On 26 August Ms. Davis writes that a digital rectal exam in the case referred to is "sexual abuse." This description is both inflammatory and misguided. Child sexual abuse refers to the mistreatment of a child for the purposes of sexual gratification. A gentle rectal exam can be an important part of the evaluation of constipation even in infants, for evaluation of Hirschprung's disease for example, although I agree that as presented this would be low on my differential. Most likely this infant is fine. Stooling patterns for infants vary extremely from many per day to up to every 10 days in my experience. There are also likely to be changes during dramatic adjustments in diet, such as changing from BF to formula or vice-versa. My concern is not with the evaluation or the pronouncement that "everything is fine" but with the prescription for suppositories every 3 days! If everything is fine, then there is no need for such. Overuse of suppositories may result in trauma, or dependence, or in some cases may obscure a more significant problem. Constipation should be judged more by the character of the stool rather than its frequency. And true constipation should usually be treated with additional fluid in the diet, rather than suppositories--certainly not regular periodic suppositories. Brian Hall, MD Staff Neonatologist US Naval Hospital, Okinawa e-mail: [log in to unmask]