Why can infants and children face occasional constipation?
When it comes to occasional constipation in children, or pediatric constipation, everything relies on spotting the signs and symptoms of constipation yourself.
The good news is that in 90 to 95% of children affected by constipation there is no reason for concern because for this type of “functional” constipation, no single mechanism or organic disease can be found to cause it.
- At least four soft, grainy, yellow discharges are considered normal per day. Breastfed babies have a higher frequency of bowel movements than those fed formula milk.
- With the start of weaning, the evacuation may become less frequent, however the stools remain soft.
- After one year of age, most babies produce soft but formed stools once or twice a day.
Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Another cause may be a diet not rich enough in fiber. Some children avoid going to the bathroom, even when they really have the urge to go. Sometimes, medicines like antidepressants and those used to treat iron deficiencies can cause constipation.
Spotting the symptoms of constipation
Kids have different bathroom habits. If children do not pass stool every day it does not necessarily mean that they are constipated. Some children go three times a day, while others go once every 1–2 days. But there are several clear signs you could notice, e.g. that your child goes less than usual, has trouble or pain when going to the bathroom, you see staining of the underwear with bits of stool or a little blood on the toilet paper3.
Fewer than three bowel movements in a week
Gassiness and Flatulence
Stool (poop) that's hard, dry, and unusually large
Feeling of bloatedness
If your child has a hard stool consistency and often suffers from straining to poop, pain with passing stool or even withholding of bowel movements, we would recommend you consult your pediatrician5,4.
What could be causing discomfort?
Most of the time, functional constipation in children is caused by painful bowel movements which results in voluntary withholding of stool passing by a child who wants to avoid unpleasant defecation (toilet training, changes in routine or diet, stressful events, intercurrent illness, unavailability of toilets, or the child’s postponing defecation, etc.)6.
Diet with a low intake of fiber
Constipation in children can be due to a diet that does not include enough fiber and fluids, which help the bowels move as they should. Kids who eat lots of processed foods and a diet full of fatty, sugary, or starchy foods can slow the bowels down4. In certain children who do not respond to behavioral and medical management, constipation could also be linked to an intolerance to milk proteins. Usually, the suspected allergy trigger is removed from the child’s diet for 2-4 months to assess the involvement of milk proteins7.
Stress can also trigger constipation in children. They can get constipated when they're anxious about something, like starting at a new school, the birth of a sibling or problems at home4.
Functional constipation in children may result from withholding of feces by a child who wants to avoid unpleasant defecation, e.g. because of anal fissures or passing of stool is postponed because he or she is too busy8.
In some rare cases, constipation in children may be linked to a physical disorder or to a use of a specific drug. This is what is called organic constipation. In these rare cases, constipation is only a sign of other medical illnesses. So talk to your doctor if your child continues to have problems or if the constipation lasts for 2 to 3 weeks3,4,8.
How to prevent occasional constipation in children?
Once constipation has been diagnosed in a child (with the help of a pediatrician), there are a few steps you can help them take towards feeling better and developing helpful habits. Children tend to imitate adults. Setting the right example and habits can have a long-term effect on their diet (and yours!).
1. Serve a healthier, fiber-rich diet
A high-fiber diet for children is essential to maintain a healthy digestion and can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along. When adding more fiber to your child's diet (including fresh fruits, vegetables, wholemeal products and also yogurts), do so slowly over a few weeks and make sure your child also drinks more liquids.
2. Developing healthy habits
If you have not done yet, develop a regular meal schedule. Eating is a natural stimulant for the bowels, so regular meals may help kids develop routine bowel habits. By getting your child into the habit of going, you can help your child to set a habit by encouraging it to use the toilet in the morning or after eating. Ensure that your child gets enough exercise. Physical activity nudges the bowels into action, so encourage your children to get plenty of exercise.
Dulco® range of solutions
Talk with the doctor before giving your child any kind of over-the-counter medicine for constipation4. However, it is often necessary to use laxative medication to help constipated children achieve regular bowel movements. Discover Dulcolax® range of solutions.
- Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005 Jan;100(1):232-42.
- Benninga MA, Candy DC, Taminiau JA. New treatment options in childhood constipation? J Pediatr Gastroenterol Nutr. 2005 Sep;41 Suppl 1:S56-7.
- Loening-Baucke V. Chronic constipation in children. Gastroenterology. 1993 Nov;105(5):1557-64.
- Murren-Boezem, J. Constipation (KidsHealth). Department of Nemours Childrens Urgent Care. 2018. https://kidshealth.org/en/parents/constipation.html
- Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr. 2005 Mar;146(3):359-63.
- Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database Syst Rev. 2016 Aug 17;2016(8):CD009118.
- Carroccio A, Iacono G. Review article: Chronic constipation and food hypersensitivity--an intriguing relationship. Aliment Pharmacol Ther. 2006 Nov 1;24(9):1295-304.
- Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2006 Sep;43(3):e1-13. doi: 10.1097/01.mpg.0000233159.97667.c3. PMID: 16954945.