Being able to go when you need to is something most people take for granted until they can’t! Constipation can happen to anyone no matter how young or old they are. If constipation isn’t taken care of properly, it can become quite painful for children and adults alike. There are some things you can do to help prevent constipation and to help relieve it if it happens to your children.

CONSTIPATION CAUSES:

• High Milk Diet. Milk and cheese are the only foods that in high amounts can cause constipation.
• Low Fiber Diet. Fiber is found in vegetables, fruits, and whole grains.
• Low Fluid Intake. This is rarely the only cause of constipation, but can contribute to it.
• Lack of Exercise. Exercise helps keep things moving! This is not usually a cause in children unless they are confined to a bed.
• Trying not to go due to pain. If going causes pain, many children will hold off on going. This can also happen in the case of bad diaper rash or other health issues.
• Holding it in because of power struggles. This is the most common cause of recurrent constipation in children. Most often it’s a battle around toilet training. If they are already trained, it may begin with the start of school. Some children refuse to use public toilets or others don’t go because they are too busy to sit down.
• Slow passage of food through the intestines. This type usually runs in families and is sometimes called slow transit time.

CONSTIPATION SYMPTOMS:

Symptoms can vary from person to person but usually include stomach pain or even crying when trying to use the bathroom. Another symptom is not being able to pass a stool after straining or pushing longer than 10 minutes. Going to the bathroom should be free of pain. Any child with pain during stool passage or lots of straining needs treatment. At the very least, the child should be treated with changes in diet.

The normal range is passing a stool once every 2 days or up to 3 times per day. Once children are on normal table foods, their pattern is like adults. If your child has gone 3 or more days without passing a stool, they could be dealing with constipation. The exception to this is breastfed babies who are over 1 month old.

TIPS TO HELP ALLEVIATE CONSTIPATION:

There are things you can do to help with your child’s constipation. These suggestions vary greatly depending on the age of your child. If your baby is constipated, help them by holding their knees against the chest. This is a natural position for pushing out a stool and can help. Gently pumping the lower stomach may also help. If the constipation is a result of toilet training, it is ok to put your child back in diapers or pull-ups for a short time. Give praise when they go into a diaper and give reassurance that it won’t hurt. Avoid any pressure or punishment and never force your child to sit on the potty against his will. This will only cause a power struggle. Treats, hugs, and rewards for not holding it in always work better!

If your child is toilet trained, try setting up a normal routine to sit on the toilet for 10 minutes after meals, especially after breakfast. Once able to go, they don’t need to sit again that day. Sitting in warm water can also help your child relax. There are also dietary changes that can help ease constipation:

• Age over 1 month old only on breast milk or formula- Add fruit juice. Give 1 ounce (30 ml) per month of age per day. Pear or apple juice is okay at any age.
• Age over 4 months old- Add baby foods with high fiber twice a day. Examples are peas, beans, apricots, prunes, peaches, pears, or plums.
• Age over 8 months old on finger foods- Add cereals and small pieces of fresh fruit.

Diet for Children Over 1 Year Old

1. Increase fruit juice apple, pear, cherry, grape, prune. Note: Citrus fruit juices are not helpful.
2. Add fruits and vegetables high in fiber content. Examples are peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, or dates. Offer these foods 3 or more times per day.
3. Increase whole grain foods. Examples are bran flakes or muffins, graham crackers, and oatmeal. Brown rice and whole wheat bread are also helpful. Popcorn can be used if over 4 years old.
4. Limit milk products. This includes limiting milk, ice cream, cheese, yogurt to 3 servings per day.
5. Try a stool softener. If a change in diet doesn’t help, you can add a stool softener such as Miralax to children over 1. Give 1-3 teaspoons (5-15 ml) each day with dinner. 
6. Fiber products such as Benefiber are also helpful. Give 1 teaspoon (5 ml) twice a day. Stool softeners and fiber work 8-12 hours after they are given and are safe to continue as long as needed.

At the Pediatric Center, we want to give you and your child the best information and treatment you can get. If your child’s constipation lasts more than 1 week after making changes to diet or you are concerned about your child’s health for any reason, please don’t hesitate to call your doctor at the Pediatric Center. You can contact us at our Idaho Falls location at (208) 523-3060 or our Rigby location (208) 745-8927, to set up your appointment. We have a wonderful team of physicians available for all of your children’s needs!