Constipation: What you need to know?

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Constipation is a digestive problem involving unusual bowel movements. Constipation is common among children.

What causes constipation?

There are numerous reasons your children may have digestive issues leading to constipation, following are some of the reasons:

  • High Milk Diet: Milk and cheese are the only foods that in high amounts can cause constipation. It causes hard pale stools. Provide your child a well-balanced diet.
  • Low Fiber Diet: Fiber is found in vegetables, fruits and whole grains. Fiber keeps stools soft, bulky and easy to pass. A low fiber diet causes hard, small stools.
  • Low Fluid Intake: This can also cause stools to be dry and harder to pass. It's rarely the only cause of constipation.
  • Lack of Exercise: Lack of physical activities may hamper the bowel activities.
  • Holding Back Stools Because of Pain: If passing a stool causes pain, many children will hold back the next one. This can happen with a Strep infection around the anus. It can also occur with a bad diaper rash or anal fissure (tear).
  • Holding Back Stools Because of Power Struggles: This is the most common cause of recurrent constipation in children. Most often it's a battle around toilet training.
  • Slow passage of food through the intestines: Most often, this type runs in families called slow transit time.

Usual Symptoms:

  • Can't pass a stool or pain when passing a stool
  • Crying when passing a stool (bowel movement or BM) or
  • Can't pass a stool after straining or pushing longer than 10 minutes or
  • 3 or more days without passing a stool (Exception: Breastfed and over 1 month old)
  • Caution: any belly pain from constipation comes and goes. Most often, it is mild. Use the Abdominal Pain (Stomach Pain) care guide if there is constant belly pain.

The above symptoms are generally seen as the signs of constipation. The condition of the child can become severe. How do we identify the severity of the problem? Following are few segregations based on the severity level of the illness:

Seek ER Help(Severe)

Vomiting bile (green color). Exception: stomach juice which is yellow.

Call Doctor Seek Care

  • Stomach pain goes on more than 1 hour (includes crying) after using care advice
  • Rectal pain goes on more than 1 hour (includes straining) after using care advice
  • Vomits 2 or more times and stomach looks more swollen than normal
  • Age less than 1 month old and breastfed
  • Age less than 12 months with recent onset of weak suck or weak muscles
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

What you as a Parent can do?

Any child with pain during stool passage or lots of straining needs treatment. At the very least, they need changes in diet. Following are few guidelines that can be followed:

Diet for Infants Under 1 Year Old

  • 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. Limit amount to 4 ounces (120 mL).
  • Pear and apple juice are good choices. After 3 months, can use prune (plum) juice. Reason for fruit juice: approved for babies in treating a symptom.
  • Age over 4 months old, also add baby foods with high fiber. Do this 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:

  • Increase fruit juice (apple, pear, cherry, grape, prune). Note: Citrus fruit juices are not helpful.
  • 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.
  • 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.
  • Limit milk products (milk, ice cream, cheese, yogurt) to 3 servings per day.
  • Give enough fluids to stay well-hydrated. Reason: keep the stool soft.

Call Your Doctor If:

  • Constipation lasts more than 1 week after making changes to diet
  • You think your child needs to be seen
  • Your child’s condition becomes worse

Disclaimer: This health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.


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