August 8, 2023/Children's Health

Unplugged: How To Relieve Constipation in Kids

Dietary and behavioral changes can help get things moving again

child walking out of bathroom

If you just finished potty training your kid, congratulations! That’s a big deal. But before you celebrate too much, know this: Your little one might not use the skill as much as they should at first.

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On average, 1 in 5 toddlers is dealing with a case of constipation — and many of those no-go situations come during or just after potty training. It’s a #2 issue that can quickly turn into a #1 concern.

That plugged-up problem also can be a frequent issue for babies and kiddos entering the school-age years, too.

So, what can you do to get things moving in the right direction for your little one? Let’s get some answers from pediatric gastroenterologists Ben Freiberg, MD, and Mohammad Nasser Kabbany, MD.

What causes constipation in kids?

When kids get plugged up, it’s typically a case of “functional constipation.” Basically, that’s an internal poop backup that can be traced to a combination of diet, personal decisions and lifestyle factors.

Four transitional stages of early childhood often come with constipation, explains Dr. Freiberg. They are:

  1. The introduction of solid foods during infancy. The dietary addition naturally makes poop a little bit harder.
  2. The introduction of dairy. Milk and other dairy products can be binding.
  3. Potty training. Anxiety about sitting on the toilet for a #2 can lead to children holding it in longer than they should.
  4. Starting school. It’s common for children to not want to use an unfamiliar potty at school. Additionally, some don’t want to be away from their classmates long enough to take care of business.

And once constipation starts, the problem typically only builds. Waiting makes stool get harder and more difficult to pass. The harder and more uncomfortable it gets, the more kids really fight the urge to go. “It becomes a vicious cycle,” explains Dr. Kabbany.

Medical reasons for constipation

Constipation in children also can be related to an underlying medical issue or prescribed medications, note Dr. Freiberg and Dr. Kabbany. Talk to your child’s pediatrician if you notice symptoms such as:

  • Bloody stool (not just with wiping and especially if it’s excessive).
  • A distended (swollen) belly.
  • Vomiting.
  • Weight loss.
  • Severe abdominal pain.

Constipation symptoms in kids

Everybody’s bowels are different when it comes to a pooping schedule. Some kids may need to go multiple times a day. Others may poop once every few days. Bottom line? There’s no single right number.

But in general, constipation may be an issue with your kiddo if they’re only going a couple of times a week or less, says Dr. Kabbany.

Other telltale signs of constipation include:

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  • Dry, hard stools that are large in diameter or very small.
  • Pain with pooping.
  • Straining and/or spending a long time on the toilet.
  • Putting off using the bathroom (you might notice crossed legs, grimacing or dancing).
  • Poor appetite.
  • Stomachache or bloating.

Tips to relieve constipation

So, what can you do if your kid has constipation? Try these tips to help your child go from having rock-hard to soft, painless stool:

Diet changes

What your child eats can go a long way toward keeping their digestive system operating at peak efficiency. “We really do rely on getting plenty of fiber in our diet to keep things moving along,” says Dr. Freiberg.

That means filling plates with items such as whole-grain bread, berries and broccoli. (Need more menu ideas? Check out this list of 31 high-fiber foods.)

Boost fiber levels gradually, though, as too much fiber can cause bloating and discomfort.

In addition, make sure your child is drinking enough fluids. Water is always a good choice. Sorbitol-containing juices like prune and apple juice also can keep the lower pipes flowing.

Cutting back on milk and cheese may be beneficial, too, as dairy products can block things up.

Post-meal pooping

It’s often said that timing is everything, right? Bring that theory to the bathroom by having your child sit on the toilet for five to 10 minutes after meals.

“This takes advantage of the natural reflex triggered by eating,” explains Dr. Kabbany. “They don’t have to strain. They can sit there and play on a tablet or read. But eventually, that reflex will kick in and they’ll go.”

But don’t let them sit too long, as hemorrhoids can become an issue.

Use a footstep

Positioning on the toilet is important for pooping, and little legs that dangle down don’t help the process. A footstep can offer some foundational support to help your child poop more effectively, suggests Dr. Kabbany.

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Watch for dancing

If you notice your kid doing that “gotta-go” dance, make sure they get to a potty ASAP. “Encourage kids to listen to their bodies and go when they get the urge to go,” says Dr. Freiberg.

Reward effort

Sometimes, a reward system like a sticker chart can motivate children and resolve constipation, says Dr. Kabbany. “But whether they poop or not, just sitting on the toilet should be praised.”

Medication

For many kids, medication is part of the solution for constipation — especially early on.

Oral laxatives often can help get kids unplugged. Once things are moving again, some children may benefit from medications such as polyethylene glycol, which pulls water into the intestines to soften stool, notes Dr. Kabbany.

Consult with your pediatrician on what medication to use and recommended doses, or on whether an enema could be beneficial.

Preventing a constipation comeback

For starters, keep encouraging the diet and behavioral tips mentioned above. “It takes time to build good habits,” says Dr. Freiberg.

And although it’s probably the last thing you want to add to your parenting to-do list, keep tabs on what’s happening behind the bathroom door if your child has struggled with constipation. Ask them how hard or soft their poop felt coming out. (Or go in and take a quick peek if you can.)

Don’t ignore problems either. Constipation can be difficult to undo if left alone. Studies show more treatment success with intervention within the first three months.

And above all else, be patient. “Typically, children learn to withhold over a long time, and it takes time to retrain their bodies,” explains Dr. Kabbany. “Try not to get frustrated if they relapse.”

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