How to relieve constipation in a young child

Treatment for Constipation in Children

In this section:

How can I treat my child’s constipation?
How do doctors treat constipation in children?
How can I treat my child’s constipation complication?
How do doctors treat the complications of constipation in children?
How can I prevent my child from becoming constipated?

How can I treat my child’s constipation?

You can most often treat your child’s constipation at home by doing the following:

Change what your child eats and drinks

Changing what your child eats and drinks may make his or her stools softer and easier to pass. To help relieve symptoms, have him or her

eat more high-fiber foods
drink plenty of water and other liquids if your child eats more fiber

Read about what your child should eat and drink to help relieve constipation.

Have your child drink plenty of water and other liquids to help prevent constipation.

Change your child’s behavior

Changing your child’s bowel movement patterns and behaviors may help treat constipation.

Ask your potty-trained child to use the toilet after meals to build a routine.
Use a reward system when your child uses the bathroom regularly.
Take a break from potty training until the constipation stops.

How do doctors treat constipation in children?

Your child’s doctor may recommend giving your child an enema or laxative to help treat his or her constipation. Most laxatives are over-the-counter medicines taken by mouth until your child’s bowel movements are normal. Your child’s doctor may recommend stopping the laxative once your child has better eating and bowel habits. You should not give a child a laxative unless told to do so by a doctor.

If your child is taking an over-the-counter or prescription medicine or supplement that can cause constipation, your child’s doctor may recommend stopping it, changing the dose, or switching to a different one. Talk with your child’s doctor before stopping any medicines.

How can I treat my child’s constipation complication?

Your doctor may recommend treating your child’s hemorrhoids or anal fissures by

making changes in his or her diet to prevent constipation
using an over-the-counter enema or laxative suggested by your child’s doctor
having him or her take warm tub baths to soothe the area

Changing your child’s bowel movement patterns and behaviors may help treat constipation.

How do doctors treat the complications of constipation in children?

Doctors may be able to treat complications of constipation in children during an office visit. Your child’s doctor may recommend at-home treatments, too.

For a child age 2 or older, your doctor may recommend giving mineral oil. Your child will take the mineral oil by mouth or through an enema.

Your child’s doctor may be able to treat rectal prolapse during an office visit by manually pushing the rectum back through the child’s anus. Helping a child prevent constipation is the best way to prevent rectal prolapse.

How can I prevent my child from becoming constipated?

You can help prevent constipation in your child with the same things that treat constipation

provide enough fiber in your child’s diet
have your child drink plenty of water and other liquids
make having a bowel movement part of your child’s routine

Learn more about how you can help prevent constipation in your child by changing what he or she eats and drinks.

Last Reviewed May 2018

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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

Constipation Treatments and Prevention for Children Age 11 and Younger

Written by WebMD Editorial Contributors

Constipation Symptoms

Stomach pain and bloating
Bleeding with bowel movements
Soiling accidents

Sometimes a constipated child might actually appear to have diarrhea, which can be confusing. What’s happening here is that a large formed stool has gotten stuck in your child’s rectum, and liquid stool gets passed around it.

When a child is constipated, they have less frequent bowel movements, and when they do “go,” their stool is dry, hard, and painful to pass. There are many possible causes for constipation, including:

Withholding stool. This means that your child is trying to hold their bowel movements in -- maybe because they're stressed about potty training, maybe because they don’t want to use the toilet in certain places (like school), or maybe because they're afraid of a painful bathroom experience. (Constipation can become a vicious cycle -- if it hurts to “poop” once, the child may be more fearful of going the next time.)
A diet that’s low in fiber or doesn’t include enough liquids (or both), commonly found in toddlers transitioning from formula to whole milk
Side effects of certain medications

Constipation Treatments

There are three primary treatments for most cases of constipation, and they usually work hand-in-hand.

