a variety of fruits & vegetables, too much of certain fruits or vegetables, or an allergic reaction.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
Constipation:
Definition: passing hard little pellet stools or hard formed BMs which do not mush or mess, but fall out of the diaper, when changed, with minimal smearing.
Causes:
- It can be caused by baby’s diet if one or more of the following occurs:
- too much low fiber foods –
- plain white starchy foods: crackers, potatoes, rice, noodles
- bananas, applesauce
- fast food or convenience foods
- too much dairy (introduction of too much yogurt or cheese)
- too much formula – some babies drink too much formula at this age and not enough solid food (most 8-12 month old babies need a maximum of 24 oz [3 cups] per day).
- not enough high fiber foods –
- oat cereals, mixed cereals, graham crackers
- fresh fruits (not bananas)
- veggies: green peas, green beans, squash, sweet potatoes, leafy greens, broccoli
- legumes (beans: kidney, red, white, etc)
- It can be caused by not enough water. As your baby becomes more active (crawls, pulls to stand, etc) s/he may need extra water each day.
- It can be caused by travel or a change in routine.
- It can also be caused by decreased feeding due to a mild illness such as a cold.
Treatment: Adjust your baby’s diet.
- Increase water and high fiber foods and decrease constipating (low fiber) foods (see above).
- You can give an extra 6-8 oz. of water or half to full strength fruit juice each day.
- You can add corn syrup to the water (1 tsp per oz) but it is not always as effective at this age.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or juice and slowly adjust the types and amounts of foods.
- Click here for more information about feeding your baby: 8-12 Month Old Infants
- If your baby continues to be constipated or is in pain, call your Doctor.
Toddlers (12-23 months old)
Normal Stool:
- Toddler’s stools can vary in color, consistency, and odor depending on what is eaten.
- Undigested particles of food may occasionally appear in the stool.
- Frequency can vary from 1-3 times per 24 hours to once every 3 days. However, most toddlers will have at least one BM per day.
- Loose stools may result from too much fruit juice or too much of certain fruits or vegetables.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
Constipation:
Definition: passing hard little pellet stools or hard formed BMs which do not mush or mess, but fall out of the diaper, when changed, with minimal smearing.
Causes:
- A common cause of constipation in a 12 month old is a quick change from formula or breast milk to whole milk.
- It can be caused by toddler’s diet if one or more of the following occurs:
- too much low fiber foods –
- plain white starchy foods: crackers, potatoes, rice, noodles
- bananas, applesauce
- fast food or convenience foods
- too much dairy products (milk, yogurt, cheeses) Most toddlers need a maximum of 3 cups [24 oz] per day of milk and/or yogurt, cheeses, etc.
- not enough high fiber foods–
- oat cereals, mixed cereals, graham crackers
- fresh fruits (not bananas)
- veggies: broccoli, leafy greens, green peas, green beans, squash, sweet potatoes
- legumes (beans: kidney, red, white, etc)
- not enough water.
- It can be caused by travel or a change in routine.
- It can also be caused by decreased feeding due to a mild illness such as a cold.
Treatment: Adjust your toddler’s diet.
- Increase water and high fiber foods and decrease constipating (low fiber) foods (see above).
- You can give an extra 8-12 oz. of water or half to full strength fruit juice each day to treat constipation.
- If your 12 month old was just changed to milk from formula, put him/her back on formula until the stools are soft. Then transition your toddler to whole milk slowly over a 1-2 week time period.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or juice to a maximum of ½ cup of juice per day and water between meals as needed.
- If your toddler continues to be constipated or is in pain, call your Doctor.
Prevention:
- Keep your toddler on a healthy, varied diet with ready access to water between meals.
- Offer water not Gatorade, soda pop, or even juice (1/2 strength or not!).
- Minimize junk food, fast food, convenience foods.
- Provide 5-6 small meals each day rather than allowing your toddler to snack or graze all day long
- Most toddlers (12-23 mos old) require about 1,000 calories each day:
- Milk, yogurt, cheese: 3 cups (24 oz.) per day
- Fruits: 3 quarter cup servings per day (¾ cup/day)
- Veggies: 3 quarter cup servings per day (3/4 cup/day)
- Grains: 2-3 oz. per day (1 ounce = 1 slice of bread, 1 cup boxed cereal, ½ cup of cooked rice, pasta, or cooked cereal)
- Meat: 2 oz. day (1 ounce = 1 egg, 1 oz meat, poultry or fish, 1 Tbsp peanut butter, ¼ cup legumes (beans)
Click here for more details on feeding your toddler: 1 Year Old Toddlers
Click here for the Who, What, When, Where, Why & How of Eating Healthfully
Go to www.myplate.gov for more details on healthy diets
2-3 Year Olds
Normal Stool:
- Stools can vary in color, consistency, and odor depending on what is eaten. Undigested particles of food may occasionally appear in the stool.
