How to treat Constipation

Constipation is one of the most common pediatric problems. To help you understand pediatric constipation better, we have put together some pediatric constipation guidelines.

What is constipation?

A regular bowel pattern is a sign of good health for your child. However, an infrequent bowel movement doesn’t mean that your child has constipation. Bowel patterns vary from child to child. They depend on a multitude of factors like age to diet. While most toddlers pass a stool twice a day, some may have a bowel movement only once in 3 days. Fret not, as this is normal. No need to panic if your child goes without passing a stool every day.

So how do you differentiate between regular bowel patterns and constipation? Well, constipation isn’t about how frequently your child poops but about how easy it is for him to pass it.

How to identify constipation in your child?

Some general signs and symptoms of constipation in children are:

-Straining while passing stool
-Bowel movements accompanied by pain and discomfort
-Two or less than two bowel movements in a week
-Stools that are dry, hard and difficult to pass
-Recurring abdominal pain
-Swollen Abdomen
-Bloodstains on the underwear or stool – a sign that stool is hard enough to produce fissures in the rectum. Thus, causing rectal bleeding.
-Smears of liquid stool on the underwear or diaper
-Loss of appetite
-Grumpy mood
-Your child may show reluctance to go to the toilet, cross legs, or clench their buttocks to avoid pain from passing stool

Causes of Constipation in Children

Withdrawing Behaviors

Children of different ages tend to hold stool for multiple reasons. Many school-going children hold stool for long periods if they’re embarrassed or afraid to ask permission from teachers to use the bathroom. Your child may refrain from passing stool when away from home because he/she is not comfortable using public bathrooms. Children also ignore the urge to pass stool if they’re sensitive to pain; if the stool is hard and painful to pass, your child will try to avoid a repeating pattern of discomforting bowel movements.

Nutritional Deficiencies

Your child’s diet has a huge impact on his/her bowel movements. A diet lacking fiber-rich fruits and vegetables can cause constipation. Diets heavy in sweets, dairy, and processed foods accompanied by fewer fluids also hardens stool.

Change in Diet or Routine

Any change in your child’s diet or routine can impact bowel function. This includes traveling, hot or cold weather, or starting school. When toddlers switch from breast milk to cow’s milk or from a liquid diet to solid foods, they are prone to get constipated.

Toilet-training Issues

Toddlers may rebel and refuse to go to the bathroom at the beginning of toilet training since they’re used to diapers or may have independence issues.

Medical Conditions

Prolonged constipation can be a result of an underlying metabolic illness or anatomic malformation such as hypothyroidism. Nervous system disorders such as cerebral palsy can also affect your child’s ability to use the toilet.


Constipation can be a side effect of certain antidepressants or supplements. High-dosage iron supplements contribute to constipation in children. Therefore, consult your pediatrician before introducing medication or supplements to your child’s diet.

How to Treat Constipation in Children

Constipation is a common pediatric problem that occurs frequently in children age 3-10. In most cases, pediatric constipation is temporary and can be easily treated without paying a visit to the clinic. Introducing the following changes to your child’s diet and routine will help alleviate constipation. They can be treated as pediatric constipation treatment guidelines.

Drinking Plenty of Fluids

For toddler constipation, add a little high-fiber juice to your baby’s bottle. You can use prune, apple, pear, or mango juice. These contain sorbitol and act as natural laxatives.
If your child is 1 year old or older, increase their water intake. Give them warm fluids, especially in the morning. This will make the stool softer and easier to pass.

Increasing Fiber Intake

A high-fiber diet helps digestion and prevents constipation. Make sure that your child eats plenty of fiber-rich fruits and vegetables. You can give them raspberries, apples, pears, avocados, broccoli, and green peas.

Whole-grain foods and a variety of legumes also promote good digestive health. More fiber-rich food options for your child are cereals, brown rice and bread, oatmeal, lentils, pecans, and black beans.

If your child is picky about his food, you can make oatmeal and top it with some fruits or cook whole-wheat spaghetti. Even better, give him an oat bran muffin as a treat for eating his greens.

Also, cut down on sweets and limit milk to 16-20 ounces a day, as it is high in dairy. High dairy intake can aggravate constipation as per AAP constipation guidelines.

Promoting Physical Activity

Make sure that your child doesn’t spend all day playing video games. Take him or her out of the house to play for at least half an hour every day. When the body becomes active, the muscles in the intestines also become more active. Consequently, bowel activity returns to normal.

Set up a Regular Toilet Routine

Set regular time intervals and encourage your child to go to the toilet at those times. For example, in the morning and before going to bed or after meals. Even if your child doesn’t feel the urge to poop, make him sit on the toilet for at least 10 minutes. If your child’s feet can’t reach the floor while sitting on the toilet, use a footstool to make him more comfortable. Instead of pushing your child to pass a stool, reward him after every bowel movement. Treat him with a muffin or a sticker. Such incentives will eliminate his fears and encourage him to regularly use the toilet.

When to see a Pediatrician about your child’s constipation?

While in most cases constipation isn’t serious, it can become chronic. If there are small fissures in the skin around your child’s anus causing pain or if you notice the rectum coming out of the anus (rectal prolapse), immediately contact your Pediatrician.

Do not give a laxative to your child without consulting a Pediatrician. Laxatives such as
Pedia-lax can be dangerous to your child’s health if not used properly. In the case of chronic constipation, bowel cleanout in the hospital may be recommended. If you’re giving your child Miralax, make sure to consult the Miralax pediatric dosage chart.

If complications arise and you can’t make it to the office, you and your child can virtually visit the doctor using telemedicine.

At Kids’ Health Alliance, we serve children in the Ocala community. If you are seeking a new Pediatrician to provide quality care to your child(ren), visit to learn more about us and to schedule your first appointment.

We hope this article on ‘How to treat Pediatric Constipation’ was helpful to you.


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