OBJECTIVES.  To assess the epidemiology, the clinical features and the long-term outcomes of constipation at diagnosis within the first 4 months of life in a community based urban population. 

METHODS.  Prospective data collection from a general pediatric population who attended a primary healthcare centre in an urban location.  

RESULTS.  In a population of 1793 children (1 month-6 years), 32.9% had constipation and of those 45.7% were diagnosed within the first 4 months of life.  The prevalence rates of constipation were significantly higher at 1-<4 months (14.9%) than in older age groups.  The earlier onset of constipation was not correlated with gender, perinatal events and type of feeding.  A long-term follow-up of 6 years was obtained in 99 children with onset of constipation at 1-<4 months.  Despite the early start of treatment, 39% of them were still constipated at 10 months and 12% at 6 years.  The long-term outcome of children who had symptoms within their first 4 months was similar to that described in older children. 


CONCLUSIONS.  We report the first prospective data predicting the clinical outcome of constipation at onset at 1-<4 months of life.  Clinicians should be aware that approximately half of all children who will develop constipation do so in the first 4 months of life.  The change from breast milk to formula and the early introduction of solids are not factors leading to constipation in infants.  Children with earlier onset of symptoms do not have either a better or worse outcome than children at later onset.  


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