- Most 2-3 year olds will have at least one BM per day. However, frequency can vary from 1-3 times per 24 hours to once every 3 days.
Constipation:
Definition: passing hard little pellet stools or a hard formed BM which usually requires straining and causes some level of discomfort. There is usually a decrease in frequency from your child’s usual pattern. There may be blood in or on the outside of the stool.
Causes:
- It can be caused by your 2-3 year olds’ diet if one or more of the following occurs:
- too much low fiber foods –
- plain white starchy foods: crackers, potatoes, rice, noodles
- bananas, applesauce
- fast food or convenience foods
- too much dairy products (milk, yogurt, cheeses) Most 2-3 year olds need a maximum of 2 cups [16 oz] per day of milk and/or yogurt, cheeses, etc.
- not enough high fiber foods –
- oat cereals, mixed cereals, graham crackers
- fresh fruits (not bananas)
- veggies: broccoli, leafy greens, green peas, green beans, squash, sweet potatoes
- legumes (beans: kidney, red, white, etc)
- not enough water.
- Travel or a change in routine.
- Mild illnesses that result in decreased intake and activity.
- Potty training is a common time for constipation to occur. This can occur even without undue pressure to potty train or punishment for accidents. Some children are truly afraid of sitting on the toilet for BMs. Other children just get too busy or distracted to take the time to drop what they are doing to go use the toilet. They can get in the habit of holding their BM until the urge to go stops. This causes a firmer BM when they finally do go, and that causes discomfort. This adds a second reason to ignore or suppress the urge to go, so that further holding of a BM results in even a harder stool and even more discomfort when they finally go, etc. A vicious cycle of holding, pain, and further holding can occur.
Treatment: Adjust your child’s diet.
- Increase water and high fiber foods and decrease the constipating (low fiber) foods (see above)
- 2-3 year old children need a maximum of 2 cups per day of milk and/or dairy products.
- You can give 2-3 cups of extra water or juice each day to treat constipation.
- If you feel your child is in a cycle of holding his/her BMs, please consult your Doctor.
Additional Treatment: Some children need to be helped with regularity. Pay attention to your child’s daily habits. Then choose a time each day to encourage or remind your child to go sit on the toilet for a BM. S/he may need to take a book or something so that s/he sits there long enough. You may have to go with him/her at first to talk or sing a song or whatever to keep her/him there long enough. You may want to use a sticker chart as a reward for having a BM once a day. Keep this positive and instructional. Don’t shame, scold, or punish.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or juice to a maximum of ½ cup of juice per day and water between meals as needed.
- If your child continues to be constipated or is in pain, call your Doctor.
Prevention:
- Keep your 2-3 year old on a healthy, varied diet with ready access to water between meals.
- Offer water not Gatorade, soda pop, or even juice (1/2 strength or not!).
- Minimize junk food, fast food, convenience foods.
- Provide 5 small meals each day rather than allowing your child to snack or graze all day long.
- Most 2-3 year olds require 1,000 to 1,400 calories each day (depending on size and activity):
- Milk, yogurt, cheese: 2 cups (16 oz.) per day
- Fruits: 2 to 3 half cup servings per day (1-1 ½ cups/day)
- Veggies: 2 to 3 half cup servings per day (1-1 ½ cups/day)
- Grains: 3-5 oz. per day (1 ounce = 1 slice of bread, 1 cup boxed cereal, ½ cup of cooked rice, pasta, or cooked cereal)
- Meat: 2-4 oz. per day (1 ounce = 1 egg, 1 Tbsp peanut butter, ¼ cup beans, 1 oz. meat, poultry or fish) [there are 16 oz per pound, so 4 oz = ¼ lb.]
Click here for more details on feeding your 2-3 Year Old: 2 Year Old Children, 3 Year Old Children
Click here for the Who, What, When, Where, Why & How of Eating Healthfully
Go to www.myplate.gov for more details on healthy diets
4 years old and older
Normal Stool:
- Stools tend to vary less in color and consistency as a child grows older.
- Most children will have one BM per day. However, frequency can vary from 1-3 times per 24 hours to once every 3 days.
Constipation:
Definition:
- The passing of hard little pellet stools or a hard formed BM.
