Constipation in Children
Many new parents become concerned that their baby is constipated because they will grunt and strain and turn red in the face when their bowels move. Sometimes all of this activity does not actually produce a stool at the time. As long as the baby’s stool is soft and he doesn’t seem to have any other symptoms of illness, there is not a reason for worry. Babies will usually begin to have less frequent bowel movements as they get older, and formula-fed babies will have less frequent and more solid BMs. As a baby transitions to solids, you may also find that stools are larger and farther between, but again, as long as they are soft that is OK.
What exactly is the definition of “constipation”?
If a child is having less than three bowel movements in a week, pain when passing a stool, bowel movements are hard and dry, making them difficult for your child to pass them, and stools that are so large they are difficult to pass are some of the symptoms of constipation. You may see blood in the toilet from tears in the skin when your child has a BM. You might also see some liquid stool in your child’s underwear. This happens when there is a large bolus of stool in the child’s rectum and the liquid stool goes around the hard stool and leaks out.
What are the causes of constipation?
In toddler age and older, not enough fiber in the diet (fruit, vegetables, high-fiber cereal and whole-grain bread, beans), and not drinking enough water or drinking too much milk are common factors. Being sedentary and not getting enough exercise often contributes to constipation. Children who have pain when passing a stool may withhold their BMs, making the stool larger and harder yet. Some kids just don’t want to stop what they are doing to go to the bathroom and ignore the urge to defecate. Some don’t want to use a public toilet and will only have a BM at home. Withholding stool can become a habit that is hard to break.
If you try to toilet train your child too soon, she may rebel and withhold her stool. That is one big reason to not push your child to use the toilet. We recommend toilet training start at about age 2. Just put the potty in the bathroom so that she can see it frequently. Every child learns to use the toilet eventually (unless there are medical conditions involved), so the best tactic is to be relaxed about it.
What can you do?
Make sure your child’s diet includes plenty of water, fruits, vegetables, and whole grain. Some children may need to have their dairy intake restricted—cheese and milk especially. Make sure your child gets plenty of exercise; running around and playing outside are crucial to both physical and mental health. Limit screen time to 1-2 hours per day. Have regular toilet times—first thing in the morning and after meals or a big snack. Tell the child it is time to go to the bathroom rather than asking if he needs to go. If his feet do not reach the floor, make sure he has a stool to rest his feet on when he is on the toilet. Offer some favorite books to help pass the time. A high-quality probiotic can help a great deal. Orthobiotic is available at Excell, and it comes in capsule form that can be opened and sprinkled into food or drink.
When should you make an appointment with your doctor?
Talk to your child’s doctor if the constipation persists, if she is crying while having a bowel movement, seems lethargic, complains of abdominal pain, or if you see blood in the stool or on the toilet paper. Do not give your child any laxatives, enemas, or suppositories without consulting the doctor. A stool softener may need to be prescribed, but you should always give this type of medication under the supervision of the doctor. A common mistake parents make is stopping the stool softener too soon after the child has one or two normal stools or if the stools become very soft. Stopping the medication too soon can start the cycle of constipation all over again. Many children will need to take the softener for a few weeks to a few months or even longer. Again, consult your child’s doctor about this. If there is any vomiting, fever, weight loss, or blood in the stool your child should see the doctor right away.
Blessings to you,