Constipation

What is constipation?

Constipation means not having a normal number of bowel movements. This happens when a child's stool becomes so hard that he has a hard time passing it.

How many bowel movements and how often someone has them varies from person to person. One child may have a hard bowel movement everyday and still be constipated, while another child may have bowel movements of normal feel only 2 to 3 times each week and not be thought of as constipated. Some infants go for several days without a bowel movement and are not constipated.

Why do some children become constipated? Not drinking enough fluids, eating a diet that is too low in fiber, eating too many foods that can cause constipation (for example, bananas, white rice, cheese) or drinking too much milk can all lead to constipation.

Not getting enough physical activity leads to constipation, too, as can brief illnesses. Rarely, constipation can be due to medical problems that affect the bowels or nervous system. Constipation can occur once in a while or can become a repeated problem. If the child goes a long time without having a bowel movement, the stool can become unusually hard and large. Passing this stool is painful for the child and may cause small scratches or tears in the opening of the rectum, where the stool comes out.

This also stretches out the walls of the intestine, so that it takes longer for the child to feel the urge to go to the bathroom the next time. This situation can happen again and again. One painful bowel movement may cause a child to stop going to the bathroom altogether. Holding in the bowel movement then leads to another large hard stool, which causes new scratches or tears, more pain, and so on.

Treatment / What you should do

If your child has severe abdominal pain but you're not sure why or this pain that lasts longer than a few hours, you should contact a doctor right away.

If you know for sure that your child is having infrequent hard stools, try changing the child's diet. Offer foods that contain a lot of fiber, such as fruits, vegetables and whole grain breads and cereals.

Make sure your child drinks lots of water and other liquids, but not too much milk. Prune juice and apple juice can be helpful.

Increase the amount of exercise your child gets each day.

Encourage regular toilet time, too.

Soaking in a warm bath can help relax muscles and relieve pain, making it easier for your child to have a bowel movement.

If these steps do not help, you should talk with your child's doctor. The doctor may recommend giving the child a stool softener or laxative (or both) for several days, until the bowel movements become regular and less hard. Some children may need to continue these medications for a month or even longer to avoid becoming constipated again.

Do not start your child on a steady dose of laxative medication, or give the child suppositories or enemas, without consulting a doctor first.

If the child has soiling, it is important that you do not scold the child, as this will decrease their self-confidence even further.

Most cases of soiling are due to constipation that the child cannot help.

For really stubborn constipation in children, it is sometimes necessary to admit the child to the hospital to empty the bowels completely.

Prevention

Encourage your child to drink enough fluids.

Give your child a diet high in fiber, including fruits, vegetables and whole grains.

Avoid excessive milk intake; children older than 2 years generally do not need more than 16 to 24 ounces of low-fat or non-fat milk per day.

Do not let your child eat too much ice cream, cheese or yogurt either.

Make sure your child gets lots of exercise every day and does not spend too much time watching television or playing on the computer.

Teach the child good toilet habits. After meals, a nerve signal will go from the stomach to the lower intestine with a message to empty. Take advantage of this by encouraging your child to go to the toilet 10-15 minutes after breakfast and dinner.

Make sure that small children have a footstool when sitting on the toilet. The footstool will make it easier for the child to push the stool out.

During potty training, when the child may be bored sitting on the toilet, the child can read a book or listen to music.

If the child has a successful bowel movement, adults should check this before flushing the bowel movement. If the stool is hard, increase the fluids and fiber in your child's diet, as discussed above.