Constipation is a common illness that affects both small infants and older children. It can be a source of pain and embarrassment for the child, and frustration for the parent. In general, we define constipation by pain and effort, instead of duration. For instance, some babies stool every 5th day. This is normal as long as there is no pain associated with the bowel movement (BM). Some babies stool 2 times a day, but have pain associated with it. This is true constipation. Constipation can occur at any time, but usually presents in 2 age groups–shortly after birth and early school years.

Signs of Constipation:

Infants:

• Straining
• Hard, pebble like stools
• Liquid stools (leakage around solid stools)
• Distended or swollen abdomen that improves after a BM
• Blood in stool
• Rectal tear

Children:

• Abdominal pain and cramping
• Very infrequent/ irregular bowel habits
• Soiling or accident in pants
• Distended abdomen

Treatment:

Infants:

• Juices–pear and prune
• If old enough, you may give fruits and vegetables
• Karo syrup
• Switching from rice cereal to oatmeal or barley cereal

Children: Goal of 1 soft BM per day

• Vegetables, fruits, whole grain cereals
• Bran cereal
• Extra water and liquids between meals
• Toilet–sitting to take advantage of the normal reflex to have a BM 15-30 minutes after each meal
• Rewards system–calendar, stickers, favorite tv show, special time

When to call the Doctor

• When your child is irritable and seems to be having abdominal or rectal pain
• If you see blood in the stools
• If symptoms last for longer than 4-5 days
• If the above therapy does not improve symptoms
• If there is fever >100.5º associated

Important points:

Try to stay calm, positive, and understanding. This is not something children decide to do, and therefore punishment is not recommended. Do not give enemas, suppositories, or laxatives unless you are told to do so by your Doctor. Call your Doctor with any further concerns or issues.