Constipation means that stools are difficult or painful to pass and less frequent than usual. A child with constipation feels a strong urge to have a stool and has discomfort in the anal area, but is unable to pass a stool after straining and pushing for more than 10 minutes.
Constipation is often due to a diet that does not include enough fiber. Drinking or eating too many mild 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 stools can make young children hold back their stool. If constipation begins during toilet training, usually the child is strong-willed and the parent is putting too much pressure on the child to use the toilet.
Changes in the diet usually relieve constipation. After your child is better, be sure to keep him/her on a non-constipating 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 a small amount of bright red blood on the toilet tissue.
For children over 1 year old:
Encourage your child to establish a regular bowel pattern by sitting on the toilet for 10 minutes after meals, especially after breakfast. Some children and adults repeatedly get blocked up if they don’t have regular sit times.
If your child is resisting toilet training by holding back, stop the toilet training for a while and put him back in diapers or pull-ups. Holding back stools is harmful. Use rewards to help your child give up this bad habit.
If a change in diet doesn’t relieve the constipation and your child is over 1 year old, give a stool softener with dinner every night for one week. Stool softeners are not habit forming. They work 8 to 12 hours after they are taken.
Examples of stool softeners that you can buy without a prescription are MiraLax, Metamucil, Citrucel, milk of magnesia, and mineral oil. Give 1/2 to 1 tablespoon daily MiraLax in 4-8 oz water daily as needed. Your doctor may instruct you to take a stool softener until the proper high fiber diet is obtained.
Don’t use any suppositories or enemas without your healthcare provider’s advice. These can irritate the anus, resulting in pain and stool holding. Do not give your child laxatives such as products that contain senna without consulting your healthcare provider because they can cause cramps.
If your child is very constipated and has rectal pain needing immediate relief, one of the following will usually provide quick relief:
If your child is still blocked up after trying this advice, talk to your healthcare provider now about seen or using an enema.
Call immediately if your child develops severe rectal or abdominal pain
Call during office hours if: