As a pediatrician, a common concern parents share with me is about their child’s bowel movements. While constipation may seem like a straightforward issue, it can look different for every child. What may be considered “normal” for one child could be a sign of something more concerning for another. It might include going less often than every two days, passing dry or hard stools, or experiencing pain while trying to go.

It’s also important to remember that it’s a myth that children need to have a bowel movement every day. Some kids have multiple bowel movements a day, while others go every other day.
Understanding constipation in children is crucial for parents to differentiate between typical variations in digestion and when professional advice is needed.

Let’s explore why constipation varies from child to child and how you can help yours stay comfortable and healthy.

What About Babies?
For breastfed babies over one month old, having a soft, large bowel movement every four to seven days can be completely normal. It’s also normal for young babies to strain while stooling – this is usually just part of learning how their body works and doesn’t always mean they’re constipated.

Common Causes of Constipation
• Low fiber intake: diets that lack fruits, vegetables, and whole grains can lead to harder, smaller stools.
• Dehydration: not drinking enough fluids can dry out stool and make it harder to pass.
• Too much milk: intolerance or sensitivity to milk proteins can contribute to constipation.
• Lack of physical activity: movement helps the digestive system stay on track.
• Withholding stool: kids may avoid going due to pain, discomfort going in public places, or simply being too busy playing.
• Post-illness: some children become constipated after recovering from a stomach bug or other illness.
• Changes in routine or stress: starting school, traveling, or big life changes can temporarily affect bowel habits.
• Slow gut transit: Some kids naturally have slower digestion, which can run in families.

Tips to Help Your Child
Make dietary adjustments
• Include more fiber-rich foods like fresh fruits, vegetables, beans, and whole grains.
• Make sure your child stays well-hydrated. Water is best, but small amounts of prune, pear, or apple juice can also help.
• Cut down on foods that can contribute to constipation – this includes processed snacks, white bread, and large amounts of dairy.

Support healthy habits
• Encourage your child to be active every day – exercise supports digestion.
• Establish a regular toilet routine. Have your child sit on the toilet after meals to build healthy habits.
• Be supportive and encourage your child feel comfortable going when their body signals it’s time and not hold in stool.

When to Call Your CPCMG Pediatrician
Most cases of constipation resolve with simple changes at home. However, it’s important to reach out to your healthcare provider if:
• Home remedies haven’t helped.
• Your child has a fever or has stomach swelling.
• You see blood in the stool.
• Your child isn’t eating or is losing weight.
• You notice rectal prolapse (part of the rectum coming out during bowel movements).