Constipation in children | Health, Medicine and Fitness

chris woolston

How do I know if my child is constipated?

Don’t measure it by the number of trips your child takes to the bathroom. Some children have to have a bowel movement twice a day; others only go once every two or three days. Unless it’s been four or more days since your child’s last bowel movement, you probably don’t have to worry. What matters is how easily it goes, not how often. If he has large or hard stools that cause him discomfort, he is constipated and needs your help.

A single uncomfortable stool can make your child anxious about going to the bathroom, and that’s where the trouble begins. Some children begin to delay bowel movements for as long as possible. Others can use the toilet every day, but don’t take long enough to completely empty their lower colon. Either way, feces can build up in the colon, causing it to stretch and lead to painful cramps. An enlarged colon can lead to larger than normal stools, possibly large enough to clog the toilet. Heavily soiled underwear can be another sign of constipation: loose stools can slip past the blockage in the small intestine and startle a child.

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You may also notice some changes to the dinner table. If your child is constipated, he may often have a small appetite or not eat much in one sitting. Also, his appetite may skyrocket after a large bowel movement and then quickly fade.

What causes constipation?

Many factors can trigger the process. If your child is fighting the urge to defecate — because they don’t like using the toilet at school, for example — chances are their stools will become big and hard. Dehydration, which often follows diarrhea or another illness, can also harden the stool. And while diet alone usually doesn’t cause constipation, a high-fat, low-fiber diet (including many snack foods and pastries) can definitely make it worse. Eating lots of dairy products, especially cheese, on a regular basis can also contribute to constipation.

In rare cases, constipation is a sign of an underactive thyroid or lead poisoning. Your pediatrician should check for these and other possible conditions if your child’s constipation is an almost constant problem.

Most cases of constipation are easily treated at home. You can soften your child’s stools by giving him prune juice and making sure he drinks plenty of other fluids. Exercise and frequent servings of whole wheat bread, bran cereal, oatmeal, fruits, vegetables, popcorn (for older children) and other high fiber foods will also help . Avoid or limit cooked carrots and squash as well as large amounts of dairy products like cheese, yogurt and ice cream.

You may also need to encourage him to go to the bathroom whenever he feels the urge to defecate. If he is still having problems, suggest that he spend 5-10 minutes on the toilet after each breakfast and dinner. He could just adopt a new healthy routine. Talk to him about spending time in the bathroom in a neutral, never angry way so he feels relaxed about the procedure.

Although stool softeners and some laxatives such as Metamucil are generally safe and effective in small doses, most children can get relief without these drugs. If a doctor recommends them for your child, use them with confidence. Otherwise, skip them. And don’t give your child a suppository or enema unless their pediatrician says it’s a good idea.

When does my child need a doctor?

Call your pediatrician if:

  • You are worried about your child.
  • Your child has gone more than four days without a bowel movement.
  • Her constipation lasted more than two or three weeks.
  • He stains his clothes.
  • The problem interferes with his normal activities.

Your child’s doctor can determine the cause of the constipation and help you develop a relief strategy. He may recommend other diet or behavior changes, or prescribe laxatives or stool softeners.

If your child has severe pain during bowel movements or there is blood in his stool, he may have a small tear in the lining of his anus. Although this type of tear, called an anal fissure, will eventually heal on its own, a doctor can speed up the process with stool-softening medications.

And remember: Constipation may just be a signal that your child needs more exercise as well as more fiber and water in their diet.

Pantell, Robert HMD, James F. Fries MD and Donald M. Vickery MD Caring for Your Child: An Illustrated Guide for Parents to Comprehensive Medical Care, Eighth edition. Da Capo Books of a lifetime.

Stephen M. Borowitz, Chronic Constipation and Encopresis in Children, Children’s Medical Center, University of Virginia:

Nemours Foundation, Constipation.

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