Constipation

What Is Constipation?

Kids might have constipation if they:

• have fewer than three bowel movements (BMs) in a week
• have trouble having a bowel movement
• have stool (poop) that's hard, dry, and unusually large

Constipation is a very common problem in kids. It usually isn't a cause for concern. Healthy eating and exercise habits can help prevent it.

What Are the Signs & Symptoms of Constipation?

Different kids have different bathroom habits. A child who doesn't have a bowel movement every day isn't necessarily constipated. One child might go three times a day, while another might go once every 1–2 days.

Generally, signs of constipation in kids include:

• going less than usual
• having trouble or pain when going to the bathroom
• feeling full or bloated
• straining to poop
• seeing a little blood on the toilet paper

It's also common for kids with constipation to sometimes stain their underwear with bits of stool.

What Causes Constipation?

Constipation can be due to a diet that doesn't include enough water and fiber, which help the bowels move as they should. Kids who eat lots of processed foods, cheeses, white bread and bagels, and meats may become constipated fairly often.

Sometimes, medicines like antidepressants and those used to treat iron deficiencies can cause constipation. Constipation can happen in babies as they move from breast milk to baby formula, or from baby food to solid food. Toddlers who are toilet training sometimes can become constipated, especially if they're not ready.

Some kids avoid going to the bathroom, even when they really have the urge to go. They might ignore internal urges because they don't want to use a restroom away from home, stop playing a fun game, or have to ask an adult to be excused to go to the bathroom. Ignoring the urge to go makes it harder to go later.

Stress also can lead to constipation. Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Research has shown that emotional upsets can affect how well the gut functions and can cause constipation and other conditions, like diarrhea.

Some kids get constipated because of irritable bowel syndrome (IBS), which can happen when they're stressed or eat certain trigger foods, which often are fatty or spicy. A child with IBS may have either constipation or diarrhea, as well as stomach pain and gas.

In rare cases, constipation is a sign of other medical illnesses. So talk to your doctor if your child continues to have problems or if the constipation lasts for 2 to 3 weeks.

How Can We Prevent and Treat Constipation?

To prevent and treat constipation:

• Give your child more liquids. Drinking enough water and other liquids helps stools move more easily through the intestines. The amount kids need will vary based on their weight and age. But most school-age kids need at least 3 to 4 glasses of water each day. If your infant is constipated during the move from breast milk or to solid foods, try serving just a few ounces (2–4) of apple, pear, or prune juice each day. If the constipation lasts or upsets your child, a health problem could be the cause, so call your doctor.
• Serve more fiber. High-fiber foods (such as fruits, vegetables, and whole-grain bread) can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along. A diet full of fatty, sugary, or starchy foods can slow the bowels down. When adding more fiber to your child's diet, do so slowly over a few weeks and make sure your child also drinks more liquids.
  
  Fiber doesn't have to be a turn-off for kids — try apples, pears, beans, oatmeal, oranges, ripe bananas, whole-grains breads, and popcorn. Adding flax meal or bran to homemade fruit smoothies is another way to slip fiber into a child's diet.
• Make sure kids get enough exercise. Physical activity nudges the bowels into action, so encourage your kids to get plenty of exercise. It can be as simple as playing catch, riding bikes, or shooting a few hoops.
• Develop a regular meal schedule. Eating is a natural stimulant for the bowels, so regular meals may help kids develop routine bowel habits. If necessary, schedule breakfast a little earlier to give your child a chance for a relaxed visit to the bathroom before school.
• Get kids into the habit of going. If your child fights the urge to go to the bathroom, have him or her sit on the toilet for at least 10 minutes at about the same time each day (ideally, after a meal).

These small changes help most kids feel better and get the bowels moving the way they should. Talk with the doctor before giving your child any kind of over-the-counter medicine for constipation.