Constipation

Constipation is very common in children and it is usually caused by not drinking enough fluids, not eating enough fiber, or having a diet high in constipating foods (milk, cheese, banannas, etc.).

Symptoms

Children with constipation usually either have very large hard stools or hard pellet like stools. Bowel movements are also infrequent and painful.

In addition to having pain when they pass a bowel movement, children with constipation might have cramping abdominal pain.

Diagnosis

Children are usually diagnosed with constipation after a careful history and physical exam. Further testing is usually not necessary.

Careful attention should be made for children who have had severe constipation from birth, especially if they did not pass meconium stools until 2-3 days after they were born. These children might have Hirshsprung's disease.

Treatments

Treatments for childhood constipation usually includes stool softeners and changing the child to a less constipating diet, with more fiber and fluids.

Good choices of fluids include apple and prune juice and perhaps switching older children to soy milk. Reading food labels can help you to find high fiber foods.

See our Constipation Treatment Guide for more recommendations and treatments, including dosages of stool softeners.

What You Need To Know

• If your child is having soft bowel movements, then she likely isn't constipated, even if she doesn't have one every day.
• Some children with severe constipation develop a blockage, past which liquid stool sometimes leak, causing your child to have soiling accidents. This condition is caused encopresis.
• Unlike laxatives, stool softeners used in children are not usually addictive and can be given every day if necessary. A common mistake is for parents to stop stool softeners once a child begins having soft bowel movements, only to have the child soon develop constipation again. Stool softeners are often used for 4-6 months and then slowly decreased to prevent reoccurances.
• Polyethyline glycol 3350, a tasteless and odorless powder that can be mixed with water, is well tolerated by most children and often prescribed by pediatricians for children with constipation.
• In addition to dietary changes and stool softeners, many kids with constipation need a 'clean out' regimen to help get backed up stool out.
• You should not have to frequently use enemas or laxatives to help your child have a BM.