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Iron Supplement Is Causing Constipation
Q: My child's pediatrician prescribed iron for my daughter. The iron makes her constipated and I have stopped giving it to her. I'm having trouble getting her bowel movements back to normal. Is there any way I can give her the iron and combat constipation at the same time?
A: Iron supplements are prescribed for treatment of anemia (low red blood-cell count), which is common in children. It is true that large doses of iron can cause constipation, which may cause some discomfort, but many children tolerate it quite well. If the stools are hard, and your daughter is having discomfort, give the iron to her at one-half or one-third the recommended dosage, and then work up to the full dosage over two to three weeks. In this way, the body gets the iron in smaller amounts, and the intestine has time to adapt. I have found that when you start the iron at a low dose like this, it does not cause painful constipation. Be sure to ultimately get up to the recommended amount of iron in order to cure her anemia.
There are other things you can do to help relieve constipation. You don't mention your daughter's age, but presuming she is old enough to eat table food, there are a number of foods that will help to keep the stools soft and moving. Fruits and vegetables are always good choices, and "P" fruits such as prunes, plums, and pears add lots of fiber that helps. Drinking some water every day goes a long way toward keeping the stools soft, too. If your child is a least a year old, you can have her drink four ounces of water two or three times a day.
If your daughter still has significant complaints from constipation, you should talk with her doctor about it.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.