Have you ever seen a child struggle to get his bowels out? It’s a pretty disheartening sight. And as it turns out, a lot of Singaporean parents have this problem with their children every few weeks. Learn more about the recent survey on constipation in toddlers here.
Constipation in toddlers
As parents, we’re always on the lookout for certain health problems or diseases that can affect our children’s well-being, regardless of how simple or how major it is. One of the things I’ve struggled with when it comes to my toddlers’ health is constipation.
According to John Hopkins Medicine, constipation is a gastrointestinal disorder where a person has very hard stools and has fewer bowel movements than he or she normally does. It is one of the most common gastrointestinal problems among children. But did you know how common it is among toddlers here on the island?
In January, global milk brand Friso released the findings of a survey that was conducted on 1,000 Singaporean parents to uncover their toddlers’ constipation woes.
The Friso #ReallyKnowPoop Constipation Survey – Singapore’s first and largest of its kind to be conducted here – found that over 1 in 2 Singaporean toddlers experience constipation ‘every few days’ or ‘every few weeks.’
Constipation is prevalent for toddlers in Singapore
The local survey also revealed the following key findings:
- Constipation is a common problem among toddlers in Singapore, with parents indicating that their child experienced constipation ‘every few days’ or ‘every few weeks.’
- 9 in 10 parents indicated they were ‘confident’ or ‘very confident’ in identifying toddler constipation, however;
- Parents surveyed said they also relied heavily on other caregivers such as grandparents, domestic helpers and childcare centres to identify signs of constipation
- Parents attributed toddler constipation largely to dietary factors and may underestimate the impact of environmental factors such as changes to the child’s routine or stress
- Half of the parents surveyed said that they would wait ‘a few days’ or ‘after a week’ before seeking a doctor’s advice.
Image source: Friso
While the survey only focused on the local numbers, Dr Christina Ong, a senior consultant for Friso and a paediatric gastroenterologist based in Singapore, said that constipation affects a huge population of toddlers globally.
“Constipation is a common digestive problem among children not just in Singapore but also in other countries. The estimated prevalence of childhood constipation may be up to 3-10% worldwide,” she said.
Looking at the results of the survey and based on what the paediatrician said, it wouldn’t be surprising if your own child struggles with constipation from time to time. For this reason, we sought the help of Dr Ong to shed light on facts regarding this common GI problem among young children.
Cause of constipation in toddlers
According to Dr Ong, the following could be the reasons why your child is constipated:
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Painful experience with passing stools
A traumatic experience with passing stools may cause a child to start withholding the stools in order to avoid the pain.
“Over a period of time, constipation develops leading to a vicious cycle of painful defecation, stool withholding and worsening of constipation,” said the doctor.
Occasionally, an anal tear may occur from the passage of a large calibre or hard stools. Anal tear (or fissure) may lead to the further reluctance of passing stools and escalation of stool withholding behaviour.
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New or unfamiliar environment
A child who is starting school may avoid passing stools as they are unfamiliar with the surroundings or they are anxious about using the bathroom. Occasionally, they may be busy with their activities and delay opening the bowels hence leading to constipation.
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Dietary factors
“Diets high in processed food and reduced fluid intake are commonly associated with constipation. Children should be encouraged to have a balanced diet that includes fruits, vegetables and fibre,” said Dr Ong.
In the Friso #ReallyKnowPoop Constipation Survey, parents largely attributed toddler constipation to dietary factors such as ‘not eating enough fibre’ or ‘not drinking enough water’ so parents should note to not overlook environmental factors as they could also have an impact on their toddler’s gut health.
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Medical Condition
According to the paediatric gastroenterologist, medical conditions account for less than 5% of constipation in children. Some of the known medical problems include anatomical problems with the anus or rectum, problems with absorption, certain medical conditions, medications, etc.
“Your doctor will be able to exclude most of these conditions with careful history taking, physical examination and appropriate tests where indicated,” she reminded.
Aside from what Dr Ong mentioned, your child other possible causes of constipation in toddlers are lack of physical activity, socioemotional issues (struggles with potty training) and stress.
Symptoms of constipation in children
Image source: iStock
Most parents ask the question, “How would I know if my child is constipated?”
According to Dr Ong, certain signs or symptoms may suggest that a toddler has constipation. They include:
- Not passing stools for a few days
- Avoiding the bathroom to escape discomfort
- Passing hard, dry stools
- Cries or screams during bowel movements
- Feeling bloated and/or has tummy pain
- Trying to hold stool in, such as clenching teeth, crossing legs, squeezing buttocks together, turning red in the face.
You may also want to check your child’s underwear for small liquid or soft stool marks that can signify that she’s withholding her poop.
“It is important to watch out for these signs as constipation can turn into a vicious cycle if it is left untreated early and holistically,” reminded the doctor.
How to relieve constipation in toddlers
Dr Ong also emphasised the importance of catching the signs of constipation early to help parents react accordingly.
Since poor diet is one of the possible causes of constipation in toddlers, dietary factors also play an important part in the management of constipation.
The inclusion of high-fibre foods such as fruits, vegetables, beans, and whole-grain bread will help form soft stools and stimulate bowel movements and drinking enough water and other fluids can promote good bowel movements. Keeping healthy with exercise lowers the time it takes food to move through the large intestine.
In persistent cases of constipation, don’t hesitate to consult your child’s paediatrician about it. After careful history taking and examination, doctors may prescribe stool softeners or order investigations as indicated.
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Dr Ong suggested the following home remedies for toddlers with constipation:
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Having a fibre-rich diet.
Constipation can be relieved by making simple changes to routines and the diet. Increasing fibre in diets by consuming more fruits and vegetables, for example, can help form softer stools, making it easier for toddlers to pass their stools.
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Increase fluid intake.
Drinking sufficient water can also soften stools and reduce the discomfort associated with constipation.
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Monitor your child’s potty habits.
To encourage toilet training in a child, get him or her to sit on the toilet for approximately 5-10 minutes once or twice to per day after eating.
“Your child is more likely to have a bowel movement after a meal. Remember to praise your child for making the effort of sitting on the toilet even if there were no bowel movement,” said Dr Ong.
However, if your child develops constipation or phobia while toilet training, he or she is probably not ready for it. Consider postponing potty training for another couple of months before trying again. Remember that toilet training should be done in a reassuring manner with plenty of praises and positive reinforcement.
Image source: iStock
How to prevent constipation
Constipation is a common occurrence for toddlers in Singapore, but you can still prevent it from happening to your child often. It all starts with a lifestyle change. Dr Ong shares the following tips to help your child avoid constipation:
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Include more high-fibre foods and avoid preservatives and unwanted additives
High-fibre foods such as fruits, vegetables, beans, and whole-grain bread will help form soft stools and stimulate bowel movements.
“Our children’s tummies can easily recognise natural, whole foods but preservatives and unwanted additives can also complicate digestion and disrupt healthy bacteria,” said the paediatrician.
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Drink enough fluid
Drinking enough water and other fluids promotes good digestion and regular bowel movements by keeping your stool soft, which moves easily through the digestive tract. Make sure your toddler is drinking 2 to 4 cups (16 to 32 ounces) of water per day to prevent constipation.
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Stay active through regular exercise
Keeping healthy with exercise can help with constipation. Exercise promotes digestion and helps the intestine to push the digested food forward aiding in bowel movement. As parents or caregivers, you can start by setting a good example and exercising together with your little ones.
If your child is suffering from prolonged constipation, or if you have other concerns about his bowel movement, do not hesitate to talk to his paediatrician about it.
John Hopkins Medicine, Dr Cristina Ong
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