Worrying about your child’s bowel habits ranks among the least pleasant aspects of the early parenting years. When your toddler is constipated, you probably wish you had a magical digestive wand you could wave to make it all better.
But here’s a fun fact — if facts about constipation qualify as “fun” — that may bring some comfort: Constipation in kids can be defined slightly differently than in adults.
Whereas the traditional measure of constipation in adults is having three or fewer bowel movements per week, according to the National Institute of Diabetes and Digestive and Kidney Disorders (NIDDK), constipation in children is defined as fewer than two per week.
The take-home message? Your child’s frequency (or lack) of “going” might not be as unusual as you may think.
And even if you have a case of actual constipation on your hands, rest assured that this is extremely common in toddlers. In fact, about 5 percent of children’s doctor visits are related to being all stopped up, per the NIDDK.
With the right interventions, you can help your child get things moving smoothly again. Here’s a look at the ins and outs of toddler constipation.
Again, defined broadly, constipation in kids will look like fewer than two successful poops per week. But children can still experience discomfort (and benefit from some gentle interventions) before things get to this point.
If you’re parenting a toddler, you know their verbal skills may not have developed to the point where they can pipe up and say, “I’m constipated!” (A four-syllable word is pretty impressive for kids still in diapers.)
Still, the signs and symptoms aren’t too difficult for parents and caregivers to spot.
Watch out for these indicators of constipation in toddlers:
- stools that are hard, dry, or pebble-like
- straining or pain (or both) when trying to pass large pieces of stool
- abdominal pain
- fear or avoidance of using the toilet
- blood on the stool
- unusual poop “accidents” or underwear stains in a child who’s already potty trained
Just like with adults, toddlers’ digestive habits are a delicate balance of multiple factors, from diet to emotional issues to daily routine. Add potty training to the mix and you may find yourself with the perfect storm of digestive delay.
Here are some of the causes of constipation in young kids.
Standard “kid” foods like chicken nuggets and French fries may get your toddler to clean their plate, but highly processed, low fiber foods don’t do much to keep your kiddo regular.
Meanwhile, changes in their diet, like switching from breast milk to formula or introducing new foods, can make kids’ bowels sluggish, too.
The digestive tract needs plenty of fluids to take waste past the “finish line.” And while some toddlers are practically inseparable from their sippy cups, others have less interest in hydrating.
Change in routine
When your little one is used to accessing the toilet at certain points throughout the day, it’s only natural that a change in routine could throw them off. Moving house, starting a new daycare, or traveling may trigger a bout of constipation.
Illness or medication
Sometimes, sickness can make little ones feel more lethargic — meaning they’re more likely to ignore the urge to get up and use the toilet. Plus, if your child is being treated for a health condition with medication, it’s possible their meds could affect their digestion.
Fear or other emotional causes
Ah, potty training — isn’t it a delight? (Said no parent ever.) In addition to the not-so-joyous elements of poo accidents and setting up camp for hours in the bathroom, potty training comes with difficult emotional aspects for some children.
Toddlers may feel fearful, skeptical, or even embarrassed about using the toilet. Then there’s the possibility of feelings of resentment at having to give up the familiarity and convenience of diapers. Any of these negative emotions can lead to minimal output.
Finally, distracted play can make some kids less likely to stop what they’re doing and answer the call of nature — because who wouldn’t rather stack blocks than visit the boring old potty?
Fortunately, getting your child to better bowel movements doesn’t always have to involve major intervention. In many cases, some simple changes can help.
For mild, temporary constipation, try these at-home steps:
Focus on diet
Fiber is the name of the game! Be sure to feed your child plenty of fiber-rich foods, such as:
- whole grains
- fruits and vegetables
- nuts (monitor your child closely, because nuts are a choking hazard)
Probiotic-rich foods such as yogurt and sauerkraut are also best bets. Minimize foods high in refined grains and sugars, like white breads and pastas, cookies, and pastries.
Add more fluids
The answer to constipation might just be hydration.
Toddlers need about 2 to 4 cups of water per day, alongside their intake of milk. So, be sure to keep a sippy cup or bottle close at hand throughout the day.
You can also try offering up to 4 ounces per day of prune juice, which combines the double whammy of hydrating and stimulating the bowels.
When offering juice, keep in mind that 100 percent fruit juice is better than juice blends or beverages that may contain added sugar. And whole fruits (which generally contain a lot of water) are even better than juice, because the fruit has more fiber.
The American Academy of Pediatrics recommends that toddlers have no more than 4 ounces of juice per day in total.
Most toddlers are naturally very active — just try keeping up with one for a whole day! But some need an extra nudge toward physical activity, especially when constipation is an issue.
Make sure your child’s day has plenty of opportunity for exercise — which, in this age group, can look more like play. Running, dancing, tossing around a ball, or playing on a playground can get them (and their bowels) moving.
Promote healthy bowel habits
We adults would probably say our bowel habits benefit from a regular routine — and the same is true for toddlers.
Although schedules can, of course, change from day to day, it’s helpful to provide your child plenty of opportunities to poop throughout the day. If they don’t seek out the toilet on their own, be sure to ask them regularly if they need to go.
Meanwhile, if your toddler fears the potty monster or has dug in their heels about ditching diapers, try to stay calm and laid back. The more you stress, the more your child may pick up on tension around all things bathroom-related — which won’t help constipation.
Seek doctor-approved interventions
If you choose to see your pediatrician about your child’s constipation, they may recommend more in-depth treatments.
Your doctor may advise using:
- prescription or over-the-counter laxatives
- fiber supplements
- probiotic supplements
- magnesium or milk of magnesia
- karo syrup
- an enema
Let your doctor be your guide on any of these treatments. (As in, don’t jump the gun on any of them without pediatrician approval.)
There’s no hard and fast rule for when to call your pediatrician about your toddler’s bowel backup. In general, though, bouts of constipation that last longer than 2 weeks warrant a doctor’s visit.
That said, some circumstances are reason to seek medical attention stat.
Be sure to speak with your pediatrician if your toddler’s constipation is accompanied by any of the following:
- severe abdominal pain
- abdominal swelling
- loss of bladder control
- loss of appetite
- rectal prolapse (when part of the intestine pushes through the anus)
- blood in stool
When your child is in the throes of digestive woes, remember that this, too, shall pass — literally!
Most bouts of constipation in toddlers are temporary and won’t cause lasting harm.
By making some simple tweaks to their diet and routine, there’s a good chance you can get their bowel movements back on track.