My son has constipation: what can I do to relieve it?

My 2-year-old son has got severe constipation problem. He is not able to pass on the stools normally, without having 10ml of laxative every night. Can a doctor suggest, if there is any remedy ? Please help!

It’s not the frequency of bowel movements or straining that determines if a child is constipated or not, it’s the consistency of the stool. A child is constipated if he passes firm, dry pebbly poop. However, if his poop is fluid, soft or paste consistency, then he’s not constipated. Crying while passing a bowel movement, bleeding from the anus, abdominal pain and reduced appetite can also be signs a child is constipated.

Possible reasons for constipation:

Inadequate fluid

It is important to make sure that kids replenish fluids lost by drinking more than the usual amount of water and lactose-free milk

Is your child gaining appropriate amounts of weight for his age? Is he passing lots of urine?

If the answer is no, he may not be getting enough fluid in the form of food or formula and this can lead to constipation.

Depending on the climate, a formula fed child may not need extra fluids until he commences solids. However, if you live in a warmer climate, offering water (in addition to formula) is often recommended at an earlier age.

Check how you are preparing his formula. Make sure you are adding the correct number of scoops of formula powder to water, as recommended by the manufacturer. Take care not to overfill or tightly pack the formula powder in the scoop. This can lead to a more concentrated formula resulting in constipation.

The type of milk formula

Switching formula (or switching to cows milk) can lead to a change in stool consistency, resulting in either constipation or loose runny poop. Most often this change is only temporary, until your child’s tummy gets used to the new formula.

Some types and brands of formula are more constipating than others. If constipation continues to be a problem for your little one, it may be necessary to change formula.

New foods

Some foods are more constipating than others. If your child passes a firm, dry, pebbly poop, think back to what he’s eaten in the previous 24 hours. Did you offer him a new food? If there’s something you can identify, wait until his constipation has cleared, then try offering it in smaller amounts next time.

Low Fibre

Fibre is only found in plant foods such as cereals, fruits and vegetables. It’s not the milk itself that cause this, it’s simply that the child fills up on milk which means he will have no appetite for other foods which provide fibre.

Food intolerance

Persistent constipation can be a sign of milk or food intolerance

You can undertake simple steps to reverse the constipation episodes :

Increasing the amount of water offered.

Add some form of sugar to a child’s diet. The sugar works by drawing additional fluid into child’s bowel to soften the stools. Sugar can come from fruit, in the form of fructose or sorbitol or sucrose from sugar cane.

You can take other steps to minimize the occurrence of constipation problems:

Tummy massage

A child’s large bowel sits in his abdomen in one large loop. Poop travels around his large bowel in a clockwise direction. To assist him to expel gas that can occur with constipation, it’s best to follow the natural path of his large bowel.

Put some oil on your hands and gently massage his abdomen (the area under his ribs) in a clockwise direction using long stroking actions. Alternate this with lifting his knees and the ‘bicycle’ motion.

Proper toilet training

Children who are toilet trained should get in the habit of sitting on the toilet for five to ten minutes after breakfast and again after supper. Many families have very busy schedules and their children are not in the habit of “making time” to pass bowel movements.

By establishing regular “bathroom times” after meals, we take advantage of intestinal contractions that occur after we eat. These contractions are often called the “gastro-colic reflex” and they explain why some people pass bowel movements every morning after breakfast or every evening after supper. It is also useful to establish regular bathroom times after breakfast and after supper because many children are completely unwilling to pass bowel movements at school (just as many adults are unwilling to go to pass bowel movements at work).

Answered by:

Dr Dana Elliott Srither MBBS (Singapore), Grad Dip Family Medicine, is a certified Family Physician who believes in the principles of “Get Well” and “Stay Well”.