Not Everyone Poops: Constipation in Kids

by: Dan Florell, Ph.D.

“He has not pooped for three days! I am starting to get really worried”, said the mother to her husband. Her husband replied, “That is a long time. What do you think we should do?” In the meantime, the child is refusing to go near the toilet and complains, “It hurts too much”.

A little known fact outside of adults who have children is how much attention is paid to a toddler and child’s bowel movements. While not the typical content in most conversations, parents with infants and young children spend considerable time discussing the subject with other parents. One of the reasons for this is the common occurrence of constipation.

While most people believe constipation is simply not pooping for several days, it is more complicated than that. Some children can wait two or three days before having a bowel movement and not be constipated while others can have small bowel movements and be constipated. For children, the key signs are to look for poop that is hard and compact with three to four days between bowel movements. Also, constipation often involves painful bowel movements and blood in or outside of the poop.  Sometimes children can soil themselves between bowel movements.

There are several possible causes of constipation. Some children withhold their stool which might be due to stress regarding potty training, being particular about what toilet they use, or because they are afraid of having a painful bathroom experience. Another possible cause is a diet that is low in fiber or does not include enough liquids. Finally, constipation can result as a side effect if the child is on medication.

Treatment for infrequent constipation can occur at home. Adding fiber and increasing daily water intake to toddlers or children’s diet can help. This diet includes eating prunes, apricots, plums, peas, beans, and whole grain cereals. Establishing a regular toileting time, particularly with younger children, can assist in combatting constipation. This can include having the child use the toilet first thing in the morning and then after every meal or snack. Make sure to tell the child to go to the toilet and not give them the option of saying no.

If the constipation is more severe and not responsive to the addition of fluids and a high fiber diet, the pediatrician should be consulted. Often the pediatrician will have children take stool softeners, mild laxatives, or be given an enema. However, parents should not try these treatments before consulting with the pediatrician.

This article was published in the Richmond Register Health Beat Magazine in July 2013.

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