What is constipation? 

Constipation typically occurs when the muscles at the end of the large intestine tighten, preventing stool from passing normally. The longer the stool stays in the bowel, the firmer and drier it becomes and the more likely it is to cause discomfort or pain when it does pass. The following factors can contribute to constipation in children:

  • Ignoring the urge to have a bowel movement 
  • Fear of passing a hard stool (which can be more painful if your child has a bad diaper rash)
  • Withholding because he’s embarrassed or uncomfortable using a public toilet
  • Beginning toilet training too soon 
  • Changes in diet 
  • Changes in routine (such as travel, hot weather, or stress) 
  • Certain medications or illnesses 
  • Cow’s milk allergy or overconsumption of cow’s milk 
  • Genetic or environmental factors 
  • Specific medical conditions such as anatomic malformation, a metabolic or gastrointestinal problem, or another underlying condition

Though constipation is a common problem in children; it’s usually temporary, treatable and rarely serious.

What are the symptoms of constipation? 

While the most obvious symptom of constipation is infrequent bowel movements, normal bowel patterns vary from child to child. Most children have bowel movements 1 to 2 times a day, but others may go 2 to 3 days before passing a normal stool. Be on the lookout for these symptoms and behaviors that may indicate your child is constipated:

  • many days without normal bowel movements
  • hard stools that are difficult or painful to pass (occurring daily or less frequently)
  • stomachaches or cramping
  • nausea
  • rectal bleeding from tears (known as fissures)
  • poor appetite
  • cranky behavior

How is constipation treated? 

Constipation due to breast milk is unusual but parents should contact a health care provider if they believe their exclusively breastfed child is constipated. Pediatricians may advise parents to give constipated infants small amounts of water or prune juice. If your baby is old enough to eat solid foods, fruits like prunes, pears, and peaches can help relieve constipation. For toddlers or older children, offering high-fiber foods such as prunes, apricots, plums, raisins, peas, beans, broccoli, and whole grain cereals and breads may help alleviate constipation. 

In certain circumstances, your child’s doctor may also recommend over-the-counter fiber supplements, stool softeners, a laxative, or even an enema, but parents should never give children any of the above without first checking with the child’s health care provider. Laxatives and the like can damage the bowel and cause persistent problems.

How can constipation be prevented? 

Making sure your child’s diet includes high-fiber foods such as fruits, vegetables, beans, and whole-grain cereals and breads can go a long way toward preventing constipation. Limit foods high in fat and avoid refined sugars. Toddlers and older children should increase their water intake. Your child’s day should include regular physical activity, which stimulates normal bowel function. For children who are potty trained, the Mayo Clinic recommends developing a routine that ensures they make time to use the toilet, even when they’d rather play. It’s also important to remind busy children that resisting the urge to have a bowel movement can lead to discomfort.

When should I call a doctor? 

Constipation is uncomfortable but rarely serious. Seek medical attention if your child’s constipation lasts more than two weeks or if it coincides with fever, vomiting, blood in stool, abdominal swelling, weight loss, painful cracks in the skin around the anus, or rectal prolapse (in which the tissue that lines the rectum falls down into or sticks through the anal opening).

Last updated June 1, 2020

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