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Understanding Causes of Constipation in Children is the First Step to Reducing It

One of the most common problems I have seen over the past 30 years of my career is constipation. Constipation is defined as infrequent bowel movements or hard, dry stools.

Constipation can be very disruptive and can lead to many other problems including urinary tract infections, stomach aches, painful passing of stool and rectal fissures or small tears. Constipation, though thought to be hereditary by many parents, has to do more with one’s diet and nutrition, fluid intake, movement and toileting habits. Babies have the most efficient bowels. They eat and poop throughout the day. However this can change as we start to introduce solid foods into the diet.

When constipation occurs, several things often take place within the gastrointestinal tract: there is slowed movement of stool passing through the colon or not enough stool is being formed, there is delayed emptying of the colon from the pelvis, or a combination of both.

6 Attributing Factors to Constipation in Children

Here are some factors that can attribute to constipation in children:

  1. Poor diet: Diets high in processed foods, sugar, refined carbohydrates, alcohol, unhealthy fats and additives can make it harder to produce normal bowel movements.
  2. Inactivity: Exercise helps to increase blood flow, strengthens muscles within the digestive tract and helps control stress.
  3. Imbalance in intestinal flora: Healthy bacteria living in the gastrointestinal (GI) tract, called probiotics, help to regulate bowel function. One of the reasons fiber is so important for gut health is because “prebiotic” fiber from plant foods feed probiotic bacteria and allow them to thrive.
  4. Magnesium deficiency: Magnesium is an electrolyte that helps with normal muscle functioning. Too little magnesium in your diet can contribute to muscle tension.
  5. Withholding stool: Introducing toilet training too early can lead to withholding. If a child has a stool that causes pain or a rectal tear, this can lead to withholding.
  6. Poor toilet habits: Having the feet grounded is the best way to pass stool. Dangling feet interfere with the passage of stool. Not allowing enough time to sit on the toilet, will prevent the evacuation of the bowels.

How Do I Know if My Child is Constipated?

Signs and symptoms of constipation in children may include the following:

  • Less than 3 bowel movements a week
  • Bowel movements that are hard, dry or difficult to pass
  • Pain while passing a bowel movement
  • Stomach pain
  • Staining of liquid or pasty stool on the underwear
  • Blood on the stool or on the toilet paper

How Can I Prevent My Child from Getting Constipated?

You can help prevent constipation in children by following these six tips:

1. Offer Your Child High-Fiber Foods

A diet rich in fiber can help your child’s body form soft, bulky stool. Serve your child more high-fiber foods, such as raw fruits and vegetables, especially leafy greens, beans, and whole-grains and seeds like flax and chia. Start slow by adding just several grams of fiber a day to prevent gas and bloating.

The recommended intake for dietary fiber is 14 grams for every 1,000 calories in your child’s diet. For younger children, this translates to an intake of about 20 grams of dietary fiber a day. For adolescent girls and young women, it’s 29 grams a day. And for adolescent boys and young men, it’s 38 grams a day

2. Drink Plenty of Fluids

Water is often the best. Fluids are crucial to help keep things moving in the intestinal tract.

3. Promote Physical Activity

Regular physical activity helps stimulate normal bowel function.

4. Create a Toilet Routine

Regularly set aside time after meals for your child to use the toilet. Provide a footstool so that your child feet are grounded and has enough leverage to release a stool. Schedule time to go to the bathroom. Sometimes, it is important to set a timer to remind your child to take a break from their activity.

5. Schedule Time to go to the Bathroom

Sometimes, it is important to set a timer to remind your child to take a break from their activity

6. Be Supportive

Reward your child’s efforts, not results. Don’t punish a child who has soiled his or her underwear.

7. Review Medications

If your child is taking any medication check to see if it could be a contributing factor of constipation.

Check out the Bristol Stool Scale here to see what a healthy stool looks like.

Don’t let constipation wreak havoc on your child or your family. Be proactive and take control. If your child is experiencing any of the above symptoms and your efforts to get things moving is ineffective, schedule an appointment and let’s get to the bottom of it.


Cindy Wechsler is an Integrative Pediatric Nurse Practitioner.  She received her Masters of Science in Nursing degree from Yale University and is certified through the Pediatric Nursing Certification Board. Cindy has been treating children for over 30 years. She specializes in the natural treatment of common childhood conditions. Her compassion and understanding of the body’s innate ability to heal itself fuels her passion to bridge the gap between traditional and integrative medicine.