Constipation(opens in a new tab) is a common problem among children, primarily occurring at the age of nine months and older. When a child is learning to go to the bathroom properly, there are bound to be some issues and instances of discomfort. Constipation is something that happens to everyone and often can be resolved easily, but it should not be ignored. While being constipated can often be seen as a mere inconvenience, it is important to know when you should take your child to the doctor to see if it is indicative of a larger health problem.

What Is Constipation?

When a child is constipated, they have infrequent bowel movements or hard, dry stools. Common causes of constipation include:

• Toilet Training - If you begin toilet training too soon, your child may rebel and hold in the stool. A voluntary decision to hold in stools or ignore the urge to poop may turn into an involuntary habit that’s hard to change.
• Withholding - Your child may also try to avoid using the bathroom if they fear a bowel movement will hurt or if they don’t want to interrupt play. You may notice them crossing their legs, clenching their buttocks, twisting their body, or making faces while trying to hold in stool.
• Dietary Choices - A lack of enough fiber-rich foods, vegetables, or fluid in your child’s diet may cause constipation. Excessive dairy and starchy foods can also be problematic.
• Changes in Routine - Any changes in your child's routine, such as traveling on vacation, hot weather, and added stress can affect bowel function. For instance, children often experience constipation when switching to school outside of home.

Signs of constipation to look out for in your child include:

• Lack of daily bowel movements.
• Bowel movements that are hard, dry, or difficult to pass.
• Pain while having a bowel movement.
• Blood on the surface of a hard stool.
• Stomach pain.
• Traces or streaks of liquid, pasty stool in your child’s underwear. This is a sign that stool is backed up in the rectum.

If your child exhibits these signs, they may be experiencing constipation. Constipation is often a temporary problem, but if it is becoming a recurrent, reach out to your child’s pediatrician.

Constipation Side Effects and Complications

While constipation is often temporary and not a cause for concern, it can become chronic. If constipation becomes chronic, complications may include:

• Painful breaks in the skin around the anus, known as anal fissures.
• Rectal prolapse, which is when the rectum comes out of the anus.
• Encopresis, which is accidental leakage of stool around impacted stool in the colon.

To prevent constipation and its further complications in your child, you can do the following:

• Make Important Dietary Choices - Keeping milk intake to under 20 ounces per day can be helpful. Certain fruits - especially pears, peaches, plums, and apples can be helpful for keeping stool soft. Limit intake of bananas, starchy foods, and processed foods.
• Keep Your Child’s Diet Rich in Fiber - A diet filled with fiber-rich foods can help your child form soft stools. Some high-fiber foods are fruits, vegetables, beans, and whole grain cereals and breads. The recommended intake(opens in a new tab) for children is 14 grams of fiber per 1000 calories. For younger children, it translates to about 20 grams a day. For adolescent girls, it is 29 grams per day and for adolescent boys, it is 38 grams per day.
• Keep a Bathroom Routine - Keeping a schedule for your child to go to the bathroom can help them to get into a habit of it. Set aside time for your child after meals to pass a bowel movement. You should also encourage them to listen to their body’s signs and not to ignore a bowel movement, even if they are in the middle of play time.
• Promote Healthy Lifestyle Choices - Regular physical activity promotes normal bowel function, so encouraging your child to be active can reduce risks of constipation. It is also important that your child stays hydrated and drinks plenty of water and fluids.
• Be Supportive - Try offering small rewards, like a snack or a sticker, to your child for trying to make a bowel movement, even if they did not succeed. Do not punish your child for soiling their pants or underwear, as this may also lead to stool withholding. Offer support and reassurance as your child learns to use the bathroom and successfully pass bowel movements.

With changes to your child’s diet, lifestyle and routine, you can help them to avoid constipation, or relieve their constipation symptoms before the problem becomes severe or chronic.

When Should I Visit My Pediatrician?

Constipation usually isn’t serious. However, it can become chronic or be indicative of an underlying health problem. You should take your child to see their pediatrician if the constipation lasts longer than two weeks, or it is accompanied by:

• Fever
• Loss of appetite / not eating
• Blood in the stool
• Pain during bowel movements
• Abdominal swelling
• Weight loss
• Rectal prolapse

If your child is experiencing any of these concerning symptoms, you should schedule an appointment with the pediatrician near you. Capital Area Pediatrics offers specialty, long-term care services for your child’s healthy development, including chronic constipation care.

If your child needs pediatric care, Capital Area Pediatrics offers top-tier pediatric care to families throughout Northern Virginia. Our dedicated team is committed to providing everything from chronic care services to sick visits. All of our providers, including those at our Ryan Park / Ashburn and Herndon locations, are accepting new patients and would be happy to reconnect with our existing families. Request an appointment online, or find a location near you today.