A high-fiber diet with plenty of fluids. This means loading your child’s plate with plenty of fresh fruits and vegetables, high-fiber cereals, whole grain breads (look for at least 3-5 grams of fiber per serving), and a variety of beans and other legumes, like chickpeas and lentils. Two good sources of fiber that kids are often happy to eat are trail mix (let them make their own) and popcorn with minimal salt or butter. Foods containing probiotics, like yogurt, can also promote good digestive health. While focusing on fiber, don't forget fluids. If your child is eating plenty of high-fiber food but not getting enough fluid to help flush it through their system, you can make matters worse. Your child should be drinking plenty of water throughout the day, along with some milk. Limit sugary drinks to 4 ounces a day in younger children and 6-8 ounces in school-aged kids.
A stool softener to clear the bowels. These are typically safe in children. Two common mistakes that parents make when giving their child a stool softener for constipation is not using a large enough dose, or stopping it too soon. For example, you might think that you can stop giving a stool softener after your child’s first normal-looking bowel movement, but stopping too soon may just set up your child for another bout of constipation. Some children may need to stay on a stool softener for a few weeks. As you continue to make and reinforce dietary modifications, your child's pediatrician can advise you on the right dosing schedule for your child.
Regular toilet time. Encourage your child to use the toilet first thing in the morning and after every meal or snack. Particularly for a younger child, you may get better results by telling, not asking. Instead of suggesting, “Do you need to go to the bathroom?” simply say, “Time to go to the bathroom now.”

You’ll get the best results if you combine all three of these approaches. A high-fiber diet isn’t likely to clear up a serious case of constipation on its own without the help of a stool softener; on the other hand, once your child stops taking a stool softener, if they stay on a low-fiber diet and doesn’t get enough healthy fluids, the problem is likely to happen again.

Children's Health Guide

The Basics
Childhood Symptoms
Common Problems
Chronic Conditions

How to help a child with constipation? – health articles

06/16/2021

Causes of constipation in children
Symptoms of constipation
Diet
Gymnastics
Benefits of contacting MEDSI

Constipation in a child can occur at various stages of growth and development. According to statistics, every fifth baby suffers from problems with stool. In this case, violations can occur already in infancy. With the start of complementary foods, the stool usually improves, which is associated with the introduction of fiber into the diet and an increase in physical activity. After a year, the number of children suffering from constipation is growing again. This is already due to the transition to solid food, the refusal of breastfeeding and the reduction in liquid in the diet.

It is dangerous to neglect constipation!

In fact, their consequences are quite dangerous and can cause:

baby stress
rectal deformities
anal fissures
general organism intoxication

What to do if the child has constipation?

Find out the cause of the pathological condition together with the doctor
Diet
Pay attention to moderate physical activity

Important! It is forbidden to self-medicate. Laxative suppositories and other means should not be given, as well as cleansing enemas.

It is forbidden to self-medicate. Laxative suppositories and other means should not be given, as well as cleansing enemas.

Causes of constipation in children

The main factors stimulating stool disorders in children include:

Insufficient fluid intake
Meals with little or no fiber
Lack of physical activity

Symptoms of constipation

A pathological condition can be suspected by the following signs:

the presence of blood (scarlet, fresh) in the stool during the act of defecation and after it in the form of blots (traces) on toilet paper
rare visits to the toilet for the purpose of defecation (2 or less times a week)
large large compartments
the need for strong straining during defecation
pain in the anus and abdomen

Diet

What can be given to a child for constipation?

This question interests many parents. The fight against the problem should begin not with taking medications, but with changing the diet.

Necessary:

Increase fluid intake
Establish fractional nutrition
Add fiber-rich foods to the diet

You should teach your child to drink plain clean water. For babies over the age of 3, 2-3 glasses of water a day are usually sufficient. Avoid sugary carbonated drinks, coffee and tea. This is due to the fact that they have a pronounced diuretic effect and stimulate constipation and dehydration.

Especially useful is the cool water that children drink in the morning on an empty stomach. Gradually, the temperature of the liquid can be reduced. The following drinks also have a laxative effect:

beet juice
fermented milk (kefir, fermented baked milk, etc.)
chamomile decoctions
dill tea

Important! They should be introduced into the diet gradually, starting with a small amount. Otherwise, you can provoke a breakdown in digestion.

You should teach your child to drink plain clean water. For babies over the age of 3, 2-3 glasses of water a day are usually sufficient.

The treatment of constipation in children also implies the introduction of laxative products into the diet, which include:

legumes
nuts
prunes and dried apricots
plum
beets
dates

They are also included in the diet gradually and under the supervision of a doctor. Cereal porridges can be useful: oatmeal, buckwheat, wheat, pearl barley. It is advisable to refuse rice, pears, sweets, muffins, animal fats, flour products. They have a fixing effect.

