Constipation: Child Over One Year of Age

Constipation (con-sti-PA-shun) in children can cause concern for parents. Sometimes children have poor bowel habits because they are not encouraged to be on a regular schedule. Sometimes, they are just "too busy" to spend enough time on the toilet to empty their bowels.

Signs of Constipation

Constipation is a change in the child's bowel habits. The child may have constipation if his or her stools are too hard, too infrequent, too painful, too large, too wide or if he cannot push it all out. Other signs include:

Picture 1 - Encourage fiber in your child's diet.

• Pain or cramping in the abdomen (belly) 
• Very infrequent, though soft, stools (less than 1 in 3 days)
• Soiling (the child has an "accident" in his pants)
• Painful bowel movements

What to Do

• If your child is toilet trained, have him or her sit on the toilet for 5 minutes after one meal, every day. It should be the same meal every day. Place a footstool under his feet. Do not let his feet dangle and have him lean forward.
• Give your child praise and rewards (stickers, candy, etc.) just for sitting. This will help your child to go on a regular schedule. Check your child's bowel movement routinely so you will know what is normal and abnormal for your child. Make sure your child eats fruits, vegetables and whole grain cereals every day (Picture 1). Adding a daily serving of raisin bran cereal to your child's diet can be helpful.
• Make sure your child drinks extra water and fruit juice between meals. A serving of prune juice or prunes once a day may help. Teach your child to come in from play every time he has the urge to have a bowel movement.
• Use a reward system (see Rewards).
• Try to stay calm and not be too concerned if your child cannot have a bowel movement. Let your child leave the bathroom and try again later in the day.

What Not to Do

Do not give enemas, suppositories or laxatives unless your doctor or nurse practitioner tells you to do so!

Picture 2 - Reward your child - do not punish

Never punish your child when he cannot have a bowel movement or if he soils his pants. Children do not have problems with bowel movements on purpose, and punishment only keeps them from developing good bowel habits.

Rewards

Every child likes to see how well he is doing on a project. Everyone likes to be rewarded for success. Every time your child sits on the toilet long enough to have a bowel movement, give him a reward whether he has a bowel movement or not. You can select a simple reward (such as favorite TV show or a sticker). Use a calendar or daily record to keep track of the extra fluids he drinks and when he sits on the toilet (Picture 2).

After a few weeks, agree on a greater reward for sitting on the toilet. If you use the reward system every day, in time your child will develop his own schedule for good bowel habits.

When to Call the Doctor

Call your doctor if any of the following occurs:

• Bright red streaks of blood in the stool.
• Constipation continues for days.
• Pain in the abdomen or rectum, along with the constipation.
• If your child continues to soil himself.

If you have any questions, please contact the GI Services Department at (614) 722-3450.

Constipation: Child Over One Year of Age (PDF)

HH-I-15 11/84, Revised 3/06 Copyright 1984-2006, Nationwide Children's Hospital