Alleviating Constipation in Children

When I first began writing this blog, I wouldn’t have believed you if you would have told me that I’d someday be writing about the topic of constipation. However, here I am, writing a post on kids’ bowel habits. Motherhood sure makes you talk about a number of topics that once seemed inappropriate to discuss with strangers!

I’d be concerned that I’m addressing a topic that is of little relevance to many of you, but doctors say that constipation is common. In fact, up to 30% of children suffer from it (source) and 5% of pediatrician visits are because of it (source). Thus, I think some of you may be interested in this information.

What causes constipation in kids?

A number of things can lead to constipation. Most of these relate to the slow movement of stool through the digestive tract, causing it to become hard and dry.

• Issues with potty training. If a child isn’t ready or isn’t willing to potty train, then he or she may refuse to poop in the potty. Withholding stool in this way can develop into an involuntary habit that is difficult to change.
• Diet. If a child doesn’t eat enough fiber or drink enough healthy fluids, then the stool may travel too slowly through the digestive track and become hard.
• Withholding. Children may withhold stool for a variety of reasons. For example, they may not want to take breaks from play, they may be fearful of using public toilets, or they may be experiencing painful bowel movements. As noted above, withholding can develop into an involuntary habit.
• Changes in routine. Whenever a child’s normal routine is disrupted, there is a chance he or she will become constipated. This is because changes in routine are stressful and cause changes in diet, physical activity, and potty routines (i.e., where and how often a child can use the potty). Common changes that may lead to constipation include travel and starting school outside of the home.
• Medications. Some medications, including antidepressants, can cause constipation.
• Cow’s milk allergy. In children who have an allergy to cow’s milk, consuming dairy products may cause constipation.
• Medical conditions. Though it is rare, children can develop constipation because of other medical conditions (e.g., anatomic malformations, hypothyroidism, Hirschsprung’s disease).

Though having a family history of constipation does not cause children to develop it, children who have family members who have experienced constipation are more likely to develop it. This is possibly due to shared genetic or environmental factors.

Signs and symptoms of constipation in kids

Kids often don’t realize they are suffering from constipation and some are too young to put into words what they are feeling. Any of the following may indicate that a child has constipation.

• Having fewer than 3 bowel movements a week
• Passing stool that is hard, dry, large in diameter, and/or difficult to pass
• Abdominal pain, cramping, and/or nausea
• Rectal pain while having a bowel movement
• Stool soiling (i.e., traces of liquid or clay-like stool in a child’s underwear)
• Blood on the surface of hard stool
• Cranky behavior
• Visible signs that he or she is withholding stool (crossing legs, making faces, clenching the buttocks, etc. when he or she needs to have a bowel movement)

Preventing and treating constipation in kids

Many cases of constipation can be treated with simple changes that help soften a child’s stool.

• Give high-fiber foods. Foods that are high in fiber (e.g., fruits, vegetables, beans, whole-grain cereals) help alleviate constipation. Insoluble fiber adds bulk to the stool and soluble fiber absorbs water to form a gel-like substance that helps stool pass smoothly through the large intestine. Many high-fiber foods contain some of both types of fiber. Doctors recommend that children aged 2 to 19 years eat a daily amount of fiber that equals their age plus 5 grams of fiber. For example, 7 grams of fiber are recommended for a 2-year-old.
• Give lots of fluids. Fiber will only help alleviate constipation if a child is sufficiently hydrated (otherwise it can actually contribute to constipation). Water is often the best, but watered down juice and things like decaffeinated tea are okay if a child won’t drink a lot of water.
• Encourage physical activity. Physical activity helps stimulate normal bowel function, so it is critical that kids get up and moving.
• Create a potty routine. Set aside time after each meal to use the toilet. This is helpful because people often feel the need to have a bowel movement after eating and because kids often don’t want to stop playing in order to take time to poop. Making it a habit to sit on the potty for 5 minutes or so after each meal takes advantage of the body’s natural urge to go and makes sure a child is taking the time needed for a bowel movement to happen. Consider providing a footstool for comfort and for the child to have enough leverage to release a stool.
• Remind your child not to withhold. Provide frequent reminders not to ignore the urge to use the potty. If it looks like a child needs to go (he or she is grimacing, squirming, clenching the buttocks, etc.), then encourage him or her to sit on the potty even if he or she denies needing to go.
• Check with the doctor about medications. Because some medications can cause constipation, be sure to check with your pediatrician to find out if this may be the source of a child’s constipation.

Sometimes stool softeners or laxatives are needed to treat constipation in kids, but you should always check with your child’s healthcare provider before giving any of these. Your doctor may also recommend a fiber supplement or probiotics.

Final thoughts

Unfortunately, chronic constipation can lead to some complications. These include encopresis, anal prolapse, anal fissures, etc. Therefore, it is very important to see your child’s doctor if constipation doesn’t go away with the measures listed above.

For additional information on constipation in kids, visit my sources:

• Constipation in Children (AAP)
• Treatment for Constipation in Children (NIDDK)
• Constipation in Children (Mayo Clinic)

Over the next couple of weeks, I’ll share some useful tips and tools for helping prevent and treat constipation in kids.

Have your kids ever struggled with constipation? What things help them have regular bowel movements?

Shared at the following:

Encouraging Hearts and Home, Tuesdays with a Twist, and Over the Moon.