Symptom

Constipation in Children

Overview | Possible Causes | Care and Treatment | HOME REMEDies | When to Call the Doctor | References

constipation in children

Overview

Constipation in children is a common problem. A constipated child has infrequent bowel movements or hard, dry stools.

Common causes include early toilet training and changes in diet. Fortunately, most cases of constipation in children are temporary.

Encouraging your child to make simple dietary changes — such as eating more fiber-rich fruits and vegetables and drinking more water — can go a long way toward alleviating constipation. If your child's doctor approves, it may be possible to treat a child's constipation with laxatives.

Possible Causes

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing the stool to become hard and dry.

Many factors can contribute to constipation in children, including:

Withholding. Your child may ignore the urge to have a bowel movement because he or she is afraid of the toilet or doesn't want to take a break from play. Some children withhold when they're away from home because they're uncomfortable using public toilets. Painful bowel movements caused by large, hard stools also may lead to withholding. If it hurts to poop, your child may try to avoid a repeat of the distressing experience.
Toilet training issues. If you begin toilet training too soon, your child may rebel and hold in stool. If toilet training becomes a battle of wills, a voluntary decision to ignore the urge to poop can quickly become an involuntary habit that's tough to change.
Changes in diet. Not enough fiber-rich fruits and vegetables or fluid in your child's diet may cause constipation. One of the more common times for children to become constipated is when they're switching from an all-liquid diet to one that includes solid foods.
Changes in routine. Any changes in your child's routine — such as travel, hot weather or stress — can affect bowel function. Children are also more likely to experience constipation when they first start school outside of the home.
Medications. Certain antidepressants and various other drugs can contribute to constipation.
Cow's milk allergy. An allergy to cow's milk or consuming too many dairy products (cheese and cow's milk) sometimes leads to constipation.
Family history. Children who have family members who have experienced constipation are more likely to develop constipation. This may be due to shared genetic or environmental factors.
Medical conditions. Rarely, constipation in children indicates an anatomic malformation, a metabolic or digestive system problem, or another underlying condition.

Care & Treatment

Depending on the circumstances, your child's doctor may recommend:

Over-the-counter fiber supplements or stool softeners. If your child doesn't get a lot of fiber in his or her diet, adding an over-the-counter fiber supplement, such as Metamucil or Citrucel, might help. However, your child needs to drink at least 32 ounces (about 1 liter) of water daily for these products to work well. Check with your child's doctor to find out the right dose for your child's age and weight.
Glycerin suppositories can be used to soften the stool in children who can't swallow pills. Talk with your child's doctor about the right way to use these products.
A laxative or enema. If an accumulation of fecal material creates a blockage, your child's doctor may suggest a laxative or enema to help remove the blockage. Examples include polyethylene glycol (GlycoLax, MiraLax, others) and mineral oil.
Never give your child a laxative or enema without the doctor's OK and instructions on the proper dose.
Hospital enema. Sometimes a child may be so severely constipated that he or she needs to be hospitalized for a short time to be given a stronger enema that will clear the bowel (disimpaction).

Home Remedies

There are several things you can do that might help relieve your child's constipation, for example:

Give your child prune juice. Prune juice can be mixed with other juices (such as apple juice) if your child doesn't like the taste. It's also important to make sure toddlers and older children are drinking sufficient water.
Cut back on constipating foods. Give toddlers and older children fewer foods that might lead to constipation, such as milk and cheese.
If possible, take your child for a walk or run. Regular physical activity can encourage bowel movements.
Ease up on toilet training. If you suspect that toilet training may be playing a role in your child's constipation, take a break from toilet training for a bit to see if the constipation improves.

When to Call the Doctor

Constipation in children usually isn't serious. However, chronic constipation may lead to complications or signal an underlying condition. Take your child to a doctor if the constipation lasts longer than two weeks or is accompanied by: