Constipation




What is constipation?

Constipation means that bowel movements are difficult or painful to pass and less frequent than usual.

A child with constipation feels a strong urge to have a bowel movement (BM) and has discomfort in the anal area, but is unable to pass a BM after straining and pushing for more than 10 minutes.

After the second month or so of life, many breast-fed babies pass normal, large, soft BMs at infrequent intervals (up to 7 days is not abnormal) without pain. For older children, going 3 or more days without a BM can be considered constipation, even though this may cause no pain in some children and even be normal for a few.

Common Misconceptions About Constipation

Some people have hard BMs daily without any pain. Children who eat a lot of food pass extremely large BMs. Babies less than 6 months of age commonly grunt, push, strain, draw up the legs, and become flushed in the face during passage of bowel movements. However, they don't cry. These behaviors are normal since it is difficult to have a bowel movement while lying down.

What is the cause?

Constipation is often due to a diet that does not include enough fiber. Drinking or eating too many milk products can cause constipation for many people. It may also be caused by repeatedly waiting too long to go to the bathroom, not drinking enough liquids, or not getting enough exercise. The memory of painful passage of BMs can make young children hold back. If constipation begins during toilet training, usually the parent is putting to much pressure on the child about using the toilet.

How long will it last?

Changes in the diet usually relieve constipation. After your child is better, be sure to keep him on a nonconstipating diet so that it doesn't happen again. Sometimes the trauma to the anal canal during constipation causes an anal fissure (a small tear). If your child has an anal fissure, you may find small amounts of bright red blood on the toilet tissue or the stool surface.

How can I take care of my child?
  • Diet treatment for infants less than 1 year old

    Give fruit juices (such as apple or pear juice) twice a day to babies over 2 months old. Switching to soy formula may also result in looser stools. If your baby is over 4 months old, add strained foods with a high fiber content such as cereals, apricots, prunes, peaches, pears, plums, beans, peas, or spinach twice a day.

  • Diet treatment for older children over 1 year old
    • Make sure that your child eats fruits or vegetables at least 3 times a day, such asre prunes, figs, dates, raisins, bananas, apples, peaches, pears, apricots, beans.
    • Increase bran. Bran is a natural stool softener because it has a high fiber content; including: graham crackers, oatmeal, high-fiber cookies, brown rice, or whole wheat bread. Popcorn is one of the best high-fiber foods for children over 4 years old.
    • Decrease the amount of constipating foods in your child's diet to 3 servings per day. Examples of constipating foods are cow's milk, ice cream, cheese, and yogurt.
    • Increase the amount of pure fruit juice your child drinks. (Orange juice will not help constipation as well as other juices).

  • Sitting on the toilet (children who are toilet trained)

    Encourage your child to establish a regular bowel pattern by sitting on the toilet for 10 minutes after meals, especially after breakfast.

  • Relieving rectal pain

    If your child is very constipated and has rectal pain needing immediate relief, one of the following will usually provide quick relief:
    • sitting in a warm bath to relax the muscle around the anus (anal sphincter)
    • gently putting a thermometer in the anus for 10 seconds to stimulate the rectal muscle.

When should I call my child's healthcare provider?

Call during office hours If:
  • Worsening of abdominal pain or rectal bleeding
  • No bowel movement in more than 5 days.

 
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The information contained in this website is to provide information of a general nature about the
practice and pediatric medical conditions. Neither Dr. Leonhardt nor Bee Well Pediatrics, P.A. is engaged in rendering medical
advice or recommendations. You should always consult your doctor for advice.