Constipation means that stools have become hard and are difficult to pass. Some parents are overly concerned about how often their child has bowel movements. That's because they've been taught that a healthy child has a bowel movement every day. But this isn't true. How often a child has bowel movements isn't as important as whether the child can pass stools easily. Your child isn't constipated if their stools are soft and pass easily. This is true even if it has been a few days since the last bowel movement.
Newborns younger than 2 weeks should have at least 1 or 2 bowel movements a day. Babies older than 2 weeks can go 2 days and sometimes longer between bowel movements. It's usually okay if it takes longer than 2 days, especially if your baby is feeding well and seems comfortable. Breastfed babies are more likely to have frequent stools. They may have a stool as often as every feeding. Constipation is likely to occur when a baby switches from breast milk to formula. This is even more likely if the change happens during the first 2 to 3 weeks of life.
As babies grow older, the number of bowel movements they have each day gets smaller and the size of their stools gets bigger. A child age 3 or 4 years may have as many as 3 bowel movements a day or as few as 3 a week.
It's important for parents to recognize that there are many "normal" patterns for bowel movements in children. Some children may seem to have trouble passing a stool. The child's face may turn red, and they may strain to pass stool. If the stool is soft and the child doesn't seem to have other problems, this isn't a concern.
Most children will be constipated now and then. The problem usually doesn't last long or cause long-term problems. Home treatment is usually all that's needed to relieve constipation that occurs now and then. Causes of constipation include:
Constipation may occur with cramping and pain if the child is straining to pass hard, dry stools. The child may have some bloating and nausea. There may also be small amounts of bright red blood on the stool caused by slight tearing (anal fissure) as the stool is pushed through the anus. All of these symptoms should stop when the constipation is relieved.
For reasons that aren't always known, some children often have constipation that doesn't get better or go away with treatment (chronic constipation). This may be because of the painful passing of a hard, dry stool. After a while, the child may not be able to resist the urge to have a bowel movement and will pass a large mass of stool. The child may have to "push hard" during the bowel movement, which may be painful. Passing the stool relieves the pressure and pain until another mass of stool collects. Then the cycle is repeated. Fear of pain may cause the child to try to hold the bowel movement.
Other causes of chronic constipation may include:
The child may not be able or willing to pass the stool regardless of its size. Liquid or loose stool may leak out, soiling the child's underwear. When this occurs in a child who is past the age of normal toilet training, it's called encopresis.
Chronic constipation usually requires several months of treatment and cooperation between the parents, the child, and the doctor to overcome the problem. Don't be discouraged if the problem comes back during these months. The rectum is made of muscle tissue. When a child has had chronic constipation, the muscle gets stretched. It may take several months to get the muscle back into shape.
In rare cases, constipation in children may be caused by other health problems, such as:
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
What you are looking for is a change in your child's usual bowel habits.
Every baby and child has different bowel habits. What is "normal" for one child may not be normal for another. In general:
Anywhere in these ranges can be considered normal if the habit is normal or usual for your child.
Many prescription and nonprescription medicines can cause constipation. A few examples are:
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, the problem may not improve without medical care.
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Here are some tips for caring for your child who is constipated.
High-fiber baby foods include cooked dried beans or peas (legumes), apricots, prunes, peaches, pears, plums, and spinach.
A diet with enough fiber (20 to 35 grams each day) helps the body form soft, bulky stool.
This may help relieve discomfort. You can also have your child lie on their back, legs flexed onto their belly. Then rotate your child's legs in a clockwise direction.
Children shouldn't need an enema or laxatives to have a bowel movement.
Call a doctor if any of the following occur during self-care at home:
To learn more about Healthwise, visit Healthwise.org.
© 1995-2022 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.