Constipation Relief

When your child is constipated, you want to do everything you can to help them find relief. Just like every child is different, every child’s bowel habits are different as well. Some kids have a bowel movement one or two times per day, while others may pass stool every two or three days or longer. Because bowel patterns vary in children, it’s important to understand the signs and symptoms of constipation and know what the options are to help provide your child some relief.

Your child’s age is the most important factor in determining how many bowel movements are ‘normal’. In infancy, children may defecate four times a day or more. As children grow, daily bowel movements will progressively decrease up until the age of about four, when most children have voluntary control over their sphincter.

While constipation is one of the most common conditions found in children, afflicting up to 30% of children worldwide2, there are risks associated with chronic constipation parents may not be aware of, so it’s important to address any concerns with your child’s pediatrician.

Chronic constipation can lead to urinary tract problems, fecal soiling (accidents), chronic abdominal pain, and psychosocial difficulties. Studies have shown that children who struggle with chronic constipation may be more withdrawn, shy, struggle with interpersonal relationships with their peers, and may be more likely to develop gastrointestinal disorders as adults.1

The majority of children and toddlers (about 95% of the reported cases) have functional constipation meaning it's not due to "secondary" causes like medications or medical conditions. Functional constipation mainly affects children between the ages of two and four, when toilet training starts.3

Young girl laying in bed holding her stomach

DocuSol® Kids - Child Constipation symptoms, signs & relief

Signs and Symptoms of Child Constipation

The most common symptom of constipation in children is infrequent bowel movements. Diagnostic criteria for pediatric constipation is commonly defined as less than three bowel movements per week, and many constipated children also suffer with fecal incontinence as well.3

Children with constipation may have stools that are hard, dry, and difficult or painful to pass. Other symptoms include:

  • Several days without a normal bowel movement
  • Stools that look like pebbly rabbit droppings.
  • Routinely strain to pass hard stools.
  • Abdominal pain, such as stomachaches, cramping, or nausea.
  • Soiling of underwear.
  • Reduced appetite.
  • Irritable behavior.
  • Abdominal bloating/pain

Here is a helpful chart to understanding stool type and consistency:

Infographic on poop types

What Causes Childhood Constipation?

There is often more than one culprit behind your child’s constipation, however, there are several common factors to consider when determining the potential cause, including:

  • Changes in diet. If your child is transitioning from breast and/or bottle-feeding to solid food, or other changes in diet, this can cause constipation. Another dietary factor could be insufficient fiber or fluid in your child's diet.
  • Illness. When your child isn’t feeling well, it can cause a reduced (or absent) appetite which can throw their system off and lead to constipation. Some medical conditions can also cause constipation.
  • Medications. Constipation can be a side effect of certain medications.
  • Stool withholding. Your child may withhold stool for several different reasons. Stool withholding commonly begins when a child has a painful bowel movement due to hard or large stool and is reluctant to have a bowel movement again as a result. Children who may be dealing with independence and control issues may also withhold stool — this is commonly seen between the ages of two and five years old. It is not uncommon to see children withhold while at school, a friend’s house, daycare, or camp if they are shy about asking to use the bathroom or uncomfortable using a public toilet. Your child may also withhold simply to continue playing.
  • Changes in Routine. In general, any changes in your child's routine, such as traveling, extreme weather, or stressful situations may affect overall health and how a child’s bowel functions.

The longer stool stays inside the lower intestinal tract, the larger, firmer and drier it becomes, causing it to become more difficult and painful to pass and creating a vicious cycle. It’s important to address any signs or symptoms of constipation as quickly as possible, to break this cycle and get your child back on track.

Dietary Habits for Healthy Bowel Movements in Children

By making a habit of providing a balanced diet during the toddler and preschool years, you are establishing the nutritional habits needed to have healthy stools.
A balanced diet should include the following:

  • Starch – bread, pasta and rice (whole wheat is the best source)
  • Large amounts of fruit and vegetables – aim for at least five portions a day
  • Protein – meat, fish, eggs, beans and lentils
  • Dairy – cheese, yogurt, whole or low-fat milk should be consumed every day
  • Fat – Essential fatty acids found in food like salmon, almonds and olive oil

Foods to avoid: it’s important to moderate (or eliminate) foods that are high in fat, sugar, and sodium, like candy, chips, and soda. Fast food should be a rare event, instead of a mainstay in your child’s diet. Too much dairy and/or red meat can contribute to constipation. To get protein into your child’s diet, chicken, pork, and fish are healthier options.

An adequate intake of daily fiber is essential for healthy bowel movements. The amount of fiber your child needs varies depending on age and gender, so it’s important to check with your child’s pediatrician to determine what is best for your kid.

