Question: How common is constipation in children, and what are some causes?
Answer: It's pretty common. The No. 1 reason in younger infants and children is they drink a lot of milk, and dairy products are extremely constipating, and formula has iron, which is constipating. Most toddlers don't have a great diet. They don't eat a diet high in fruits, vegetables, whole grains, the things that keep you regular.
Toddlers and school-age kids learn that playing is more fun than stopping and using the bathroom. There's something called the busy little girl syndrome where they keep playing and holding it and then it's hard.
Q: What can parents do?
A: The first thing that we usually address is the diet. We talk about limiting dairy, cutting back on cheese and other constipating foods such as bananas, and increasing things that help make bowel movements more regular, like fruits and vegetables, whole-grain cereals and breads.
The other thing is focusing on the behavioral side. What I usually instruct parents to do is to get their child into a regular toilet routine, rather than waiting for them to go. After every meal, sit the child on the toilet for five to 10 minutes and see what happens. If they don't go, I would just take them off the toilet.
Q: How can you tell a child is constipated?
A: In babies, they're screaming, twisting their legs, or turning red and you find no stool. In toddlers, sometimes they squat in a corner or complain of bad abdominal pain. Sometimes kids have vomiting.
Q: What's considered normal in terms of bowel movements?
A: For babies, it's from five times a day to once every five days. With toddlers, you would expect them to go two times a day. By the time they're in kindergarten, it would be once a day or every other day. And along with how many times they go is the consistency.
Q: Are there any tricks to prevent constipation?
A: Drinking water, increasing fluid intake, is a really good way to prevent it or treat it. In babies, usually we say no juice. There are suppositories you can use to lubricate the stool or a powder that you drink that acts to pull the water into the stool.
Q: Can constipation be a sign of something else that's wrong?
A: One of the more common things is hypothyroidism, where they don't have enough thyroid hormone and everything moves slow. Many children with cystic fibrosis also have constipation. One disease that's diagnosed close to birth is Hirschsprung's disease; it's a problem with the nerves that integrate your colon.
For the average infant to school-age kid, it's either diet- or behavior-related. It's fine to go see the doctor to discuss it. It's just a childhood problem.
Courtesy of the Indianapolis Star
Bonnie - it is refreshing to hear a doctor mention diet as the first thing to look at with constipation in children. A recommendation I commonly make for kids is to add a little more healthy oil/fat to the diet as well as a bit of supplemental magnesium.
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