When you’ve got to go, you’ve got to go. Except when you can’t, which is even worse. It’s one thing to deal with constipation as an adult, but it’s another to watch your child struggle with it. Seth Webb, DNP
, UnityPoint Health, treats constipation more often than you’d think, and he offers advice on signs to watch for, as well as home remedies for constipation in kids.
Constipation in Kids
Constipation in kids is extremely common, affecting roughly 30-35 percent of children. Webb says toddlers and preschool-age children are the largest age group, which can be related to a variety of factors, like not going due to activity, food intake and forgetting to use the bathroom.
“Constipation can be a range of issues that affect elimination,” Webb says. “It can vary from infrequent bowel movements, to having hard stools, passing large stools that are painful and even accidentally passing stools due to build-up.”
Child constipation symptoms include any of the following:
- Two or fewer bowel movements per week
- Hard stools (balls of stool or firm stools)
- Painful bowel movements
- Blood in the stool or when wiping (small fissure, or tear, of the rectum)
- Firm or painful abdomen
- Fear of using the toilet (along with painful bowel movements)
Home Remedies for Constipation in Kids
If you believe your child is constipated, Webb lists safe and easy options to help get quick relief at home:
- Juice (pear, white grape and prune). The recommendation for juice is 4 ounces or less per day. Juice promotes bowel emptying because of a sugar, called sorbitol, that isn’t digested well, so it stays in the stool. It increases fluid in the stool, making it softer and easier to pass.
- Abdominal massage. For infants and small children, massaging the abdomen and bicycling the legs are great measures to help pass stools. You can also massage the anus with your finger, or gently insert a cotton swab to help stimulate a bowel movement. These measures are safe and not too traumatic for the infant or parent.
- Increased water intake (for children older than 1). Water keeps the body hydrated, which also makes passing stools easier. Getting enough water helps prevent constipation and promotes regularity.
- Increased fiber. We all know processed foods, high-fat foods and unhealthy eating habits can factor into many health problems, including constipation. To build a diet rich in fiber, get several servings of fruits and vegetables each day, along with drinking plenty of water.
- Increased Opportunities. Have your child sit on the toilet for a few minutes every hour or two. You can make this more fun by having a toilet chart where each attempt is rewarded with a sticker. After a set number of attempts, the prize level is reached, and the child receives a treat or toy. Rewarding stooling and making it a safe, enjoyable experience helps the child feel at ease about going, plus helps them understand it’s a normal thing to do, so they don’t withhold bowel movements and cause, or worsen, constipation.
“There’s no specific time frame for each remedy, and it will depend on how the child reacts to each individually. For example, juice can often help pass a stool within a few hours, but it may take longer,” Webb says.
What to Give Kids for Constipation
When it comes to giving your child products or over-the-counter medication to help with constipation, Webb says you should first talk to your child’s provider. He outlines common options you might discuss.
- Probiotics. Probiotics are often used for pediatric patients, especially while on antibiotics. They help keep the good bacteria in the stomach, since antibiotics fight all bacteria. These good bacteria also help promote bowel regularity. But, there is very limited research supporting probiotic use to treat constipation itself, and it’s not routinely used as a sole treatment.
- Suppositories & enemas. Suppositories help stimulate rectal muscles to encourage a bowel movement but can be uncomfortable for the child when inserted and, if not done correctly, can potentially cause rectal trauma. Enemas also help to directly soften the stool, but they, too, can be uncomfortable and must be done correctly. If you’re concerned your child may need either of these options, visit with your child’s care team.
- MiraLAX. MiraLAX is actually a good medication for constipation, both acute and chronic, when used correctly in children over 1 year old. MiraLAX helps to bring fluid back to the stool, so it doesn’t get too hard and is easier to pass. MiraLax comes in a powder with no color or taste, which is great for young patients. It can be picked up over-the-counter, but always see your child’s primary care provider before starting it.
“There is a bit of a misconception that MiraLAX is unsafe and should not be used, which is why I always suggest talking with your pediatrician. That way, you make sure proper dosing is provided and a safe regimen is started,” Webb says.
Webb says MiraLAX is the one of the safest and only pharmacological treatments he would personally use, and often, children don’t need this medication long-term. Once the initial constipation episode is treated, providers work on non-pharmaceutical options, usually taking the child off MiraLAX or only using it as needed.
“I’d never recommend giving any other laxative to a pediatric patient, as there are many things providers can do to help the child relieve constipation before putting them on medications. Most of the time, constipation in kids isn’t serious and usually involves simple, easy treatment,” Webb says.
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