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Constipation

How do I know if my child is constipated?

If your child doesn't have daily bowel movements, you may worry that she is constipated. Constipation occurs for a variety of reasons.

  • Diet. Changes in diet, or not enough fiber or fluid in your child's diet, can cause constipation.
  • Illness. If your child is sick and loses his appetite, a change in his diet can throw off his system and cause him to be constipated. Constipation may be a side effect of some medicines. Constipation may result from certain medical conditions (such as hypothyroidism or low thyroid).
  • Withholding. Your child may withhold his stool for different reasons. He may withhold to avoid pain from passing a hard stool—it can be even more painful if your child has a bad diaper rash. Or he may be dealing with issues about independence and control—this is common between the ages of 2 and 5 years. Your child also may withhold because he simply doesn't want to take a break from play. Your older child may withhold when he's away from home, at camp or school, because he's embarrassed or uncomfortable using a public toilet.
  • Other changes. In general, any changes in your child's routine (such as traveling, hot weather, or stressful situations) may affect his overall health and how his bowels function.

Symptoms of constipation

Symptoms of constipation may include the following:

  • Many days without normal bowel movements
  • Hard stools that are difficult or painful to pass
  • Abdominal pain (stomachaches, cramping, nausea)
  • Rectal bleeding from tears called fissures
  • Soiling
  • Poor appetite
  • Cranky behavior

You also may notice your child crossing her legs, making faces, stretching, clenching her buttocks, or twisting her body on the floor. It may look like your child is trying to push the stool out but instead she's really trying to hold it in.

Treatment

Constipation is treated in different ways. Your pediatrician will recommend a treatment based on your child's age and how serious the problem is. If your child's case is severe, he may need a special medical test, such as an x-ray. In most cases, no tests are needed.

Treatment of babies. Constipation is rarely a problem in younger infants. It may become a problem when your baby starts solid foods. Your pediatrician may suggest adding more water or juice to your child's diet.

Treatment of older children. When a child or teen is constipated, it may be because his diet doesn't include enough high-fiber foods and water. Your pediatrician may suggest adding more high-fiber foods to your child's diet, and encourage him to drink more water. These changes in your child's diet will help get rid of abdominal pain from constipation.

Severe cases. If your child has a severe case of constipation, your pediatrician may prescribe medicine to soften or remove the stool. Never give your child laxatives or enemas unless your pediatrician says it's OK; laxatives can be dangerous to children if not used properly. After the stool is removed, your pediatrician may suggest ways you can help your child develop good bowel habits to prevent stools from backing up again.

Prevention

Because each child's bowel patterns are different, become familiar with your child's normal bowel patterns. Make note of the usual size and consistency of her stools. This will help you and your pediatrician determine when constipation occurs and how severe the problem is. If your child doesn't have normal bowel movements every few days, or is uncomfortable when stools are passed, she may need help in developing proper bowel habits.

You can. . .

  • Encourage your child to drink plenty of water and eat more high-fiber foods.
  • Help your child set up a regular toilet routine.
  • Encourage your child to be physically active. Exercise along with a balanced diet provides the foundation for a healthy, active life.

If you are concerned about your child's bowel movements, talk with your pediatrician. A simple change in diet and exercise may be the answer. If not, your pediatrician can suggest a plan that works best for your child.

 

Published online: 3/07
Source: Constipation and Your Child (Copyright © 2005 American Academy of Pediatrics)

Healthcare professionals may order this publication in multi-copy packs.
Parents can find more information on this topic in Caring for Your Baby and Young Child: Birth to Age 5. To order a copy of this book visit the AAP Bookstore.

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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.



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