If you’ve been constipated as an adult, you know how uncomfortable it can be. Now imagine being a baby, toddler, or young child with constipation. They don’t understand what’s happening and depending on their age, they can’t always communicate their symptoms. Your child could be constipated for some time before you realize it. Constipation is infrequent bowel movements, typically fewer than three in 1 week. In many cases, child constipation is short term and resolves with treatment. To treat it, though, you must learn how to recognize the signs of constipation in your child. Here’s everything you need to know about constipation in children, from the symptoms to look out for to quick fixes.
Some formula-fed and breastfed infants get constipated once they’re introduced to solid foods. Symptoms of constipation in a baby or infant include:
- pellet-like bowel movements
- difficulty passing stools
- crying during bowel movements
- hard, dry stools
- less frequent bowel movements
Stool frequency can vary from baby to baby, so use your baby’s normal activity as a baseline. If your baby normally has one bowel movement a day and it’s been a few days since their last stool, this could be a sign of constipation.
Toddlers may have similar symptoms to a baby, as listed above. You may see other symptoms in toddlers, too, such as:
- unusually large stools
- stomach feels hard to the touch
- abdominal swelling
- traces of blood on toilet paper
Along with the aforementioned symptoms, older kids may complain of stomach pain and have traces of liquid in their underwear from backed-up stool in the rectum. Your older child may also have pain during bowel movements and avoid going to the bathroom.
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 fibre-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.
Increase Fibre Intake
A diet rich in fibre can help your little one’s body form soft, bulky stools. Serve your child more high-fibre foods, such as fruits, vegetables, beans, and whole-grain cereals and bread. Include fruits and fruit juices that contain sorbitol such as prunes, mangoes and pears. If your child isn’t used to a high-fibre diet, start by adding just several grams of fibre a day to prevent gas and bloating. The recommended intake for dietary fibre is 14 grams for every 1,000 calories in your child’s diet. Fibre increases the weight and size of your stool and softens it. A bulky stool is easier to pass, decreasing your chance of constipation. If your little one defecates loose, watery stools, fibre may help to solidify the stool because it absorbs water and adds bulk to stool.
Get Into Position
When they’re sitting on the toilet, make sure your child’s feet are firmly supported flat on a box or stool. Knees should be above the hips in a secure position. You might need a children’s toilet seat to help with this. Your little one should lean forward slightly, rest their elbows on their knees and gently push out their tummy. Sitting in the said position will help rectal muscles into a more neutral position, reducing the straining. Getting your child to relax and calm down a little bit in a “pooping” position might be just the ticket into finally getting it out.
Abdominal massage has long been used to relieve constipation in adults and children alike, and if you feel confident enough (and your child will sit still long enough to let you), you could try giving your little one’s belly a little rub down. Remember to use very little pressure as you massage your little one’s tummy. Here are a few ways you can massage constipation out of your little one:
- Gently but firmly press down on their tummy (left side, three finger-width below their belly button) with your fingertips. Rub your little one’s tummy until you feel a mass or firmness. Once you’ve found the spot, press and hold on it for 3 minutes.
- Gently move your little one’s legs in a bicycling motion to help stimulate their bowels.
- Get your child to lie down on their back, rub a little body cream or almond or coconut oil into your palms and gently rub onto your child’s belly. Using your thumbs or the first three fingers on each hand, start from the belly button and make circular motions downwards, pressing lightly.