What else to feed the child so that there is no constipation?

The answer to this question should be given by the pediatrician.

Gymnastics

For the prevention of a pathological condition, walking and running, swimming, exercises to strengthen the abdominal press, squats, bends are useful.

It is believed that mobile, active children are less likely to suffer from constipation. For the prevention of a pathological condition, walking and running, swimming, exercises to strengthen the abdominal press, squats, bends are useful.

If the child is already suffering from stool problems, it is recommended to start the day with simple morning exercises. Massage may also be helpful.

It is important to pay attention to the general change in the behavior of the baby.

The child should be taught to go to the toilet at about the same time, encouraged for observing the daily routine (motivate and praise).

It is also important to create a favorable environment in the toilet. Nothing should distract the child from the act of defecation or scare him in the bathroom.

Benefits of contacting MEDSI

Help from experienced doctors. Pediatric coloproctologists, gastroenterologists and psychologists work with patients. They know exactly how to treat constipation in a child in accordance with the reasons that provoked it
Diagnostic options. The clinic can conduct comprehensive examinations. They allow you to identify the causes of the pathology, find out how and what causes constipation in a child, help him as soon as possible
Comprehensive approach to troubleshooting. Doctors not only recommend diet and gymnastics. If necessary, specialists prescribe laxatives, antispasmodics, as well as agents that stimulate the evacuation of feces (enemas and suppositories). All drugs are selected individually
Prevention of complications. To prevent the undesirable consequences of constipation, check-ups by a coloproctologist are mandatory
Comfort of visiting clinics. We provide timely consultations without queues at a convenient time for patients

To make an appointment, just call 8 (495) 7-800-500. Our specialist will answer all questions and suggest the best time to visit a doctor. Recording is also possible through the SmartMed application.

Do not delay treatment, see a doctor right now:

Pediatric gastroenterologist appointment

Constipation in children. Prevention. Diet therapy

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Sabitova Vasily Ilyasovna Gastroenterologist

06/21/2019

Constipation is widespread among both adults and children (5-30% depending on the diagnostic criteria). Symptoms become chronic in more than 30% of patients, not only cause discomfort and pain to the child himself, but also disrupt the quality of life of his family.

CONSTIPATION - a condition manifested by an increase in the intervals between bowel movements (compared to the individual norm) or systematically slow, difficult and / or insufficient bowel movements. Constipation also includes stools with “gruel”, but after defecation was absent for up to 3 days.

Constipation can be related to functional or organic causes (abnormalities, inflammation). In children, 90-95% of constipation is functional. The peak incidence of functional constipation falls on 2-4 years, when they begin to accustom the child to the potty / toilet.

Main causes of functional constipation

Pain
Fever
Dehydration
Wrong diet of a nursing mother
Insufficient drinking regime of a child with artificial feeding
Insufficient drinking regimen of a breast-fed child with the introduction of complementary foods
Early transfer of a child to artificial feeding
Fast transition of the baby from one mixture to another (less than 7 days)
Irrational nutrition of the child (for a long time the child receives food with a large amount of proteins, fats and insufficient dietary fiber, abuse of drinks containing a large amount of astringents - tea, coffee, cocoa)
Excessive use of baby care products or the development of an allergic reaction of the skin of the perianal area
Consequences of perinatal injuries of the nervous system
Rickets, vitamin D deficiency
Anemia
Impaired thyroid function (deficiency - hypothyroidism)
Food allergy, especially cow's milk protein allergy
Forced potty training, period of adaptation to new conditions (nursery, kindergarten)
Physical inactivity - a sedentary lifestyle
Mental trauma or stress
Systematic suppression of the urge to empty the bowels, associated, for example, with the beginning of attending a kindergarten, school, etc.
Taking certain drugs
Constipation in family members

Frequency of defecation in children of different ages

Age	Number of bowel movements per week	Number of bowel movements per day
0 – 3 months breastfeeding artificial feeding	5 - 40 5 - 20	2.9 2.0
6 - 12 months	5 - 28	1.8
1 - 3 years	4-21	1.4
4 years and older	3 - 14	1.0

In addition to the frequency of the chair, you should pay attention to its nature. For a more objective assessment, the “Bristol fecal shape scale” is convenient, since it is the shape of the feces, and not the frequency of the stool, that is more consistent with the time of intestinal transit.

