Constipation is a common problem for toddlers. If you notice your toddler is having a hard time going to the bathroom, don’t panic.
Toddlers are, by nature, a demanding bunch. Their moods and whims can change on a dime.
Even something as basic as going to the bathroom can get tricky.
While some toddlers go to the bathroom every day like clockwork, other kids can go two, three, or even more days without having any bowel movements.
Seeing an empty toilet day after day might fill parents with panic, but constipation in toddlers isn’t usually a sign of any severe disease.
Most often, it’s caused by a problem that’s easy to solve, like dieting or ignoring the urge to go.
So how do you know if infrequent bathroom visits are regular for your child or if you have a constipated toddler? Read on to find out when toddler constipation is a problem and how to treat it.
What Causes Constipation?
Most of us find out the hard way – no pun intended – that diet can quickly trigger constipation, especially in toddlers.
Many foods toddlers love have a binding effect that can make stools hard to pass.
Some of these foods include bananas, cheese, yogurt, ice cream and even veggies like cooked carrots and squash.
The first thing you can do to help ease symptoms of constipation is to eliminate these foods from your baby’s diet.
A variety of things can cause constipation in toddlers, from diet to medication. Here are a few of the most common causes:
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In many cases of toddler constipation, the culprit is a diet that’s too heavy in processed foods, dairy, and sweets and too light in the fibre (like whole grains, fruits, and vegetables).
Not getting enough fluid can also lead to constipation because it makes the stools harder.
Any change in diet — such as when your toddler transitions from breast milk or formula to cow’s milk or starts eating new foods — can also affect the stools.
I am holding it In
The average 2-year-old is far more interested in playing with toys than going to the bathroom.
Some children are embarrassed or afraid to use the toilet, especially when it’s a public restroom.
Toddlers who rebel against the toilet training process sometimes express their power struggle in a refusal to go.
Fear of Discomfort
Constipated toddlers who’ve had painful bowel movements in the past sometimes avoid using the bathroom out of fear that it will hurt again.
Not using the bathroom can turn into an uncomfortable cycle.
Stool begins to build up in the lower part of the bowel, getting bigger and harder until it’s even more difficult and painful to pass.
Change in Routine
Going on vacation and being away from their regular toilet can make some toddlers unwilling to go to the bathroom.
Lack of Physical Activity
Exercise helps with the movement of food through the digestive process.
Changes in appetite due to a stomach bug or other illness can affect your child’s diet, leading to constipation.
Some medications or supplements can lead to a constipated toddler, including high-dose iron supplements or narcotic pain medication.
The low-dose iron in a baby formula does not cause constipation.
An anatomical problem with the intestines, anus, or rectum can cause chronic constipation in rare cases.
Cerebral palsy and other nervous system disorders can also affect a child’s ability to go to the bathroom.
Constipation Symptoms in Babies and Children
The symptoms of constipation in babies and children aren’t much different from symptoms in adults. The main difference is that babies and some children can’t communicate how they feel, so you need to pay attention to their bowel movements to recognise irregularity.
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 usual activity as a baseline.
If your baby has typically 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:
- huge stools
- stomach feels hard to the touch
- abdominal swelling
- traces of blood on toilet paper (due to small tears around the anus from straining)
Along with the symptoms above, 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.
Is My Toddler Constipated?
The average toddler (if there is such a thing) makes a bowel movement once a day.
Usually, a child who has a bowel movement fewer than three times a week (or less often than they typically do) and whose stools are hard to pass is constipated.
Also, according to the American Academy of Pediatrics, any child with stools that are large, hard, dry, and accompanied by painful bowel movements, soiling between bowel movements, or blood on the outside of the seat may have constipation.
Don’t be worried if your child has about of constipation — it’s perfectly normal once in a while.
But if your toddler’s constipation lasts for two weeks or more, it’s called chronic constipation, and you should see your pediatrician.
Your doctor may ask you to keep track of your child’s bowel movements — how often they occur, how big and hard they are, and if there is any blood in your toddler’s stool.
It would help if you also looked for other symptoms that can occur along with constipation, such as:
- Loss of appetite
- General crankiness
- Crying or screaming during bowel movements
- Avoiding the toilet (signs that your child is doing this include clenching the buttocks, crossing the legs, turning red, sweating, or crying)
- Smears orbits of liquid stool in the diaper or underwear (soiling)
Treatments for Toddler Constipation
When toddler constipation is a problem, you can try one of these remedies:
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To soften the stools and make them easier to pass, increase the amount of non-dairy fluid and fibre your child gets each day.
