Remedies for constipation in children: All you need to know about this condition

Does your child have less than three bowel movements per week? Are they hard and painful? If your answer is “yes”, then chances are he is suffering from constipation. But don’t worry, this is a common problem and can usually be sorted out fuss-free with a few remedies for constipation in children.

First, let’s first understand why this might be happening to your little one.

Irregular stool and remedies for constipation in children

What’s normal and what’s not?

When a child has infrequent bowel movements and passes a hard or painful stool, it is a clear sign of constipation.

Keep in mind the definition of constipation usually depends on the normal frequency of your child’s bowel movements. Many children pass stool four or five times a week, while some may do it four times.

But generally, the following are typical patterns:

• Newborns who are younger than two weeks should ideally have one or two bowel movements each day.
• Babies who are older than two weeks can even go two or three days without any bowel movement. This is not a cause of worry if your baby is comfortable and feeding well.
• Breastfed babies may have a stool after each feed or after a few hours.
• A child aged three or four years might have anywhere between two bowel movements per day to three a week.

So why does constipation occur?

Constipation in babies sometimes occurs when your baby is put on formula milk from breast milk. But this should correct itself as your baby’s digestive system gets used to the change.

Also, as babies grow older and they start eating adult food, their bowel movement pattern also changes. The frequency decreases and the size of the stool increases.

It’s important to note that these are typical bowel movements patterns. Some children make faces or turn red while passing stool, but even that is normal.

Unless your child’s bowel movements are fewer than three per week and he is in pain while doing so, there is nothing to worry about. Even so, you should keep an eye out for symptoms that may suggest severe constipation.

Common symptoms of constipation in children

The following are some of the most common symptoms of constipation in children.

• Irregular bowel movements. You will notice fewer than three bowel movements per week. These might be hard, painful and difficult to pass. In addition, his stool may have a large diameter. He may feel abdominal pain during the day and especially while passing stools.
• Changes in stool. You might notice traces of clay-like stool stuck to your child’s diaper or underwear. It’s a sign that the stool is blocked in the rectum. A bloody stool or traces of blood on the hard stool is also a sign. This could be due to anal fissure. As explained by WebMD, it is “a tear that extends from the muscles that control the anus (anal sphincter) up into the anal canal.”
• Reluctance in using the bathroom. Your child might develop a fear of going to the bathroom and even try to avoid passing stool. He may try to clench his buttocks or control the painful stool. Infants may also try to raise their legs and squeeze their buttocks to prevent passing stool. Similarly, toddlers may rise up and rock back and forth on their toes and even clench their buttocks.
• Changes in urinary passage. You may notice your infant might urinate frequently and wet the bed. Also, there is a possibility of reoccurring urinary tract infections.
• Changes in appetite. Your child may not want to eat as much he did before for fear of using the bathroom. So you may notice decreased appetite, nausea and sometimes even vomiting.

These symptoms are often easy to spot. Sometimes your child might even tell you about his discomfort.

However, if the pain and discomfort become unbearable, you might have to rush your baby to the doctor. Sometimes it takes a thorough check up to diagnose the root cause of constipation.

That’s because in some infants and children constipation can occur not just because of a change in diet, but also due to certain medical conditions.

Medical causes of severe constipation in children

Doctors usually treat constipation in infants and children differently from adults. This is due to kids’ changing bowel movement patterns.

From the time they are born till they turn three or four, children’s bowel movement patterns are still developing. Therefore, these patterns are in a constant state of change.

Although a majority of children do not suffer from constipation due to a medical condition, some might. Here are a few conditions you should look out for.

1. Hypothyroidism

When the thyroid gland slows down in its regular functioning, it also reduces the activity of the intestinal muscles. This leads to severe constipation in children.

Ideally, a newborn should be tested for hypothyroidism. This type of test is done through a blood test (either a heel prick or Guthrie test). This medical condition can occur at any age.

2. Hirschsprung’s disease

If your baby has been constipated since birth and the condition remains even after he has grown up, it can be due to a birth condition called Hirschsprung’s disease.

In this rare congenital condition, the child’s colon lacks ganglion cells. These are nerve cells that help the colon receive instructions from the brain. In their absence the colon is unable to function properly.

Most infants with this disease exhibit symptoms from the first few weeks. For instance, underweight babies who vomit often may have the disease. And it is quite common in babies who have Down Syndrome.

3. Anal fissure

As mentioned earlier, an anal fissure occurs when there is a crack or tear that “extends from the muscles that control the anus (anal sphincter) up into the anal canal.”

This leads to painful and hard stools, and it becomes more painful with each subsequent stool.

4. Other medical conditions

Medical issues like diabetes, cystic fibrosis, lead poisoning and changes in blood mineral and electrolyte levels can also cause constipation.

Sometimes kids with nerve disorders like cerebral palsy and those with spinal cord issues might also be constipated. The reason for this is lack of movement and proper functioning of the colon and/or intestines.

Sometimes, you might notice a liquid stool in your child’s underpants. Usually, when this occurs in a child who has had potty training, it is known as encopresis. This means that the child has poor or almost no control over his bowel movements.

