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What is Constipation?
Constipation is difficulty passing stools, hard-large-caliber stools, or having less frequent bowel movements. It is a common problem in children of all ages and is usually unrelated to an underlying medical condition. Normal versus abnormal bowel movements vary from child to child and by age and what they eat. For example, a four-month-old formula-fed baby may have two-three soft bowel movements a day, but a four-year-old may have one or two formed BMS per day. Constipation in an infant may present as tiny, pellet-like stools and straining, whereas an older child may complain of pain and “hold it” instead of trying to use the bathroom.
What Causes Constipation?
There are many possible causes in children, including:
- Changes in diet
- Changes in routine
- Not enough fiber in the diet
- Potty training and holding stools
- Too busy to go and ignoring the urge to go to the bathroom
How Can You Care For Your Child at Home?
For Babies Less Than One Year:
Breastfeed if you can. Breastfed babies rarely have hard stools.
If switching breastmilk to formula and the baby is older than two months, give the baby 1-2 oz of water twice a day for up to two weeks in addition to their regular milk intake.
If older than six months, you can give fruit juices, such as apple, pear, or prune juice, to relieve constipation. Do not offer your child more than 4 oz daily. After a week or two, take a break from their daily juice intake. You can also dilute with 50% warm water.
Once your baby can have solid foods, offer cereals, fruits, and vegetables.
Rectal stimulation can help a baby have a bowel movement. Talk to your doctor or nurse for their recommendations.
For Children One Year or Older:
Drink plenty of water (~32 oz per day for school-age children) and other fluids.
Eat foods high in fiber, like fruits, vegetables, beans, and whole grains.
Daily exercise helps the body have regular bowel movements.
Take regular bathroom breaks. Make a routine of sitting on the toilet at about the same time each day. For example, seat your child on the toilet twice daily for 10 minutes after a meal. Give praise and encouragement even if there is no bm. Sit in a squatting position. Use a stool to support feet if needed.
Give stool softener, such as MiraLAX, if directed by a healthcare professional.
When Should You Call For Help?
Seek immediate attention for blood in stool, severe belly pain, or vomiting.
If constipation is getting worse, make an appointment with your pediatrician.
Call your pediatrician if your child is less than three months old and struggles with constipation <1 after starting home care.
For children three months to 11 years old with constipation lasting >1 week with home care.
Call your pediatrician if other new, concerning symptoms appear, such as fever.