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Constipation is a very common problem for children. For most children, constipation means passing hard stools (feces), with difficulty, less often than normal. Regular soiling (often mistaken for runny diarrhea) may indicate that a child has bad constipation with impaction (a blockage of feces). Where no particular disease or illness is the cause of the constipation, it is called idiopathic constipation. It is important that constipation be recognized early to prevent it from becoming a long-term (chronic) problem. Poop – a necessary part of life. It’s amazing how traumatic it can be for kids and parents alike. So, if your child has a problem with constipation. Then here are some things that you can do to make it a little easier. Some of what you can do depends on the age of the child.

Young Infants With Constipation 

Babies will open their bowels from several times per day, to once every few days. The frequency of bowel movements is not very important. What is important is that the stools (feces) are soft and easily passed. Babies tend to strain when they poop, especially newborns. This is normal as long as the poop is soft. As doctors, we don’t consider it true constipation unless the stools are hard. Parents often assume that it’s hard for the baby to poop (if we did what they did, we would feel constipated!). Not true. But if your baby has not pooped for 5 days or more, or if they are having hard stools, then it’s constipation. If you think it is constipation give the baby a couple ounces of water or take your rectal thermometer to see if you can stimulate a bowel movement. If all this fails put a teaspoon of Karo syrup in their bottle. Call your doctor if the baby cannot poop or seems in pain or has blood in the stool.

Toddlers with Constipation

Toddlers usually have bowel movements several times a week. Your child may go after every meal, or she may wait a day or two in between. Her individual pattern depends on what she eats and drinks, how active she is, and how quickly she digests food. If you’re concerned that your child may be constipated, watch for these signs…

  • Less frequent bowel movements than usual, especially if she hasn’t had one in at least four days and is obviously uncomfortable when she does
  • Hard, dry stools that are uncomfortable for her to pass
  • Very watery stool in your child’s diaper (or soiled underwear if she’s potty-trained). Don’t assume this is diarrhea – it may actually be evidence of constipation. Liquid stool can slip past the blockage in the lower intestine and wind up in your child’s diaper or underwear.

Again, it’s the consistency of the poop (how hard it is) as opposed to the frequency (how often) of the poop that determines constipation.

Foods to Avoid If You Suspect Constipation

For older infants and toddlers who are now eating foods, there are certain foods to avoid if they are having hard stools. Bananas, Rice, Applesauce, and Toast (the infamous BRAT diet) are foods that cause constipation. So, avoid giving your grunting groaning toddler these foods when they are having trouble. Also, too much cheese or milk can sometimes constipate. Your baby needs at least 16-20 oz of milk (formula, breast-milk or whole milk if older than age 1). More than that may be adding to the hard poop problem.

Things That Help Constipation 

More water, fresh fruits and vegetables (other than bananas). More fiber – in the form of oats (oatmeal), bran, whole wheat, will help. I like to say that white foods constipate (rice, white flour), and brown foods help (whole wheat, bran, etc). Check the labels of your whole wheat products. Sometimes the wheat is so processed, that the bread appears brown, but has almost no fiber content. Prune, raisins and prune juice can also help.

Potty-trainers With Constipation 

This group is notorious for holding poop. Something about pooping into the freedom of a potty terrifies those who are learning. Some children need Miralax, an over-the-counter stool softener. This is a flavorless powder that you mix into your child’s drink. It helps to keep the stools soft and can help children get back into a regular pattern with soft, painless stools. It is safe to use for a period of time. And don’t forget the diet changes (it’s the same as what I’ve written for toddlers above). Often, a child will hold his poop until someone puts him back into a diaper. By holding it in, more water is absorbed from the poop… and voila, constipated, hard stools that hurt. Then, they are not only worried about the potty, but they are afraid of the next painful poop. So, they hold it in… and the vicious cycle continues. Do something to help your child to relax and forget about the fact that they are sitting on a potty. Then, if they happen to go – CELEBRATE! If they don’t, no reason to make a fuss. Just wait until the next time.

Older Children and Adults With Constipation

Constipation occurs when stools are difficult to pass. Some people are overly concerned with the frequency of their bowel movements, because they have been taught that a healthy person has a bowel movement every day. This is not true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you are not constipated. Constipation is present if you have 2 or fewer bowel movements each week. It’s hard to tell sometimes that an older child or teenager has constipation since you no longer are involved in that process anymore (thank goodness). However, if your child complains of intermittent mild stomachaches, it may be related to constipation. Avoiding the BRAT diet (Bananas, Rice, Applesauce and Toast) and too much cheese and milk (make sure they get calcium from other sources) might help. Increasing fiber and using fiber supplements such as Metamucil or Benefiber will help. Drinking plenty of water makes a difference. Prunes, raisins, prune juice will help a lot of people. I If the stomach pain is severe, there is blood in the stool, or your child is vomiting, call your doctor immediately.

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About The Whole Child Pediatrics

The Whole Child Pediatrics provides pediatric primary care that helps children thrive physically, mentally, and emotionally. We give our patients and their families one-on-one, personal, and comprehensive evidence-based medical care. We serve the Cincinnati and Northern Kentucky area and have hospital privileges at St. Elizabeth South, St. Elizabeth West,and Cincinnati Children’s Hospital.
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