What causes constipation in children? Read on and learn all you need to know about constipation in children, what you can do to prevent it and common treatments.

Baby and child constipation symptoms

Children can have varying bowel movements, depending on their age.

• Newborns have more frequent bowel movements in a day, sometimes with each feed.
• Breastfed babies may have bowel movements without pain up to 7 days apart, as breastmilk is more easily digested and absorbed by the body. Breastfeeding stools can range from as infrequent as once in several days to as many as 10 to 12 stools per day. Your baby’s stool is likely to be soft and the colour of mustard.
• Babies drinking formula milk may have stools that are bulkier and tend to have bowel movements daily, or once in 2 days.

You may be alarmed that your baby is not passing motion for days, or think that your child should have a bowel movement each day. However, the frequency of bowel movement is not a good indicator of constipation. Rather, it is the ease of passing motion and the consistency of his stools that matter.

Your child may have constipation if he experiences any of the following:

• His/her bowel movements are irregular or less frequent than usual.
• He/she has difficulty passing stools which are often harder than usual.
• He/she complains of a stomach ache, or pain at the anus when passing stools. There could be slight bleeding or blood on the surface of a hard stool due to a minor tear at the anus.
• You may notice soiling of his/her undergarments in between bowel movements.
• You may also notice your child crossing his/her legs, stretching, clenching his/her buttocks or twisting his/her body on the floor.
• He/she complains of bloating and may have a loss of appetite.

​What causes constipation in young children

1. Changes in Diet: As your child's diet changes, so does his bowel movements. If he is not taking enough fibre-rich foods or fluid, his stools can harden and become more difficult to pass out. Commonly, constipation may be experienced when children transit from an all-liquid diet to solid foods.

2. Holding the Urge to Go: Your child may not want to disrupt his play, may be uncomfortable to have a bowel movement outside his/her house, or is afraid of passing stools due to an earlier painful episode. Frequent holding back of bowel movements can lead to harder stools.

3. Emotional Anxieties: Are you trying to potty train your child too early? Or is there a new baby in the family? Emotional factors may disrupt bowel movements too.

4. Changes in Routine: Travelling to a different country or starting out at a new school can disrupt the child's routine and affect their bowel function.

5. Medications: Certain medications such as antihistamines and antidepressants, and iron supplements can contribute to constipation.

6. Medical Conditions: There are some rare anatomic (e.g. malformation of the intestines) and functional (e.g. irritable bowel syndrome) causes of constipation. Other medical conditions such as thyroid gland disorders or neurological disorders can also lead to constipation.

What can you do if your child has constipation

• Increase fibre intake: Offer your child more fibre-rich foods such as wholegrain crackers, fruits, vegetables and beans. Reduce consumption of junk food and fast food as they can slow down digestion.
• Adequate hydration: – Encourage your child to drink more water or milk to increase the fluid in his diet.
• Regular physical activity: Being active promotes regular bowel movements.
• Start a potty/toilet routine: Help your child get used to taking "toilet breaks", just like how he also needs to take time off from play for meals and naps.
• Review medications: If your child is taking a medication or supplement that may cause constipation, consult your doctor to switch to alternative medications that may not induce constipation.
• Be calm and supportive: Reward your child whenever he/she has a successful bowel movement and do not punish a child who has soiled his/her underwear.

Bring your child to see a doctor if

• Your child's general health, appetite or activity seems to be affected.
• Your child has severe tummy pain.
• Your child has constipation associated with abdominal distension and vomiting.
• There is blood in the stool.
• Your child cannot pass a bowel movement after 4 days despite increasing fibre-rich foods and fluid intake in the diet.
• Your child loses some control of his or her bowel actions and begins to soil the underclothes.
• Your child has constipation associated with leg weakness.

Disclaimer: The information provided in this article is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical condition.