- It usually requires straining and causes some level of discomfort.
- There may be blood in or on the outside of the stool or on the toilet paper after wiping.
- Constipated BMs usually occur with less frequency than your child’s normal pattern.
- Your child may complain of abdominal pain which is relieved by passing a large BM.
- Your child may soil his/her underwear between bowel movements.
Causes:
- It can be caused by your child’s diet if one or more of the following occurs:
- too much low fiber foods –
- plain white starchy foods: crackers, potatoes, rice, noodles
- bananas, applesauce
- fast food or convenience foods
- too much dairy products (milk, yogurt, cheeses, ice cream) Most children need a maximum of 2-3 cups [16-24 oz] per day of milk and/or yogurt, cheeses, etc.
- not enough high fiber foods –
- oat cereals, whole grain cereals and breads, bran (cereals, muffins), popcorn
- fresh fruits (not bananas), raisins, dried fruits (apricots, prunes)
- veggies: broccoli, leafy greens, green peas, green beans, squash, sweet potatoes
- legumes (beans: kidney, red, white, etc)
- not enough water.
- Not enough daily exercise. As children get older, especially during the Junior High and High School years, they often become less physically active and more sedentary.
- Not enough sleep each night. Sleep deprivation alters the body’s rhythms and functions.
- A change in routine:
- Travel usually involves a change in routine, a change in diet, and having to use unfamiliar bathrooms.
- Starting preschool or kindergarten is a common time for constipation to occur.
- Older children may experience constipation with the start of school in the fall. Their relaxed summer schedule changes to hectic mornings with not enough time for their a.m. BMs.
- Many children do not like to use the school bathroom for BMs. They may get in the habit of holding or suppressing the urge to go, and then they don’t get the urge again until the next day during school. Thus a vicious cycle of holding, going less frequently, and passing hard BMs is begun.
- Our busy, hectic modern life schedules. Our day to day schedules may not be regular and/or so rushed as to not allow your child enough time to have a complete BM or to go at all on some days. This irregularity can result in your child getting “backed-up.”
- Mild illnesses that result in decreased intake and activity.
Treatment:
- Adjust your child’s diet
- Increase water and high fiber foods and decrease the constipating (low fiber) foods (see above)
- Children (4-18 years of age) need a maximum of 2-3 cups [16-24 oz] per day of milk and/or dairy products.
- If you feel your child is in a cycle of holding his/her BMs, please consult your Doctor.
- Encourage daily exercise
- Establish regular and adequate sleep
Additional Treatment: Some children need to be helped with regularity, even older children and teens. Review your child’s daily schedule and talk about when they need to take the time to have a BM. Devise a way to help remind them. Keep this positive and instructional. Don’t shame, scold, or punish.
- It may take a day or two to soften the stool. Once BMs are softened, you can slowly decrease the amount of extra water or juice to a maximum of ½-1 cup of juice per day and water between meals as needed.
- If your child continues to be constipated or is in pain, call your Doctor.
Prevention:
- Keep your child or teen on a healthy, varied diet with ready access to water between meals.
- Offer water not Gatorade, soda pop, or even juice (1/2 strength or not!).
- Minimize junk food, fast food, convenience foods.
- Have set meal times. Children and teens should eat 3 meals a day plus an after-school snack.
Go to www.myplate.gov for more details on healthy diets
Click here for the Who, What, When, Where, Why & How of Eating Healthfully
Click here for calorie and food group needs for
When diet changes are not enough:
You’ve increased your child’s water and dietary fiber and cut down on low fiber foods and dairy product intake, but s/he is still constipated. The usual cause is that the constipation has been there longer than you or your child is aware. However, you also want to be sure that there is no other cause. You should consult your Doctor. Your child may need an x-ray to determine how “backed up” s/he is. Your Doctor will then give you directions on what to do. If medications are needed, they are OTC (over the counter):
Glycerin Suppositories:
- May be needed to provide urgent relief for a child with severe pain from constipation.
- They should never be used on a chronic basis.
Please consult your doctor prior to using a suppository on your child.
Enemas:
- May be needed to provide urgent relief for a child with severe pain from constipation.
- They should never be used on a chronic basis.
- Never use
- Hyperphosphate enemas (can cause dehydration),
- Hydrogen peroxide enemas (can cause an embolus),
- Tap water enemas (can cause hyponatremia)
- Soupsuds enemas (can cause colitis and rectal irritation lasting for weeks.
- The only safe enemas are normal saline or mineral oil enemas.
