One of the hardest things a parent can experience is watching their child struggle with the pains that come with conditions such as constipation. Constipation in children is very common, and in most cases is caused by either behavioral or dietary factors. Thankfully, constipation is usually a temporary condition that can be easily alleviated by simple dietary changes, such as including more fibrous fruits and vegetables in your child’s daily diet, and getting them to drink more fluids.
What is constipation and why does it happen?
Constipation is what occurs when stool moves too slowly through the lower intestine, and as a result, it becomes very hard and dry, making it more painful to relieve. Many factors contribute to constipation developing in kids, one of the most common being ignoring the urge to go and holding it in. “The last thing on any child's mind during play is taking time out to go to the bathroom. As a result, kids are notorious for ignoring the signals from their body that are telling them it’s time to go to the toilet,” suggests Lisa Hoang, MD, a board-certified pediatrician at St. Joseph Heritage Medical Group.
Changes in a child’s diet are also a common contributor, especially in toddlers switching from a liquid diet to a more a solid one. “The trick is to introduce solids slowly and ensure you include appropriate solids that are fruits and vegetables high in fiber. You can also add fruit juices such as diluted white grape juice, apple juice or pear juice. Pureed prunes or prune juice are also excellent options,” suggest Dr. Hoang. “These particular types of fruits and fruit based fluids contain fiber and sugars which are not easily absorbed into the intestine, and therefore pass through the intestine more quickly allowing more moisture to remain in the stool.”
How can I stop my child from ‘holding it in’?
“It’s a good idea to establish a bowel sitting program, allocating up to three, 10-minute slots a day where your child must sit on the toilet and try relieve his or her bowels,” she suggests. If your child has a time that he or she tends to go more regularly, then that should be the time slot you allocate. “These sessions can seem tediously boring for your child, so the trick is to ensure you give them something engaging to do while they are sitting on the toilet,” Dr. Hoang adds. Establishing a reward system may also do the trick. A simple star chart on the wall where they are rewarded with a gold star for their stellar performance each time helps motivate them to go more often.
My child doesn’t like to use public toilets. What should I do?
For some kids, withholding may not be a case of ignoring the signals, but may be because they feel uncomfortable or embarrassed using toilets outside of their home, and therefore refuse to use public restrooms. As a result, they may spend most of the day holding it in, waiting until they are at home and are more comfortable. In this instance, you’ll need to spend some time talking to them to understand why they feel this way, reassuring them that using public toilets is OK. “Sitting with them in the bathroom of a place they frequently visit, such as their school, also helps them to get more comfortable and reinforces the fact that bowel movements are absolutely normal, and everyone does it,” she says.
What about older children?
For older children, aside from increasing the number of fruits and vegetables they eat daily, fiber supplements and/or probiotics are also great solutions. Although research on the effectiveness of probiotics in relieving constipation is inconclusive, many health care providers and gastro intestinal specialists praise its ability to help rebalance the bacterial environment in our guts and aid the process of waste removal.
"Give your child probiotics only if they are having constipation problems. However, if they are regularly relieving their bowels, then probiotics are not necessary," Dr. Hoang advises.
My child is constipated right now. What should I do?
The first thing you need to do is relieve the current blockage in their system. “Miralax is a laxative powder specially designed for kids, and is an excellent option for immediate relief,” suggest Dr. Hoang. “Once their system is unblocked, sit with your child and talk about what may have caused the problem to happen. Perhaps they ate more dairy that day than normal or have not been great at eating higher fiber diets or drinking plenty of water- or maybe they had needed to go earlier but didn’t want to use the toilet at school. Getting to the route of the problem is the best way to avoid reoccurrence.”
If you are finding that even after changing your child’s diet or working through behavioral challenges they are still having problems, then make an appointment to see your pediatrician. They will be able to help identify the underlying causes of the condition and develop a plan to get your child’s bowel movements back to regular.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.