All children are different. Some have fewer bowel movements (BMs) without
constipation than others.
Constipation is a change in how often a child has a BM, the size and thickness
of the BM, or how easily the BM is passed.
Normal BMs happen a few times a week or once a day.
A school-age child who has less than 3 stools per week is considered constipated.
What are signs that my child is constipated?
Painful BMs.
Child can't have a BM after pushing.
A baby crying while trying to have a BM.
Less than 3 stools in a week.
Large, hard BMs that are painful.
A swollen belly.
Runny stool in a child's underpants.
Loss of appetite.
Fear of using the toilet.
Blood mixed in with the stool.
What causes constipation?
Not eating enough fiber or drinking enough water.
Eating and drinking too many milk products.
Waiting too long to have a BM.
Switching from breast milk to formula or cow's milk.
Some illnesses and medications.
A child who is being toilet trained may get constipated if he doesn't want
to sit on the toilet. Do not force him. Instead, put him back in diapers or
pull-ups. Do not continue toilet training until constipation has passed.
Not being able to get rid of the whole BM can make a child constipated.
In these cases, children commonly soil their underpants.
How is constipation treated? Changes in diet can help your child have regular BMs. Taking regular trips
to the bathroom, using stool softeners, and easing rectal pain can also treat
constipation. Do not use suppositories, enemas (putting fluid into the rectum
using a tube), or oral (by mouth) laxatives without asking your doctor first.
Diet for infants under 1 year old
Babies over 2 months old- Give fruit juices twice a day. Prune juice
is best.
Use soy formula or put brown sugar in formula to soften stools. Ask
your doctor first.
Babies over 4 months old- Give fruit juices twice a day. Give strained
food with fiber twice a day like cereal, apricots, prunes, peaches, pears,
plums, beans, peas, and spinach.
Diet for children over 1 year old
Give your child fruits and vegetables 3 times a day. Prunes, figs, dates,
raisins, beans, peas, cauliflower, broccoli, and cabbage work well if
your child can chew them.
Eating bran can soften stools. Bran flakes, bran muffins, shredded wheat,
graham crackers, oatmeal, brown rice, and whole-wheat bread are some choices.
Children over 6 years old can have popcorn.
Avoid large amounts of milk, ice cream, cheese, yogurt, and cooked carrots.
Give your child lots of fruit juices. Orange juice does not work well.
Regular bathroom breaks
Tell your child not to wait when he has to have a BM.
Have your child use the bathroom at the same time each day. 10 minutes
after each meal works well, especially breakfast.
A child who is being toilet trained may not want to sit on the toilet.
Do not force him. Instead, put him back in diapers or pull-ups.
Stool softeners
Ask your doctor before using a stool softener.
If a change in diet doesn't help constipation you can use a stool softener
(such as Haley's M-O, Metamucil, Citrucel, and mineral oil).
Choose the laxative that is best for your child's age. Give the right
amount.
Rectal pain
If your child has rectal pain, a warm bath might help.
Gently putting a rectal thermometer in the anus for 10 seconds may help.
How long should constipation last?
Constipation should not last more than 3 days after switching to a better
diet.
Punishing a child for soiling his pants may make his constipation last longer.
How can constipation be prevented?
Eating fruits, vegetables, bran, and fiber can help prevent constipation.
Drinking water and fruit juices can help.
Avoid large amounts of milk, yogurt, cheese, meat, fatty foods, candy, and
desserts.
When should I call the doctor? Constipation can cause a small tear in the anal canal called an anal fissure.
A child with a tear may have a small amount of bright red blood on his toilet
paper or in his stools. You do not need to call the doctor unless:
there is a large amount of blood mixed in stools.
your child has bad rectal or stomach pain.
your child doesn't have a BM after 3 days of trying a new diet.
you have questions or concerns.
Quick Answers
Constipation is painful, infrequent, or inability to have bowel movements
(BMs).
The wrong diet and waiting too long to have a BM can cause constipation.
Changes in diet, eating regular meals, and taking regular bathroom breaks
can help constipation.
Constipation should not last more than 3 days.
Constipation can be avoided by eating fruits, vegetables, bran, fiber, and
drinking plenty of fruit juices and water.
Call the doctor if your child has stomach or rectal pain, has not had a
BM in 3 days, or if you have questions.
References
American Academy of Family Physicians. Constipation in Children. 1996-2000
(cited 2001 September 10). Available from: URL: http://www.familydoctor.org/handouts/222.html
American Academy of Family Physicians. How to deal with Your Child's Chronic
Constipation. (cited 2001 September 26)
Loening-Baucke V, MD. Chronic Constipation and Stool Soiling. <cited
2001 September 26).
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