Bristol stool scale

In accordance with this scale, 3 and 4 form of feces is regarded as normal, and 1 and 2 indicate delayed transit (constipation). Quite often, in practice, there are situations when a child has a bowel movement frequency within the normal range, but the stool is dense, fragmented, in a meager amount. These signs indicate incomplete emptying of the bowels and are considered as manifestations of constipation.

The consistency of the stool in newborns and infants should be mushy. From 6 months to 1.5 - 2 years, feces can be both formalized and mushy. From the age of two, the chair must be decorated.

Signs and symptoms of constipation

abdominal pain, often bursting, aching, sometimes colicky
bloating
change in the shape and consistency of the stool
excessive flatulence
unpleasant smell of flatus and stool
may have pain during bowel movements
straining to defecate
there may be blood in the stool - on the surface of the feces or in the form of traces on a napkin (indicates an anal fissure)

If you do not eliminate constipation and do not establish bowel movements, then there is a risk of coprostasis (formation of fecal stones) and fecal intoxication:

loss of appetite
lack of energy
general malaise
depression, irritability
nausea, vomiting
skin symptoms - dryness, rash, peeling
fecal incontinence, stool spotting
urinary retention and incontinence due to pressure from a crowded bowel on the bladder
bleeding from fissures, hemorrhoids

The treatment of constipation involves the following goals:

1. Normalization of stool consistency (soft, painless stools)

2. Regularity of bowel movements (prevention of re-accumulation of feces)

The treatment of constipation is a sequential, complex, individual process and consists of several stages:

child and parent education
correction of nutrition and drinking regimen
elimination with the help of medications of existing coprostasis
maintenance therapy

It is necessary to exclude factors that provoke and contribute to constipation (normalization of motor and nutritional regimen, discontinuation of medications that can cause constipation, identification of a food allergen, exclusion or confirmation of neuromuscular disease, celiac disease, etc.).

Lifestyle normalization includes:

development of a conditioned reflex
mobile lifestyle
gymnastics
gentle abdominal massage training
for small children - laying out on the stomach, bending the legs to the stomach.

Education is the first step in the treatment of functional constipation. It must be remembered that episodes of fecal smearing and encopresis (fecal incontinence) are not arbitrary and should not be blamed on the child, who may already be frightened and disoriented. In some cases, when the intra-family situation is difficult, the help of a family psychologist may be needed.

It is important to understand that the treatment of functional constipation can be lengthy, based on trust, partnership and requires patience. Modern laxatives that are legal in children will not make the intestines “lazy”, will not cause “addiction”, they enter the bloodstream in minimal amounts or are not absorbed at all and are safe for long-term use.

Correction of the behavior of a child with constipation is based on the development of a routine of visiting the toilet, in order to achieve regular defecation. Defecation should be every time at the same time. The urge to defecate is based on the gastrocecal reflex, which manifests itself in the morning 1 hour after eating. A child with constipation needs to spend 3-10 minutes in the toilet (depending on age). It is necessary to plant the child on a potty or offer to visit the toilet after each meal.

A prerequisite for effective defecation is to provide a good support for the legs (a low bench on which the child can put his feet), which helps to increase intra-abdominal pressure.

If the defecation is not successful, the child should never be punished and vice versa. The daily frequency of bowel movements can be noted in a diary, which can be analyzed at a scheduled visit to the doctor.

Treatment of constipation should begin with lifestyle changes, which include dietary modification, drinking regimen and physical activity.

Calculation of fluid volume for healthy children

Children under the age of 1 year should drink at least 100 ml of water per day.

For healthy children weighing 10 to 20 kg the water requirement is calculated using the formula:

100 ml (volume of water for children under 1 year old) + 50 ml per kg for body weight over 10 kg.

For example, with a mass of 12 kg: 100 ml + 2 x 50 ml = 200 ml.

A child weighing 20 kg should drink water: 100 ml + 50 x 10 = 600 ml

For children weighing over 20 kg the following calculation formula is suggested:

600 ml (volume of water for a child weighing 20 kg) + 20 ml for each kg over 20 kg.

