Dr. Mom: When your child is constipated

06/28/2012 12:00 AM

07/03/2012 8:42 AM

When your child is constipated, it hurts.

Aside from the common cold and ear infections, constipation is one of the most common complaints at both well- and sick-child visits. It causes abdominal pain, frustration (for both parent and child) and guilt.

As parents, we often assume responsibility for these sorts of things. Such is parenthood.

So, what's a parent of a constipated child to do?

Recognition

Most parents know when they're dealing with constipation. Their world revolves around "when was the last time you had poop?" It's not fun. It's necessary. They're familiar with the long waits at the bathroom door as well as the groaning, the crying, and sometimes the howling that comes from their child as they try to pass a bowel movement.

It can be heartbreaking, frustrating and guilt-inducing all at once.

And while each child has an individual "normal" as far as frequency of bowel movements goes, there are good indications that your child is constipated: having a bowel movement fewer than three times per week or passing hard, dry, painful and large stools.

Vicious cycles soon set in. If a child holds it in for fear of the pain associated with large and hard stools, he or she after a while becomes unable to feel the urgency to go. This can exacerbate the constipation and accidents or soiling of underwear. So, regardless of frequency, if your child is in pain and/or afraid to go to the bathroom, it's time to help things along.

Treatment

Most childhood constipation can be turned around with close attention to a child's diet. Fiber and water – lots of it – are your child's friends. Whole fruits and vegetables, whole wheat bread and oatmeal are great sources of fiber. If you've got yourself a picky eater, giving a daily fiber supplement will help provide the needed daily fiber.

Wash it away by giving your child water throughout the day; with every meal and snack times, too.

Prune or pear juice served once or twice daily will aid in softening the stools and get your child on the right track. If your little one is reluctant to drink it plain, blend it in a smoothie. Add some whole fruit, low-fat yogurt, ice and a little skim milk. It's healthy and full of fiber – a win-win. The goal is to soften the stool so it's no longer painful to pass and for your child to start having regular, non-painful bowel movements.

Make sure your child gets the recommended 60 minutes of vigorous physical activity per day.

Sometimes, children will need a short course of laxatives to turn things around. Milk of magnesia, mineral oil or Miralax are common pediatric stool softeners used to end the vicious cycle of constipation. In these cases, working closely with your child's doctor will help you decide how long to continue.

Special considerations

While most cases of childhood constipation will respond to the dietary changes discussed above, some children have persistent constipation in spite of it. In these cases, it's important to consider other conditions such as irritable bowel syndrome, food allergies or thyroid problems, to name a few.

If your child's constipation has gotten so bad that he starts having fecal soiling of his underpants, consultation with a pediatric gastroenterologist may be in order to further evaluate and treat his constipation.

Constipation is distressing for parents and children alike. Help your child regain control by re-evaluating and revamping his diet to include plenty of fiber and fluids. Get creative with daily homemade smoothies and be consistent about having him sit on the toilet at the same time each day until he becomes more regular. Help him recognize the signals from his body and explain to him how important those whole fruits and vegetables are in order for him to have pain-free bowel movements.

Constipation is a pain, but one you and your child can remedy together.

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