Bowel movement patterns vary in children. A child around age 2 will have about 2 bowel movements per day. After 4 years of age, a child may have 1 bowel movement per day.
A normal stool is soft and easy to pass. But sometimes stools become firm or hard. They are difficult to pass. They may pass less often. This is called constipation. It is common in children. Each child's bowel habits are a little different. What seems like constipation in one child may be normal in another. Symptoms of constipation can include:
Refusal to eat
Streaks of blood in stools
Problems holding in urine or stool
Stool in your child's underwear
Painful bowel movements
Itching, swelling, bleeding, or pain around the anus
Constipation can have many causes, such as:
Eating a diet low in fiber
Eating too many dairy foods or processed foods
Not drinking enough liquids
Lack of exercise or physical activity
Stress or changes in routine
Frequent use or misuse of laxatives
Ignoring the urge to have a bowel movement or delaying bowel movements
Medicines such as prescription pain medicine, iron, antacids, certain antidepressants, and calcium supplements
Less commonly, bowel blockage and bowel inflammation
Simple constipation is easy to stop once the cause is known. Healthcare providers may or may not do any tests to diagnose constipation.
Your child’s healthcare provider may prescribe a bowel stimulant, lubricant, or suppository. Your child may also need an enema or a laxative. Follow all instructions on how and when to use these products.
You can help treat and prevent your child’s constipation with some simple changes in diet and habits.
Make changes in your child’s diet, such as:
Replace cow's milk with a nondairy milk or formula made from soy or rice.
Increase fiber in your child’s diet. You can do this by adding fruits, vegetables, cereals, and grains.
Make sure your child eats less meat and processed foods.
Make sure your child drinks more water. Certain fruit juices such as pear, prune, and apple, can be helpful. However, fruit juices are full of sugar so limit fruit juice to 2 to 4 ounces a day in children 4 to 8 months old, and 6 ounces in children 8 to 12 months old.
Be patient and make diet changes over time. Most children can be fussy about food.
Help your child have good toilet habits. Make sure to:
Teach your child not wait to have a bowel movement.
Have your child sit on the toilet for 10 minutes at the same time each day. It is helpful to have your child sit after each meal. This helps to create a routine.
Give your child a comfortable child’s toilet seat and a footstool.
You can read or keep your child company to make it a positive experience.
Follow up with your child’s healthcare provider.
Learn to be familiar with your child’s normal bowel pattern. Note the color, form, and frequency of stools.
Call 911 if your child has any of these symptoms:
Firm belly that is very painful to the touch
Loss of consciousness
Rapid heart rate
Call your child’s healthcare provider right away if any of these occur:
Abdominal pain that gets worse
Fussiness or crying that can’t be soothed
Refusal to drink or eat
Blood in stool
Black, tarry stool
Constipation that does not get better
Your child is younger than 12 weeks and has a fever of 100.4°F (38°C) or higher because your baby may need to be seen by his or her healthcare provider
Your child is younger than 2 years old and his or her fever continues for more than 24 hours or your child 2 years or older has a fever for more than 3 days.
A child 2 years or older has a fever for more than 3 days
A child of any age has repeated fevers above 104°F (40°C)