For children over 3-5 years old you can use the calculation of the amount of water: 30ml / kg of weight

Principles of Dietary Therapy for Constipation:

satisfaction of physical needs for nutrients and energy
exclusion of excessive consumption of proteins and fats, which can inhibit intestinal motility
enrichment of the diet with dietary fiber
normalization of intestinal microflora with pro- and prebiotics

If the child is breastfed, then the mother's nutrition is corrected (restriction of products that promote gas formation). With artificial feeding, special mixtures are shown. For constipation associated with an allergy to cow's milk protein, therapeutic mixtures are prescribed if the child is bottle-fed. If the child is breastfed, cow's milk and products based on it are completely excluded from the mother's diet.

After the introduction of “thick” complementary foods, boiled water is necessary for all children, regardless of the type of feeding.

For older children, it is recommended to eat foods rich in vegetable fibers. It is not recommended to “smear food”, puree, “snacks”, “eating on the go”. Food should be crumbly, meat / poultry / fish - “piece”. A “bulk” breakfast is required to stimulate the “gastrocecal reflex”.

The main source of coarse-fiber vegetable fiber, containing a large amount of dietary fiber, is cereal bran, rye bread, as well as a number of vegetables and fruits. According to the principles of evidence-based medicine, a statistically significant increase in stool frequency and improvement in its consistency was demonstrated with the use of fiber compared with placebo.

Bran, as the main source of vegetable fiber, is recommended to be added to the second and third dishes, after pouring boiling water over it and settling for 20 minutes. Bran can also be used in between meals, drinking plenty of fluids. For school-age children, the total amount of fluid when taking bran should be at least 1.5-2 liters per day, otherwise they mainly act as sorbents, absorbing fluid from the intestines, thereby increasing constipation. The dose is selected individually, it is recommended to start with 1 teaspoon 2-3 times a day, with a gradual increase to 40 g per day. When the effect is achieved, the dose is reduced and limited to one dose.

The American Academy of Pediatrics (2009) recommends a fiber intake of 0.5 g/kg/day (maximum 35 g/day) for all children. Fiber intake below the minimum recommended value has been shown to be a risk factor for chronic constipation in children.

However, long-term intake of a large amount of plant fibers due to fermentation by intestinal microflora is naturally accompanied by bloating and flatulence.

Children with constipation are shown to take cool liquids on an empty stomach (drinking and mineral water, juice, compotes, kvass), to enhance the laxative effect, it is possible to add honey, xylitol or sorbitol. It is very beneficial for bowel function to increase the intake of juices containing sorbitol/sorbitol, such as juice from plums, pears, apricots, peaches and apples,

With “sluggish” bowel function (hypomotor constipation), cool mineral water of medium and high mineralization is used, such as Essentuki 17, Batalinskaya, Arzni, Donat Magnesium, etc.; with spastic constipation (hypermotor constipation, stool form more often type 1) - warm and low mineralization (Essentuki 4). Calculation of mineral water - 3-5 ml / kg per day.

It is necessary to limit milk in its pure form and in dishes, as flatulence may occur with the appearance or intensification of abdominal pain. It is better to replace whole milk with sour-milk products - kefir, acidophilus, yogurt, yogurt, etc.

The diet of children with constipation includes dishes rich in vegetable fiber - salads from fresh vegetables, greens 2-3 times a day, baked apples, stewed vegetables, diluted vegetable and fruit juices with pulp. Food is cooked mostly unground, steamed or boiled in water.

It is preferable to take raw vegetables and fruits (in the absence of contraindications). Especially recommended are tomatoes, zucchini, pumpkin, carrots, beets, lettuce, cauliflower, apples. Dried fruits (prunes, dried apricots, figs) are given in soaked form and as part of cooked dishes. White cabbage, young green beans, green peas are allowed with good tolerance. Parsley, dill, celery are good to add to various dishes and salads.

If after reading the article you still have questions or you do not understand how to apply the recommendations in your particular case, we invite you and your child to be examined by a pediatric gastroenterologist at the DDC. For the convenience of parents, you can make an appointment with a pediatric gastroenterologist at the Children's Diagnostic Center on a weekday and on Saturdays.