Constipation In Children

GENERAL INFORMATION:

What is constipation? Every child has different bowel habits. Some children have two or three bowel movements (BMs) daily, while others may have only three to four BMs each week. Breast fed children may have soft BMs after every feeding. Formula fed children may have firmer (harder) BMs that occur less often. If your child is having fewer BMs than usual, and they are hard or painful to push out, he may be constipated. Constipation (kon-sti-PAY-shun) causes a child's BMs to be hard and dry, and a different size than usual. Constipation commonly occurs after a change in a child's diet or during toilet training.

What causes constipation?

• Adding new foods to your child's diet. Eating or drinking too much milk, cheese, yogurt, ice cream, or other milk products may cause constipation.
  
  
• Eating too many low fiber, high fat, and high sugar foods. Some examples of these foods are crackers, white bread, high sugar cereals, chips, cookies, and candy. If your child eats more of these foods than high fiber foods on most days, he may become constipated. Healthy, high fiber foods include vegetables and fruits, whole grain breads and cereals, and legumes (beans and lentils).
  
  
• Emotional issues. Family problems can cause your child to be constipated. Constipation may also be a way for your child to get attention, show anger, or be in control.
  
  
• Family history. Constipation may be a problem that runs in your family.
  
  
• Health problems such as Hirschsprung disease, celiac disease or cystic fibrosis. Your child's constipation may also be caused by certain medicines that he takes.
  
  
• Not drinking enough liquids each day.
  
  
• Not going to the bathroom often enough. Your child may become constipated because he waits too long to go to the bathroom. School-age children may become constipated because they are too afraid or embarrassed to use the school bathroom.

What are the signs and symptoms of constipation?

• Abdominal (belly) pain, discomfort, or cramping.
  
  
• Hard, dry BMs. No BM for two or three days, or fewer BMs than your child normally has. Your child may "soil" his underwear. You may find liquid or solid BM that leaked onto your child's underwear. Your child's BMs may also be much larger than they usually are.
  
  
• Pain while having a BM. Your child may cry while trying to pass the BM or say that it hurts to have a BM. Your child may not be able to pass the BM with pushing or straining. Many days may pass without your child having a BM.
  
  
• Tearing around the rectum. Constipation may cause small tears that bleed near the rectum (rear end). These tears may be caused by your child trying to push out the BM. You may notice small amounts of bright red blood on the toilet tissue or the BM. These tears should heal without medicine. A diaper rash may also cause your child to have pain while having a BM. Your child may not want to have a BM because of the sore rash on his bottom.
  
  
• Upset stomach and bloating (feeling of fullness).

How is constipation diagnosed? You may be able to treat your child's constipation at home. When you bring your child for a medical visit, the caregiver will examine your child and ask questions. The caregiver may take some of your child's BM and test it in the lab. Sometimes caregivers will do an abdominal (belly) x-ray. An x-ray shows a picture of the inside of your child's belly. It may help caregivers to see if your child is constipated or has other belly problems. The caregiver may draw blood or do other tests, but this is not common. Sometimes a child has long-term problems with constipation. Your child may need to go to a special caregiver for help in planning regular bowel habits.

How is constipation treated? Constipation is often treated at home with simple diet changes. Ask your child's caregiver for suggestions, and if your child should be on a special diet. You may also do one or more of the following:

• Children less than one year old:
  
  
  • Increase the amount of liquids your baby drinks. Give your baby apple, pear, or prune juice to drink. Soy formula may also help soften his BMs. Talk to your baby's caregiver. Ask how much water, juice, breast milk and formula your baby should drink while he is constipated.
    
    
  • Feed your baby a high fiber diet. For babies over four months old, serve high fiber strained baby foods such as cereal, apricots, or peaches. Other high fiber foods are plums, pears, prunes, beans, peas, or spinach. Cooked carrots and bananas may make the constipation worse. You may feed your baby solid food two to three times a day.
    
    
  • Start giving your baby formula again if needed. Some children become constipated after they are taken off their regular infant formula. If your constipated baby has just started drinking cow's milk instead of formula, start giving him formula again. Formula is less constipating than cow's milk. Talk to your baby's caregiver about your baby's constipation. Ask about the best ways to slowly stop formula and start giving cow's milk.
    
    
  • Put your baby in a warm bath. Put your baby in a tub with warm water several times a day. This may make it easier for your baby to pass a BM. Never leave your baby alone in the bathtub.
    
    
  • Ask your baby's caregiver about using corn syrup or other BM softeners. Ask your baby's caregiver about adding barley malt extract, lactulose, or corn syrup to your baby's drinks. These may help to soften your baby's BM. Ask the caregiver how much of these you should add to your baby's cup or bottle.
    
    
  • Glycerin suppository: Follow your baby's caregiver's instructions carefully if you are told to give a suppository to your baby. A glycerin suppository (su-POZ-i-tohr-ee) may be put into your baby's rectum (rear end) to help him have a BM. Do not give your baby an enema. Do not give your baby a suppository unless his caregiver said it is OK.
  
  
• Children older than one year old:
  
  
  • Increase the amount of liquids your child drinks. Water may help keep your child's BMs soft. Ask caregivers how much extra water and other liquids your child should drink every day. Limit the amount of caffeinated liquids that your child drinks. Caffeine may be found in drinks such as coffee, tea, soda pop, and some sports foods and drinks. Read the ingredient labels to learn if foods and drinks have caffeine in them.
    
    
  • Feed your child a high fiber diet. Feed your child fruits and vegetables three times a day. Encourage him to eat raw unpeeled fruits and vegetables, like prunes, figs, dates, or raisins. Peaches, pears, apricots, beans, peas, cauliflower, broccoli, or cabbage are also good for your child to eat. Other high fiber foods are those with bran (bran cereal or muffins), shredded wheat, graham crackers, oatmeal, or brown rice. Whole wheat bread and popcorn are also high fiber foods. Do not give your child food that is hard for him to chew. Cut your child's food into small pieces to keep him from choking.
    
    
  • Help your child to do regular exercise each day. Take walks with your child, play at the playground, go swimming, and otherwise encourage him to exercise often. Being active may help him to have more regular BMs.
    
    
  • Set up a regular schedule for your child to have a BM. This may be helpful, especially for a young child. For example, help him to sit on the toilet for at least 10 minutes at about the same time each day, preferably after a meal. Do not put pressure on your young child to go to the bathroom. If you see that he needs to go to the bathroom, give him a gentle reminder. Say good things to him or give him a reward when he has a BM, like a special toy to play with or a visit to the park.
    
    
  • Ask your child's caregiver before giving your child any constipation medicine. Your child may need a laxative (LAK-sah-tiv) or stool softener. A laxative is medicine to help empty your child's bowel. A stool softener is medicine that softens the BM and makes it easier to pass. Follow the caregiver's instructions carefully if you are told to give your child medicine for constipation.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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