How can I tell if my child is constipated?
Young children usually have bowel movements several times a week. Your child may go after every meal, or she may wait a day or two in between. Her individual pattern depends on what she eats and drinks, how active she is, and how quickly she digests food.
If you're concerned that your child may be constipated, watch for these signs:
- Less frequent bowel movements than usual, especially if she hasn't had one in at least four days and is obviously uncomfortable when she does
- Hard, dry stools that are uncomfortable for her to pass
- Very watery stool in your child's diaper (or soiled underwear if she's potty-trained). Don't assume this is diarrhea – it may actually be evidence of constipation. Liquid stool can slip past the blockage in the lower intestine and wind up in your child's diaper or underwear.
Why is my child getting constipated?
Constipation in young children usually results from several factors. The most likely reasons are:
Drinking too much milk. Filling up on milk instead of eating food high in fiber is often the main cause of constipation in toddlers and preschoolers.
Eating too many other low-fiber foods. Your child could wind up constipated if he eats a lot of cheese, yogurt, or peanut butter, for instance, and not enough fruits, vegetables, and whole grains.
Toilet anxiety. If your child feels pressured about toilet training, he might deliberately withhold his stool. If he shows all the signs of straining to have a bowel movement – stiffening his body and getting red in the face – he may actually be trying to hold it in.
Even if your child is potty-trained, he may not take enough time on the toilet to completely empty his bowels. That can cause a buildup of feces that makes the colon cramp and stretch. An enlarged colon can lead to hard stools that are larger than normal and difficult to pass – which only makes your child even more reluctant to use the potty.
Dehydration. If your child becomes dehydrated, his system will respond by absorbing more fluid from whatever he eats or drinks – and also from the waste in his bowels. The result is hard, dry stools that are difficult to pass.
Lack of activity. Movement helps blood flow to your child's digestive system, so he may experience trouble in the BM department if he's not active.
Underlying medical issues. Constipation is sometimes a symptom of other conditions, including lactose intolderance, hypothyroidism, diabetes, and cystic fibrosis.
How can I treat my child's constipation?
Here are some things to try:
- Avoid giving your child too many foods that have a binding effect. These include bananas, cooked carrots or squash, and large quantities of dairy products such as milk, cheese, yogurt, and ice cream. Two cups of dairy a day are adequate for a young child. (For example, 1 cup is a cup of milk or yogurt, or 1 1/2 ounces of hard cheese.) For more information, see our guides to feeding your toddler or preschooler.
- Boost your child's fiber intake. Give her plenty of whole grains, fruits, and vegetables. Offer apricots, plums, peas, beans, broccoli and, of course, prunes. If she doesn't like the taste of prunes, try adding prune juice to her milk: Just 1 ounce of prune juice in half a cup of milk is very effective.
- To help keep your child's stools soft, increase the amount of fluid she drinks. Water is your best choice, but a little prune juice or apple juice can help. Limit your child's juice consumption to 1/2 to 3/4 cup (4 to 6 ounces) a day to prevent tooth decay and a ruined appetite. Encourage her to drink at least 32 ounces of something other than milk each day.
- Encourage her to cruise or walk every day to get the blood flowing to all her organs.
- Massage your child's belly. Measure three finger-widths below her navel on her lower left side, and apply gentle but firm pressure there with your fingertips. Press until you feel a firmness or mass. Maintain gentle but constant pressure for about three minutes.
- Don't pressure your child to toilet train before she's ready. Forcing her to use the potty can make her afraid or resentful, and she could wind up withholding bowel movements. If you notice your child doing this, increase the amount of fiber she eats (see above) and back off on training. Wait to try again until you spot the signs she's really ready.
- Encourage your child to use the potty as soon as she feels ready to poop. If she says she never feels ready, try having her spend five to 10 minutes on the toilet after breakfast and dinner. (Children who have been constipated for a long time may have trouble perceiving that their rectum is full.) Make it a pleasant experience by reading a book to her while she's sitting on the potty. But don't force her to stay there if she doesn't want to or she'll start to think using the toilet is a punishment.
- Talk to your child's doctor about other treatment options. If your child is very constipated, the doctor may suggest using an over-the-counter stool softener, lubricant (such as mineral oil), laxative, or suppository. A glycerin suppository will stimulate your child's rectum and help her pass a stool. Using a suppository occasionally is fine, but don't do it on a regular basis because your child could wind up relying on them to have a bowel movement. Note: If your child is deliberately holding back her stools, treating her with suppositories or an enema could be extremely upsetting to her. Always check with your doctor before resorting to this type of treatment.
- If your child is passing such hard, dry stools that you see a little blood or even slight tears (fissures) in the delicate skin near the opening of her anus, you can apply some aloe vera lotion to the area to help it heal. Be sure to mention the fissures to your child's doctor.
When should I call the doctor?
Call the doctor if your child isn't eating, loses weight, or has blood in his stool. Or if basic treatments, such as adjusting his diet, aren't helping his condition. Don't give your child a laxative without consulting his doctor first.