Foods that are high in fiber include4:

Whole Grains: whole wheat bread, oatmeal, whole wheat pasta, and bran based cereal
Fruits: berries, oranges, pears, and apples (leave the skin on!)
Legumes: kidney beans, black beans, soybeans, lentils, and chickpeas
Vegetables: collard greens, broccoli, green peas, and carrots
Nuts: (as long as your child does not have a nut allergy): almonds, peanuts, and pecans

DocuSol® Kids - Fast, predictable results typically in 2-15 minutes.

At-Home Remedies for Constipation in Children

Generally speaking, if your child's constipation lasts longer than two weeks, it is recommended to seek advice from a pediatrician about the right course of action, but it’s always a good idea to check with a pediatrician to be sure.

There are some simple at-home remedies that can help relieve constipation as well.

Exercise: Moving the body helps keep stool moving, too! Try some fun games that also get the blood pumping, like tag, hide-and-seek, tossing a ball around, going for a walk, and playing at the playground!

Increase Fiber: As indicated above, fiber is to keep stools moving. Try increasing your child’s fiber intake to relieve constipation.

Abdominal Massage: To help move stool along, try gently massaging your child’s lower abdomen. In addition, try having your toddler lie on his or her back while you move their legs in a bicycling motion.

Stick to a Routine: Have there been any recent changes in your child’s routine? Did they start daycare or camp? Are there any unusual stressors at home? If your child is off their routine, do what you can to stick to a regular bowel schedule.

Encourage your child to sit on the toilet first thing in the morning, and about 20 or 30 minutes after a meal, even if they don’t pass stool. This helps them establish a healthy routine around using the bathroom. If your child is away from home during the day, talk to your child’s daycare provider, camp counselor, teacher, or other responsible adult to ensure this routine is maintained outside the home as well.

Increase Hydration: Especially during the warmer months, and before and after exercise, ensure your child is hydrated. For younger children, fill a sippy cup with water instead of juice, and for children of any age avoid any diuretic fluids.

Warm Bath: Try a warm bath to soothe any abdominal discomfort, relax your child, reduce stress, and get stools moving.

Medications for Children’s Constipation

Always talk to a pediatrician to determine what treatment is best for your child before making a decision about over-the-counter constipation medication. It’s helpful to keep track of the at-home remedies you try, as well as your child’s daily food and beverage intake, to be as informed as possible when you speak to a pediatrician.

With so many choices for child constipation relief, how do you decide which constipation relief is best for their child? Here is a summary of the different types of constipation medications, their ingredients, and potential side effects:

  • Stool Softeners contain docusate sodium or docusate calcium. Stool softeners work by drawing water into the bowel from surrounding body tissues and softening the stool. Because stool softeners increase the amount of moisture in the stool, it allows for a more comfortable bowel movement that should not require straining. Oral stool softeners can take 12 – 72 hours to be effective, and rectal stool softeners can provide relief more quickly.
  • Lubricant Laxatives contain mineral oil, and work by coating stool in a lubricant, making it slippery and more comfortable to pass. Lubricant laxatives can inhibit the absorption of certain minerals, including Vitamins A, D, E, and K.5
  • Stimulant Laxatives often contain bisacodyl or sennosides, and work by stimulating the rectal muscles, activating them to push the stool out. Bisacodyl can have some uncomfortable side effects, including nausea, cramps, diarrhea, and electrolyte depletion.6
  • Osmotic Laxatives may contain polyethylene glycol or glycerin, and work by increasing the amount of water in the intestines to allow stool to pass more easily through the intestine.

In certain cases, your child's doctor may prescribe medication to soften or remove stool. Ask your child’s pediatrician about options like DocuSol® Kids to provide relief. After the stool is evacuated, your child's doctor may suggest ways you can help your child develop healthy bowel habits to prevent stool from backing up again.

The last thing any parent wants to do when their child is not feeling well is to make them wait for relief. Parents and caregivers can help children with constipation not only feel better faster but also avoid further complications by being aware of the causes and signs of constipation.

DocuSol® Kids Can Help!

Docusol Kid's Enema box

DocuSol® Kids is a first-of-its-kind, mini enema with a non-irritating formula that functions as a stool-softening, hyperosmotic laxative by drawing water into the bowel from surrounding body tissues, replicating a normal bowel movement. This unique formulation provides children ages 2–12 fast, predictable relief of constipation.

DocuSol® Kids was designed for easy use at home. The DocuSol® Kids tube is designed to offer a minimally invasive, soft, and flexible tip, avoiding any scratching or irritation to the skin. Just a 5-milliliter tube delivering 100mg of docusate sodium, the medication provides fast relief in just a few, easy steps!

For more information, be sure to check out our family resources and doctor tips!