Constipation (Child)

Image showing a cross-section of the colon blocked by stool.

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:

  • Abdominal pain

  • Refusal to eat

  • Bloating

  • Vomiting

  • 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.

Home care

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.

Food, drink, and habit changes

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 care

Follow up with your child’s healthcare provider.

Special note to parents

Learn to be familiar with your child’s normal bowel pattern. Note the color, form, and frequency of stools.

Call 911

Call 911 if your child has any of these symptoms:

  • Firm belly that is very painful to the touch

  • Trouble breathing

  • Confusion

  • Loss of consciousness

  • Rapid heart rate

When to seek medical advice

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

  • Weight loss

  • 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)