Father and Son

Constipation is common in kids, and usually gets better when kids get older but can also be helped with increasing fluid and fiber intake. Constipation is more likely at certain times in a child’s life. These include when they’re moving from milk to solids, toilet training, or dealing with changes in routine or stress.

If pediatric constipation doesn’t improve or frequently recurs, your doctor can determine the cause and provide treatments. They can also help with a prevention plan.

Symptoms of Pediatric Constipation

Kids have a wide range of ‘normal’ bowel patterns. For example, infants may dirty diapers three or more times a day. Older children may have two bowel movements per day, or once every two to three days.

If your child is passing stool far less often than usual, straining to stool, passing hard or painful stools, and/or not feeling like they are getting all of the stool out when they are going, they may be constipated. There is not a test to diagnose constipation — your healthcare provider usually concludes a diagnosis by gathering information and a physical examination. If you don’t know what’s typical, no bowel movements for several days is a sure sign of pediatric constipation.

Other signs of constipation include:

  • Abdominal pain and cramping.
  • Nausea.
  • Bleeding.
  • Leaking of brown liquid.
  • Unusual daytime or nighttime wetting (due to pressure from hard stool on the bladder).
  • Movements to avoid passing painful stools (these include wiggling and clenching buttocks and are especially common in toddlers).

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What Causes Pediatric Constipation?

There is no one reason that pediatric constipation may occur, but it is commonly caused by developmental changes or changes in routine.

For example, children who are starting school may hold in bowel movements, which can cause constipation. Children who are toilet training may resist going to the bathroom because they don’t want to stop playing.

Sometimes a medication, such as a strong pain medication, can cause constipation in children. Underlying medical conditions, such as abnormal nerves in the colon and celiac disease, can also cause constipation. But fewer than 5% of children who experience constipation have an underlying medical disorder.

Pediatric Constipation Treatment at Home

The most surefire way to treat and prevent pediatric constipation is to increase the fiber and liquid in your child’s diet. Make sure your child eats at least five servings of fruits and vegetables every day. Beans, nuts, and whole grains (like whole wheat bread and pasta) are also fiber-rich.

A child over a year should drink 32 ounces (960 mL) of liquid, ideally water, each day. Cow’s milk can increase constipation in some kids.

It’s best to limit milk if your child has constipation and is more than one year old. They can resume routine milk once they’re feeling better, unless the doctor suggests otherwise.

Another at-home pediatric constipation treatment option is prune, apple, and pear juice. Pediatric experts recommend no more than six ounces of juice a day to help constipation in kids between one and six. (Older kids can have up to eight ounces.)

If your child’s constipation is due to ‘holding it in,’ get them into a toilet routine. Encourage them to sit on the toilet for 10 minutes at least once a day.

After a meal is often a good time, as your child is more relaxed. You can sing songs or read books with your child to help them pass the time.

Constipation in Children: When to Worry

If your efforts to address constipation aren’t working, or if your child frequently gets constipated, you should see a doctor.

You should also see your child’s pediatrician right away if constipation is causing:

  • Blood in the stool.
  • Weight loss.
  • Severe pain.
  • Vomiting.
  • Bleeding from the rectum.

For severe cases of constipation, your doctor will prescribe a laxative. (Inappropriate laxative use can worsen long-term bowel issues in kids. For this reason, you should only give a laxative if the doctor prescribes it and stop it accordingly.)

Your doctor may perform imaging, blood, or other tests to look for a blockage or signs of disease. Your doctor can also recommend dietary changes.

Editor's Note: This article was originally published on , and was last reviewed on .

American Academy of Pediatrics. Constipation in Children. Link

Constipation in children: Beyond the basics. UpToDate. Link

National Institute of Health. Constipation in children. Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.