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Pediatrics

Constipation in kids (>1 year of age)

Constipation is a frequent problem for children because they often don't eat enough fiber, they wait too long because they are playing, or they have little patience to sit on the toilet. This is especially true during the time they are potty training and developing greater independence in general.

Constipation is seen when the passage of stool is painful, straining is noted and lasts longer than 10 min, and/or no stool is passed for longer than 3 days. Passing a bm that is large in size or is very firm but does not require excessive straining or cause pain is not classified as constipation. Children who eat larger amounts pass larger stools.

Constipation almost always can be helped by changes in the child's diet. The following is a list of foods that may be helpful:

Fruit juices—apple, pear, cherry, prune (citrus juices are not helpful, and we recommend not more than 4 oz/day of juice on a regular basis when the constipation has improved.) Make sure plenty of water is being taken in as well.

High fiber fruits/vegetables—peas, beans, broccoli, apricots, peaches, pears, figs, prunes, dates, raisins. (Limit bananas and cooked apples or applesauce)

Whole grain foods—bran flakes, bran muffins, graham crackers, oatmeal, brown rice, whole wheat breads/pasta, whole grain cereals, popcorn (>3 yrs of age)

Decrease milk products—limit milk, ice cream, cheese, yogurt to 3 servings a day total

Dietary changes take 3 days to work, so be patient.

If your child is "blocked up" you can use glycerin suppositories to assist evacuation of stool that is already in process before dietary changes were made. These are also indicated if there has been a small amount of blood on the surface of the stool or on the toilet tissue, signaling irritation with the passage of hard stool. They should not be used instead of dietary changes being made. You should keep in mind that suppositories may clean out the lower gut, so it may be a few days before the child will pass another bowel movement after the success of a suppository. Don't repeat the suppository, as long as the child is comfortable and not straining again.

Call back if:

  • Cramps or abdominal pains continuously for longer that 2 hours at a time
  • Your child continues to go 3 days without a bowel movement after a week on a non-constipating diet.
  • There is blood mixed throughout your child's stool, and not just on the surface.
  • The constipation does not improve or becomes worse.