Constipation accounts for 3 percent of visits to pediatricians. Constipation is a common problem in children. Constipation doesn’t simply refer to less frequent stools or discomfort, but a decrease in frequency of stools involving hard painful bowel movement. Constipation is a bowel movement less than every 4 days that involves hard to pass, painful stool. The most common causes of constipation are dehydration and diet, though in toddlers potty training can add to the problem.     

The remedy for dehydration is to increase water intake. For constipated babies more than 6 months old, or in very hot weather, give 1 to 2 ounces of water. For babies more than 8 months old give water and diluted apple juice. For toddlers, offer water often. Avoid carbonated, sparkling, or seltzer water until over 2 years old. Fizzy water can make children gag, may have sugar, salt, flavorings.     

The dietary solution is to increase fiber. For babies started on solids, switch from rice cereal to barely or oat, and avoid binding foods like bananas, cooked carrots, squash. For toddlers and those older, provide 2 servings of fruit and 3 servings of vegetables daily, and give whole wheat breads, cereals, or granola. Try Nutri grain, All-bran, Bran Flakes, Raisin Bran, Shredded Wheat, Oatmeal, Oat Bran, cereals. Offer cereals as finger food snacks too. Try prunes, apricots, plums, apples (with skin), papaya, mango, nectarines, dried fruits, figs, dates, oranges, applesauce, raisins, to the diet. Whole fruits are better than fruit juice. Whole fruit have higher fiber content and less sugar. Add fiber rich vegetables with peas, beans, broccoli. Add high fiber popcorn for children 5 to 8, but don’t give popcorn to younger children as it can pose a choking hazard. Remember to introduce new foods one at a time, about every three days.     

Half of all toddlers experience constipation at some point. The added problems for toddlers are the switch to cow’s milk, high in fat and calcium, in maturing body systems that eliminate waste more slowly, and holding back on passing stool while toileting. The answer is to limit milk intake to 10 to 16 ounces daily. Keep the dairy products to 2 to 3 servings a day (about ½ cup per serving). Encourage use of potty after meals. Eating often stimulates a bowel movement 30 minutes to an hour post and intestinal reflexes make passing stool easier.     

If constipation exists, massage may help. Massage the belly about three fingers below the navel, press gently but firmly until you feel the mass then maintain a little pressure a few minutes. Prevention is the key. Hard stools produce a nasty cycle - stool painful to pass out leads to avoidance and further constipation, and can irritate or tear the anal lining.     

Consult your MD if pain or problem persists, and for all problems with young infants not on solid foods.   
 

Babycenter.com

Diaper-free Before 3 by Jill Lekovic, M.D.