In all these conditions, your child might be unwilling to pass the stool, irrespective of its size.

You should know that chronic constipation takes time to treat. But there is no need to worry because it is treatable. It simply requires your patience and cooperation with the doctor as well as some home remedies for constipation in children.

Remedies for constipation in children

There are several home remedies for constipation in children. Most of these you can try at home. Let’s discuss them one by one.

1. Adequate intake of fluids

Make sure that your child is drinking adequate amounts of liquid, including water and fresh juice. This is one of the best remedies for constipation in children.

• Infants. If your are feeding your infant formula milk, make sure you make it up with the exact measurement of water given on the package instructions. With fully breastfed infants, constipation is rare. However, it is normal for them to pass stools less frequently due to the highly digestible nature of breastmilk. Avoid giving any water to your baby till he is six months, unless on strict medical recommendation.
• Six-month-old. It’s quite normal for babies to experience some constipation as they expand their liquid diet to include solids at around six months of age. In order to help a baby of this age with hard stools, try small quantities of pear and even prune juices if you feel his poop is hard. These will help relieve constipation. Remember that the quantity of these juices should be between 7ml and 30ml. You can increase the amount gradually as your baby grows.
• Nine-month-old. If your child is nine months old or above, you can increase the quantity of fresh fruit juice such as prune or pear to anything between 22ml and 45ml. Remember that whole fruits are always a better option than juice, and will contain more fibre overall.

2. High fibre diet

The soluble fibre that we consume — through a wide range of fruits and vegetables, as well as options such as barley and wheat — softens the waste in our bodies.

You can make use of fibre-rich foods to ease constipation issues in little ones.

• Six-month-old. In addition to sips of water after meals and plenty of breastmilk, you can introduce fibre-rich food to your baby at this age. For example: cooked brown rice, cooked beans and legumes, prunes, apricots, peaches and plums. You can also add greens such as blanched or cooked spinach into his daily diet.
• Nine months and above. For kids who are nine months and older, a high-fibre diet (20-25gm) can make the stool soft and easier to pass. So you can give one cup of whole fruit, one cup of vegetables, and increase the amount of high-fibre foods. Include oats, barley, brown rice and even whole wheat bread on a daily basis. In addition, you can cut down on food that is not high in fibre, such as processed foods and white bread.

3. Gentle massage

Sometimes your baby might need an additional push to help pass the stool. This is where a gentle body massage comes into the picture. This is perhaps one of the easiest remedies for constipation in children.

You can place your baby on his back. Flex his legs and rotate them clock-wise and then anti-clockwise. This will help him relieve gas and any kind of discomfort caused by constipation.

4. Warm bath and lubrication

You can also try a warm bath and even lubrication as remedies for constipation in children.

A warm bath given in a tub can relieve the anal muscles as well as the rectum. This will certainly make it easier for your baby to pass his stool.

Only on your doctor’s recommendation, you can try lubrication for his rectum with glycerin (one suppository, which is a small, cone-shaped object that is inserted into the child’s bottom). This will automatically dissolve inside and make it easy to pass the stool.

Remember to not use laxatives as remedies for constipation in children, unless recommended by a paediatrician.

Apart from home remedies for constipation in children, you can also try some home remedies for its prevention.

Preventive remedies for constipation in children

There are two things you need to keep in mind when it comes to preventing constipation in children: diet and toilet training.

1. Diet for kids

• Infants younger than 12 months. If you constantly breastfeed your baby, it reduces his chances of developing constipation. So keep at it. Also, if you are giving him formula, make sure to mix it with the suggested amount of water in the instructions.
• Toddlers aged 12 months and above. Give your toddler a high-fibre diet (20-35gms/day) and make sure that he drinks adequate amounts of water. A cup of whole fruit as well as one cup of vegetables is also important at this age. As mentioned earlier, give him oats, whole wheat items, as well as brown rice, beans and fibre-rich food.

Make sure you eat the same so he can follow suit. A fibre-rich diet is good for your health and tummy as well.

2. Toilet training

Constipation can become a problem when your child learns to use the toilet. So keep the following in mind to help him ease into this new change in his life:

• Encourage your child to go to the bathroom whenever he has to pass urine or stool. Usually, our bowels send out signals to encourage us to pass the stool. If your child ignores those signals, the stool may become dry and difficult to pass. So ask him if he wants to use the bathroom every few hours.
• Establish a routine for his bowel movements. This is one of the most efficient remedies for constipation in children. Usually, your child would want to go to the bathroom after a meal. So encourage and ask him after each meal. This will also help the both of you establish a routine.
• Teach your kid about squatting positions. This helps to relieve the muscles and eases the passage of stool. In addition, make sure he gets plenty of exercise and food support from home.

If you follow these remedies for constipation in children, you can help your child relieve his discomfort and pain. Remember that constipation is not an untreatable medical condition, nor does it cause other problems.

In sum, the best thing to do is to keep your child hydrated, add lots of high-fibre food in his daily diet and practice toilet training.

Sources: WebMD, EMedicineHealth, MedicineNet

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