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Constipation Care Plan

Constipation Care Plan

McKenzie Pediatrics, P.C.

Child’s Name: ___________________________________________ DOB: ___________________ Date of Plan: __________________

What Are The (Many) Definitions of Constipation?

What Is NOT Constipation?

What Are Possible Causes (or Combinations of Causes) for Childhood Constipation?

What Should I Know About My INFANT’S Diet If (S)He Is Constipated?

What Should I Know About My OLDER CHILD’S Diet If (S)He is Constipated?

What Else Can I Do With My Older Child Who Is Constipated?

What If All This Fails?

My Child’s Constipation Care Plan

□ Diet Adjustments: _____________________________________________________________________________

□ Fluid Adjustments: ____________________________________________________________________________

□ Disimpaction Method: _________________________________________________________________________

□ Maintenance Method: _________________________________________________________________________

□ Follow-Up Appointment: ______________________________________________________________________

□ Labs or Tests: ___________________________________________________________________________________