Constipation in Children: Causes, Solutions, and When to Worry
Constipation in Children: Causes, Solutions, and When to Worry
Constipation is one of the most common digestive complaints in children. While it can cause discomfort and worry, the good news is that most cases can be successfully treated with dietary changes, behavioral strategies, and sometimes medication.
What Is Constipation?
Constipation means infrequent or difficult bowel movements. Normal bowel patterns vary widely among children. Constipation is generally defined by fewer than 3 bowel movements per week, hard or pellet-like stools, painful bowel movements, stools that clog the toilet, abdominal pain or bloating, withholding behavior (crossing legs, clenching buttocks), small streaks of blood on stool from small tears, or soiling/leaking of stool in underwear.
Note: Breastfed babies may go several days without a bowel movement and still be healthy, as long as the stool is soft when it does come.
Common Causes of Constipation
Diet-Related: Low fiber intake, insufficient fluids, excessive dairy products, too many processed foods, or sudden dietary changes.
Behavioral: Toilet training stress, ignoring the urge to go while playing, avoiding public or school bathrooms, changes in routine (travel, starting school), withholding after painful bowel movements, or not allowing enough time for toileting.
Medical Causes (Less Common): Food allergies, medication side effects, hypothyroidism, or neurological problems.
Home Treatment Strategies
Dietary Changes: Increase fiber with fruits (prunes, pears, peaches, plums, berries, apples), vegetables (peas, broccoli, beans, sweet potatoes), and whole grains (oatmeal, whole wheat bread, brown rice). A good rule: daily fiber intake equals child's age plus 5 grams. Increase fluids, especially water. For children over 1 year, diluted prune juice or pear juice can help. Limit constipating foods like excessive dairy, bananas, white rice, and processed snacks.
Behavioral Strategies: Establish a regular bathroom routine at the same times each day, especially 10-15 minutes after meals. Allow plenty of time (at least 10 minutes) without rushing. Provide a footstool for proper positioning. Encourage physical activity to stimulate bowel function. Use positive reinforcement and avoid punishment or shaming.
When to Call Your Pediatrician
If your child in Robbinsville or the surrounding areas experiences severe abdominal pain or vomiting, blood in the stool (more than small streaks), constipation lasting more than 2 weeks despite home treatment, significant pain with bowel movements, persistent withholding behavior, soiling or leaking (encopresis), constipation in infants younger than 6 months, signs of dehydration, weight loss, or poor appetite with constipation, contact our office.
Medical Treatment Options
Your pediatrician may recommend stool softeners (docusate sodium), osmotic laxatives (polyethylene glycol or lactulose), glycerin suppositories for infants, enemas for severe impaction (under medical guidance only), or prescription medications for chronic constipation.
Important: Never give your child laxatives or enemas without consulting your pediatrician first.
Preventing Constipation
Maintain a high-fiber diet, ensure adequate hydration, encourage regular toilet habits, promote physical activity, respond quickly to early signs, and reduce stress around toileting. Our experienced pediatricians can provide personalized recommendations and ensure no underlying medical conditions are contributing to the problem.
What to Expect
With appropriate dietary changes, increased fluids, and behavioral strategies, most children with constipation improve within a few weeks. However, establishing regular, comfortable bowel patterns may take time. Chronic constipation may require several months of treatment to fully resolve, and stopping treatment too soon can lead to recurrence.
Frequently Asked Questions
What dietary changes can help my constipated child?
Increase fiber through whole grains, fruits (especially prunes, pears, and berries), vegetables, and legumes. Ensure adequate fluid intake, particularly water. Limit constipating foods like cheese, bananas, white rice, and processed foods. For babies, offer pureed prunes or diluted prune juice.
When should I see a doctor about my child's constipation?
Call your pediatrician if your child has severe abdominal pain, blood in stools, constipation lasting more than 2 weeks despite dietary changes, symptoms of fecal impaction (soiling accidents, hard mass in abdomen), or if constipation began after starting a new medication.
Is it normal for my child to have a bowel movement only every few days?
Frequency varies by age and diet. If stools are soft and pass easily without pain, infrequent bowel movements may be normal for your child. Constipation is defined more by difficult or painful passage of hard stools than by frequency alone.
Can I give my child a laxative or stool softener?
Don't give any over-the-counter laxatives or stool softeners without consulting your pediatrician first. They will recommend the appropriate type and dosage based on your child's age and symptoms. Never use adult laxatives or enemas on children without medical guidance.
Will toilet training cause constipation?
Toilet training can sometimes trigger constipation if children hold their stool due to anxiety about using the toilet. Make toilet time relaxed and positive, never punish accidents, and ensure your child's feet can touch the ground or a stool for proper positioning.
Need Personal Guidance?
This article provides general information. For questions specific to your child's health, please call our office or book an appointment online.