Constipation in children

Constipation refers to passage of small, hard, dry stools and should not be confused with infrequency of bowel movements.


Constipation [Illustration by Shiju George]

Causes of constipation in new born babies and infants:

  • Breast-fed babies are rarely constipated. However, bowel habits could be quite infrequent with a baby passing stool only once in a few days. Do not get worried so long as the stool is soft.
  • Babies on bottle feeds tend to be constipated more often. This could be due to:
  • Inadequate fluid intake, especially in hot weather.
  • Excessive sweating (causing water loss) due to extra clothing.
  • Inadequate sugar in the milk feed.Inadequate or delayed introduction of semi-solid foods. Most children have some degree of constipation when introduced to solid foods.

Some parents, who are obsessed by the idea that their child should have daily bowel movements, use laxatives. Prolonged used of laxatives could cause diarrhoea, alternating with constipation.

Causes of constipation in older children:

  • Inadequate dietary roughage and large amounts of milk are the commonest causes in this age group.
  • Poor toilet training could lead to constipation. Parents anxious about their child’s daily bowel movements may force the child to sit on the pot for too long. Others may examine the child’s stool critically, inducing her to refuse to empty her bowels. So much of obvious attention is bound to get the child worried and affect her bowel movements. This is often seen in children whose parents are tense, over protective, anxious and indulgent.
  • Constipation could also have a psychological origin, especially among children who are one or two years old. If your child has painfully hard movements, she may tend to hold back for weeks or even months afterwards for fear of being hurt again. If she holds it for a day or two, the bowel movements will continue to be hard and the problem will persist.
  • A hyperactive playful child may ignore nature’s call and, in course of time, disregard the sensation. This could also lead to hard stools.

Management of constipation in children

  • For new borns, you could give some sugar water or add sugar to milk.
  • Increase the content of water and roughage, which can be provided by vegetables, fruits and whole wheat flour in the child’s diet.
  • Encourage your child to use the toilet regularly, without hurry, coercion or distractions.
  • Do not give her a laxative.

Consult your doctor:

  • If your child complains of pain while moving her bowels.
  • If your child has streaks of blood in her stools or on her diapers. Occasionally, hard bowels could bring about streaks of blood in her stool. It is caused by a small tear in the lining of the anus.
  • If your child has gross abdominal distension with vomiting along with constipation.
  • If your child is constipated for more than three days.