Healthy Tip Tuesday: Constipation in Children

What’s normal for your child may be different from what’s normal for another child.

In this week’s Healthy Tip Tuesday, brought to you by Trinity Hospital Twin City, THTC Certified Nurse Practitioner Angela Simmerman explains bowel patterns vary from child to child just as they do in adults, but as adults it’s important we know the signs of constipation and when it’s time to act.

Simmerman notes that most children have bowel movements 1 or 2 times a day while other children may go 2 to 3 days or longer before passing a normal stool. For instance, she says if your child is healthy and has normal stools without discomfort or pain, having a bowel movement every 3 days may be his or her normal bowel pattern.

What Are the Symptoms?

Simmerman explains that for infants, just because they are pushing and red-faced when trying to pass a bowel movement it doesn’t necessarily mean they are constipated. “They are just trying to figure out how to coordinate it all,” she says. “They are still learning all the muscles they have to use.” However; if babies and young children do not have soft stools, then they are likely constipated. “And at that age, you really should consult your primary care provider. If you try and do too much you could cause more harm,” she adds.

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Additional symptoms may include:

  • Many days without normal bowel movements
  • Hard stools that are difficult or painful to pass
  • Abdominal pain, such as stomachaches, ­cramping, or nausea
  • Rectal bleeding from tears called fissures
  • Soiling
  • Poor appetite
  • Cranky behavior

What Causes Constipation?

According to the American Academy of Pediatrics, there are a number of things that could lead to constipation in your child.

  • Changes in diet, or not enough fiber or fluid in your child’s diet, can cause constipation.
  • If your child is sick and loses his ­appetite, a change in his diet can throw off his system and cause him to be constipated. Constipation may be a side effect of some ­medicines. Constipation may result from certain medical conditions, such as hypothyroidism (underactive thyroid gland).
  • Your child may withhold his stool for different reasons. He may withhold to avoid pain from passing a hard stool, which can be even more painful if your child has a bad diaper rash. Or he may be dealing with issues about independence and control—this is common between the ages of 2 and 5 years. Your child may also withhold because he simply doesn’t want to take a break from play. Your older child may withhold when he’s away from home, at camp, or at school, because he’s embarrassed or uncomfortable using a public toilet.
  • Other changes. In general, any changes in your child’s routine, such as traveling, hot weather, or stressful situations, may affect his overall health and how his bowels function.

Simmerman adds that it all goes back to a healthy diet. The better-quality foods your child is consuming, the better their overall system will function. She also notes plenty of water also helps!

Dietary Changes:

  • Constipation is rarely a problem in younger infants. It may become a problem Chart.jpgwhen your baby starts solid foods. Your child’s doctor may suggest adding more water or juice to your child’s diet.
  • Older children. When a child or teen is con­stipated, it may be because his diet doesn’t include enough high-fiber foods and water. Your child’s doctor may suggest adding higher-fiber foods to your child’s diet and may encourage him to drink more water. These changes in your child’s diet will help get rid of abdominal pain from constipation.

Officials note that although constipation can cause pain and discomfort, it can usually be treated. If it isn’t treated, however, it may get worse. The longer the stool stays inside the lower intestinal tract, the larger, firmer, and drier it becomes. Then it becomes more difficult and painful to pass the stool. Then, your child may hold back his or her stool because of the pain creating a vicious cycle.

How is Constipation Treated?

The American Academy of Pediatrics adds that constipation can be treated in different ways. Your child’s doctor will recommend what is best for your child’s situation. In some cases, your child may need to have a medical test before your child’s doctor can recommend treatment. For example, your child’s doctor may need to look inside your child’s body and x-rays may be used to create these images. In most cases, no tests are needed.

Simmerman encourages parents and guardians concerned with their child’s bowel movements to talk with their primary care provider. A simple change in diet or exercise may be the answer and if not, your child’s doctor can suggest a plan unique to your child.

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