High-fibre foods include fruits and fruit juices that contain sorbitol (prune, mango, pear), vegetables (broccoli, peas), beans, and whole-grain bread and cereals.
Limit foods that can increase constipation, such as fatty foods that are low in fibre. Limit milk to 16 ounces per day.
Make sure your toddler gets out to play for at least 30 to 60 minutes a day. Moving the body keeps the bowels moving, too.
Improve bowel habits.
Please encourage your child to use the bathroom regularly during the day, especially after meals and whenever they feel the urge to go. Let your toddler sit for at least 10 minutes at a time.
Put a small stool under your child’s feet — the leverage will help them push.
Reward your toddler for using the toilet with a unique story or a sticker, so it becomes a positive experience.
Your health care provider may recommend medication to treat your toddler’s constipation, especially if it’s chronic.
You may also need to discuss stopping or changing a medication your child is taking if that is causing constipation.
Baby and Toddler Constipation Home Remedies
Even though constipation is uncomfortable for infants and toddlers, it’s rarely a sign of an underlying condition. Several home remedies can help soften stools and relieve constipation.
Drink More Water
Constipation can develop when stools become dry and hard. Drinking water can soften stools, making them easier to pass.
If your baby is at least six months old, you can offer 2 to 3 ounces of water at a time to relieve constipation. Keep in mind that water doesn’t replace regular feedings.
Drink Some Fruit Juice
Fruit juice is also effective for relieving constipation because some contain the sweetener sorbitol, which can function as a laxative.
If your baby is at least six months old, you can offer 2 to 4 ounces of fruit juice. This includes 100-per cent apple juice, prune juice, or pear juice in addition to regular feedings.
Add More High Fiber Foods
If your baby has started eating solid foods, incorporate more high fibre baby foods into their diet. This includes:
Reduce Amount of Rice Cereal
Rice cereal can also trigger constipation because it’s low in fibre. Reduce the amount of rice cereal you feed your baby to relieve constipation.
Another option is to insert an infant glycerin suppository into your baby’s anus. These are safe for infants and available over the counter for fast relief.
Babies under the age of 6 months only need the formula and breast milk, no other fluids.
If you’ve been giving a baby under six months solid foods or rice cereal, stop giving these foods. See if their symptoms improve. If symptoms don’t improve, see their pediatrician.
Constipation Remedies for Older Kids
For older kids, here are a few essential tips to stimulate bowel movements.
Increase Their Water Intake
Lack of fluids contributes to constipation in older children. Make sure your child drinks at least 32 ounces of water each day to help soften their stools.
Give Your Child a Suppository
Like infants, glycerin suppositories can soften stools in older children, so they’re easier to pass.
Increase Fiber Intake
A low fibre diet is another contributing factor to constipation in children. Be sure to include more fibre-rich options in their diet.
This includes more fruits, vegetables, and whole grains. You can also administer children fibre supplements.
To figure out how much fibre your child needs per day, take their age and add 5. So, if your child is eight years old, they’ll need 13 grams of fibre per day.
Increase Physical Activity
A sedentary lifestyle may also play a role in constipation. Encourage physical activity to help stimulate intestinal contractions and bowel movements.
Foods That Ease Constipation
First, make sure your little one is eating non-binding, low-fat foods that are high in fibre like potatoes, raspberries, whole-wheat pasta, avocado and pears.
Because fibre is ingested but not digested, it adds bulk to the stool, passing through the digestive system more efficiently.
And, of course, there’s always prune juice. At the first hint of constipation, we would give my boys organic prune juice/apple juice, which we jokingly called “apple juice.” But, hey, it did the trick!
Keep them Hydrated
Drinking water sounds like an obvious need, but it’s essential if your baby is constipated.
The more hydrated baby’s body is, the better her organs function, including her intestines and bowels.
Breast milk and formula help, too, especially if you’re incorporating solid foods into her diet. The introduction of new foods to her sensitive system can trigger constipation and belly pain.
A Potty Problem
Sometimes toddlers who are potty training get constipated because they don’t want to do “number two” on the toilet. It’s a common problem.
If they “hold it” for too long, things can get backed up. If you think that’s the case, try a different approach until constipation resolves.
Her bowels will let her know when she needs to go, so don’t force it. She should sit on the potty when she feels the urge and gets off the potty when the urge passes.
Resolving Toddler Constipation: Do’s and Don’ts
It’s a common toilet-training roadblock: children have no trouble peeing in the potty, but when it comes to poop, well, that’s a different obstacle.
Some kids are so opposed to pooping on the potty they hold bowel movements, which can cause chronic and sometimes severe constipation.
Over time, hard stools can cause hemorrhoids or tiny tears in the anus (fissures).
Not surprisingly, this makes the child even more afraid to poop, which leads to more toilet trouble and a maddening cycle of pain and frustration all around.
If this is the story in your house, take heart: Children rarely hold their bowel movements complicated.
Instead, they’re potty-averse because they’re used to doing their business on the run (in a diaper), or they can’t wrap their minds around the concept of letting their poop loose.
Whatever the reason, these basic dos and don’ts can help pave the way toward successful (and seamless) pooping:
- Encourage your child to drink plenty of fluids. Stick to water or water with just a splash of fruit juice. Milk can be constipating for some kids.
- Get your child moving. Exercise stimulates digestion and helps prevent constipation.
- Stock up on fibre-rich foods. Foods high in fibre and whole grains help keep the bowel happy by moving food through the digestive tract steadily. So make sure your child noshes on fibre-rich fruits (apples and pears are great options), vegetables (incredibly raw) and whole grains (such as oats, millet and barley).
- Institute some reward system. A small non-food reward for pooping on the potty, such as stickers or the promise of a special outing, typically boasts big payoffs. No matter which tangible reward you choose, make sure to praise your child wildly when the deed is done. Call grandma and grandpa. Call daddy or mommy at work. Make it a big deal so he (or she) will want to repeat the process.
- Use petroleum jelly. If your child is constipated, apply a bit of Vaseline or petroleum jelly around the anus. Not only will lubrication make for a smoother passage, but the extra stimulation may also provoke a bowel movement. And if constipation has led to fissures (cracks in the skin in and around the anus), dab some diaper cream on them to help the healing process.
- Get angry. Scolding your child or making him feel shame will only create a power struggle — one that kids usually win. Remember, he’s not avoiding the potty to make you angry. They’re trying to wrap their minds (and bodies) around a complex process. If your child poops in his pants, calmly lead him to the bathroom, flush the loaded contents and explain that poop goes in the potty.
- Make your child sit on the potty until she poops. Bowel movements come when the body is ready. Rather than posing your child on the toilet and forcing them to “try,” take note of the first signs your child makes before she poops. Does she pause during an activity, make a funny face, walk over to a different part of the room? If you notice these pre-pooping signals, you can rush your child to the toilet (or at least to the bathroom) before the bowel movement occurs.
- Let your child strain. While there’s nothing wrong with a bit of pushing during a bowel movement, grunting and forcing out poop could spell trouble (both in terms of constipation and anal fissure and hemorrhoids). Instead of forcing it, have your child drink a tall glass of water and eat a piece of bowel-friendly fruit (peaches, pears or prunes!) and then try again about 30 minutes later.
- Let your child load up on constipating foods. Sugar and refined carbohydrates (like white bread, pasta and rice) are known toddler constipation culprits. Bananas and dairy, too, may lead to toilet troubles.
- Fret. Nearly every child masters the art of pooping on the potty. If your child is taking his time, encourage him with baby steps. Let his poop in his diaper, but lead him to the bathroom when he has a bowel movement. Once your kid gets used to pooping in his diaper in the toilet, have him sit on the potty with a loosely fastened diaper. And finally, ditch the diaper altogether and do a happy dance when he lets the poop fall in the toilet.
When to See a Pediatrician?
See your pediatrician if constipation lasts longer than two weeks or if your child develops other symptoms, such as:
- refusal to eat
- abdominal swelling
- weight loss
- pain during bowel movements
How to Prevent Constipation in Children?
Here are a few tips to help prevent constipation in babies, toddlers, and children:
- Don’t give solid foods until your baby is at least six months old.
- Aim to serve more high fibre foods, such as beans, whole grains, fruits, and vegetables.
- Increase your child’s water intake to at least 1 litre (32 ounces) a day.
- Encourage physical activity, such as riding a bike, kicking a ball, or walking the dog.
- Teach your child not to ignore the urge to have a bowel movement.
- Help your child develop a pattern of using the bathroom after meals. Have them sit on the toilet for about 10 minutes after eating so that bowel movements become a regular part of their routine.
Constipation in babies and children is often short term and not related to an underlying health condition.
It can, however, be a symptom of something else. See your pediatrician if constipation becomes chronic and doesn’t resolve with home remedies.
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