Constipation in Children

Constipation is a very common problem among children and usually occurs because a child's diet does not include enough fluids and fiber, or can be due to a factor in the child's environment.

A child is considered constipated when

• He or she has had fewer than three bowel movements in a week.

• The stools are hard, dry, and unusually large.

• It is hard for the child to have a bowel movement.

Constipation is usually not a cause for concern. It is preventable and most cases can be remedied with healthy eating and exercise habits.

WHAT CAUSES CONSTIPATION?

Most of the time, constipation in children is due to a diet that does not include enough water and dietary fiber. Fiber and water help the bowels to move properly. Children who have a typical fast-food diet, that is rich in fats (burgers, fries, milkshakes) and processed sugars (candy, cookies, sugary soft drinks), may find that they are constipated more often.

Antidepressants and medications used to treat iron deficiencies could lead to constipation. In babies, constipation can occur as they transition from breast milk to baby formula or from baby food to solid food.

Children tend to avoid going to the bathroom, even when they really have to go. Kids often ignore internal urges because they do not want to stop playing a fun game, use a restroom away from home, or have to ask an adult to be excused to go to the bathroom. Ignoring the urge to go now makes it harder to go later on.

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

Some kids get constipated because of a condition called irritable bowel syndrome (IBS). This can occur when they are stressed or eat certain trigger foods (trigger foods are usually fatty or spicy). A child with IBS may have either constipation or diarrhea, as well as stomach pain or gas.

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

SYMPTOMS OF CONSTIPATION

Children have different bathroom habits. A child who does not have a bowel movement every day is not necessarily constipated. One child might go three times a day, while another might only go once every 2 days. A child is constipated when he or she is going less than usual.

Your child might complain of feeling full, say that it hurts to poop; that he or she has to strain to poop, or that there is a little blood on the toilet paper.

DEALING WITH CONSTIPATION

You can take the following steps to prevent and treat constipation:

• Give your child more fluids. Drinking enough water and other liquids helps stools move more easily through the intestines. The amount of fluids your child needs is going to vary according to weight and age. Most children need 3 to 4 glasses of water each day. In addition, also give your child 1 to 2 cups of juice each day. If your infant is constipated during the transition from breast milk or into solid foods, try giving him just a little prune - or apple juice each day. If the constipation persists, or it seems to be causing your child distress, it may be due to something like food allergies, so call your child's doctor.

• Feed your child more fiber. Food that is high in fiber, such as fruits, vegetables, and whole-grain bread, can help prevent constipation. Fiber cannot 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. Fiber does not have to be a turn-off for your child: try apples, oatmeal, oranges, bananas, baked potatoes, and popcorn.

• Make sure your child gets enough exercise. Physical activity nudges the bowels into action, so encourage your child to get plenty of exercise. It can be something as simple as playing catch or riding a bike.

• Develop a regular meal schedule. Eating is a natural stimulant for the bowels, so regular meals could help your child 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 your child into the habit of going. If your child is holding it when he or she has to go to the bathroom, you may want to have your child sit on the toilet for at least 10 minutes at about the same time each day, preferably after a meal.

In most cases, these small changes can go a long way toward helping your child feel better and getting the bowels moving the way they should.