Constipation in Children
How do I know if my child is constipated?
Your child may be constipated if one or more of the following are true:
He or she has fewer than 3 bowel movements a week.
The stools are hard, dry and unusually large.
The stools are difficult to pass.
For some children, it is normal to pass stools as far apart as every few days. Whether your child is
constipated or not depends on how often he or she normally passes stools and how easy this is to
do. If stools are soft and easy to pass, less frequent stools are not a problem. If they are hard and
difficult to pass, constipation is likely. If your child is having trouble with constipation for more than
2 weeks, it is called chronic constipation.
What causes constipation?
Constipation is likely to happen when your child doesn't drink enough water, milk or other fluids, or
if your child doesn't eat a healthy diet that includes enough fiber. Fiber is found in foods such as
cereals, grains, fruits and vegetables. If your child eats a diet high in fat and refined sugars (candy
and desserts), he or she is probably not getting enough fiber, which may result in constipation.
Constipation may also begin when you change your baby from breast milk or baby formula to
whole cow's milk, and when you switch from baby food to solid food. Sometimes constipation
happens after your child has been sick or has taken certain medicines. You should not be
concerned if your child becomes constipated for a short period of time. Constipation is common in
children and usually goes away on its own.
Young children who have chronic constipation often ignore the urge to have a bowel movement.
Your child may not want to interrupt play, or may be afraid or embarrassed to ask a teacher or use
a public restroom. When a child avoids bowel movements, stool builds up in the lower bowel. The
stool becomes larger and harder. Passage of the stool can be painful and makes children want to
avoid having a bowel movement even more.
What can I do if my child is constipated?
There are many things you can do to help your child:
Diet. You can start by increasing the amount of fluid your child drinks each day. If your
baby is eating cereal, you can try adding a little prune juice to it. If you have an older child,
make sure they are drinking plenty of water. You can also give them prune juice, bran
cereal, fruits and vegetables to increase the amount of fiber in his or her diet and help your
child pass a stool. Decrease the amount of candy and refined sugar in your child's diet.
Bowel habit training. Your child should be taught not to wait to have a bowel movement.
To establish a regular bowel habit, ask your child to sit on the toilet for at least 10 minutes
at about the same time each day, preferably after a meal. Make sure your child can place
his or her feet firmly on the floor while sitting on the toilet. If this is not possible, put a
footstool in front of the toilet. While your child is sitting on the toilet, you might let your child
read a story book or listen to the radio.
Medicine. Many laxatives are available to treat constipation in children. The choice of
laxative depends on the age of your child and how serious the constipation is. Ask your
family doctor to suggest a brand name and tell you how much to use.
Start a reward program. Begin rewarding your child for just sitting on the toilet. For
example, if your child sits on the toilet at the planned time, reward your child with a favorite
activity. If your child has a bowel movement, give your child praise and a reward. Try not to
use food as a reward. Young children may like to be awarded with stickers or stars on a
chart. Older children may like to add up points for a larger reward, such as a trip to a movie
theater or the park.
Take your child to see your family doctor if the constipation doesn't get better or if you think your
child has chronic constipation. Constipation can sometimes be a sign of a more serious medical
condition.
How can the doctor tell if my child has constipation?
The pattern of your child's bowel movements may show that he or she has constipation. You can
help the doctor by keeping a day-by-day list of your child's bowel movements. You should include:
When your child sat on the toilet
How long your child sat on the toilet
What your child's stool looked like
If your child has any soiling in his or her underwear
It also is important to note unusual changes in your child's stools or behavior. Some things to
watch for include:
Stools that are large in diameter
Stools that are very hard
Small amounts of bright red blood on the toilet tissue after your child has a bowel movement
Stomach pain and bloating
Loss of appetite
Crying or screaming during bowel movements
Avoiding the toilet or resisting toilet training
The doctor also will do a physical exam. This may include an exam of your child's rectum. The
doctor also may order an X-ray of your child's abdomen. If constipation is very severe, an enema
may be necessary to physically remove the stool from your child's bowels. An enema is a
procedure where liquid is injected into the rectum. The enema helps loosen the stool and can ease
severe constipation.