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Is my child constipated?

Like many other parents, I tend to fuss over my children’s GI tracts – what goes in, and what comes out. Has my son pooped already today? Is the poop too soft or too hard? What did I feed my daughter that made her poop look like that? Are my kids pooping too much or too little?

Constipation is a very common issue in children that many parents will need to help take care of at some point in time. Since all children have different bowel patterns, it may be difficult to tell if your child is constipated. One child may have a bowel movement every 2 to 3 days that is passed easily and is not constipated, while another child who has daily bowel movements that are difficult and painful to pass is constipated.

How do I know if my child is constipated?

  • In a newborn, a hard and firm stool less than once a day (but some exclusively breastfed babies may not poop every day)
  • In an older child, a hard stool that is difficult to pass that occurs every 3-4 days
  • At any age, stools that are large, hard, and dry
  • Painful bowel movements
  • Episodes of abdominal pain after passing a large bowel movement
  • Blood in or outside the stools
  • Leakage of stool in between bowel movements

Why is my child constipated?

Constipation can occur when the muscles at the end of the large intestine tighten, making it difficult for the stool to pass during a bowel movement. The longer that stool stays there, it becomes hard and dry. The hard and dry stool is difficult and painful to pass. Then since the child remembers that having a bowel movement was painful, he or she may consciously try to hold their stool in so that they do not have to experience pain again. This stool withholding can make the problem of constipation worse. Other children may resist using a toilet away from home, such as at school, and withhold stool until they come home.

If a child withholds stool, the stool may become large and the rectum stretches in size. He or she may not actually feel the urge to pass stool until the stool becomes so large that some assistance with an enema or a laxative may be necessary. In some cases, the stool is so large and firm, that liquid stool will actually pass around the hard stool and cause leakage and soiling of the child’s underpants. In these severe cases of constipation, a physician can help with emptying the large stool and formulating a new bowel routine to help establish more regular stooling patterns.

How can I treat my child’s constipation?

If your child has mild or intermittent episodes of constipation, dietary changes may be able to help. For babies, talk to your pediatrician or family doctor about giving small amounts of water or prune juice. For infants that are talking solid foods, fruits such as prunes and pears can often help. For a toddler or older child, adding some high-fiber foods to their diet can improve constipation. Cutting back on foods such as rice, bananas, and low-fiber or white bread can also help. It’s also important to make sure that your children are well-hydrated (especially in this Florida summer!). Encourage your child to be physically active, since this can also help establish a pattern of regular bowel movements.

High-fiber foods include:

  • Prunes
  • Apricots
  • Plums
  • Raisins
  • Peas
  • Beans
  • Broccoli
  • Whole-grain cereals and breads
In addition to making a few dietary changes, establishing regular times to sit on the toilet may be helpful for your child. Most children feel the urge to poop within a half an hour after a meal, so having a child sit after breakfast before they go to school might help if the child is avoiding the bathrooms at school.

Since each child has different stooling patterns, it’s important to become familiar with your child’s bowel patterns so that you can recognize when your child is constipated. While many laxatives and enemas are available over the counter, it’s always important to involve your pediatrician if medications are necessary. So if dietary changes and exercise aren’t helping with a child’s constipation, it’s best to come up with a plan with your pediatrician.