Please consult your doctor prior to using an enema on your child.
Oral High-dose Miralax
- This may be recommended by your Doctor to help “clean out” a child who is really “backed up” or “full of stool”.
- The recommended dose is given once a day for 3 days only. It is not safe to use this on a routine or chronic basis.
- A “clean out” requiring oral High-dose Miralax should occur very infrequently. Ideally, this would be just once – at the time of diagnosis of severe constipation.
- A child who has severe constipation requiring the use of High-dose Miralax is very likely to recur if his/her large intestine is not given time to shrink back to normal size and regain its normal tone and function. This can take 6-8 weeks. During this time, it is extremely important to maintain a high fiber / high fluid diet and establish regular bowel habits. Sometimes stool softeners and/or fiber supplements are also needed.
Please consult your doctor prior to giving High-dose Miralax to your child.
Stool Softeners:
These are used as supplements to maintain regular BMs after an episode of severe constipation requiring a “clean out” with High-dose Miralax. The large intestine needs time to shrink back to normal size and regain its normal tone and function. This can take 6-8 weeks. During this time, it is extremely important to maintain a high fiber / high fluid diet and establish regular bowel habits.
Stool softeners are also used for children who are picky about eating a variety of foods or they are just not big eaters. These are generally safe to use on a routine or chronic basis for years. However, if they reduce your child’s appetite or reduce the intake of food or cause gas, bloating, cramping or diarrhea, they should not be used.
The amount of stool softener needed will vary. Your goal is for your child to have one soft BM daily. Consult your doctor on how to “titrate” or adjust the dose needed for this goal.
- Mineral Oil
- Inexpensive
- Difficult to dose – can be hidden in a glass of chocolate milk, mixed with pudding or something similar, or blended with ice and fruit juice concentrate to make a “slushee”
- Can cause leakage or soiling
- Should not be given to a child with GE reflux, vomiting, or to a child that is not yet walking.
- Dosing ranges from 1-3 tsp twice a day in a 1 year old to 2 oz twice a day in a teen. Dosing varies in different people and can be adjusted according to output.
- Miralax (Polyethylene Glycol 3350). The bottle says it is a laxative, but it is a stool softener and not addictive.
- Usually well tolerated and well liked.
- Safe to use on a routine or chronic basis for years.
- Dosing is the recommended starting dose. The amount and frequency can be adjusted according to output. Some people need to take it daily, others need it once a week or less.
- 12 yrs to adult (over 96 lbs): 17 gms dissolved in 4-8 oz liquid once a day
- 6-11 years old (48-95 lbs): ½ adult dose
- 2-5 years old (24-47 lbs): ¼ adult dose
- Pedialax Liquid (Docusate sodium).
- Usually well tolerated and well liked.
- Safe to use on a routine or chronic basis for years.
- Recommended for 2-11 years old (24-95 lbs): 1-3 Tbsp mixed with juice or milk. The amount and frequency can be adjusted according to output. Some people need to take it daily, others need it once a week or less.
Fiber Supplements:
These are used for children who are picky about eating a variety of foods; or they are just not big eaters; or they are prone to constipation despite a healthy diet, enough exercise, and regular sleep patterns.. These are generally safe to use on a routine or chronic basis for years. However, if they reduce your child’s appetite or reduce the intake of food or cause gas, bloating, cramping, or diarrhea, they should not be used.
The amount of fiber supplement needed will vary. Your goal is for your child to have one soft BM daily. Consult your doctor on how to “titrate” or adjust the dose needed for this goal.
- Benefiber: http://www.benefiber.com/products/index.shtml?benefiberPowders
- 12 yrs to adult (over 96 lbs): 2 tsp dissolved in 4-8 oz liquid up to 3 times daily
- 6-11 years old (48-95 lbs): 1 tsp dissolved in 4-6 oz liquid up to 3 times daily
- 2-5 years old (24-47 lbs): ½ tsp dissolved in 4 oz liquid up to 3 times daily
- Pedialax Fiber Gummies: http://pedia-lax.com/products/fiber-gummies
- 2-11 years old (24-95 lbs) 1 gummy, 3 times daily
- Metamucil: http://www.metamucil.com/faq.shtml#3
- 12 yrs to adult (over 90 lbs) one dose mixed in 8 oz liquid up to 3 times daily
- 6-11 years old (48-95 lbs): ½ adult dose mixed in 6 oz liquid up to 3 times daily
- 2-5 years old (24-47 lbs): ¼ adult dose mixed in 4 oz liquid up to 3 times daily
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