Childhood Constipation - Constipation is a commonly encountered problem in child health and the prevalence of childhood constipation is estimated to reach up to 30% children (depending upon criteria used for diagnosis reference).
Constipation in children can be due to the same reasons as in adults - diet, fluid intake, illness or medication. But there can be some emotional reasons surrounding starting potty training or starting school for the first time. The main thing is not to worry and sort the problem out as quickly as possible.
When a child complains it is painful to go to the toilet, it must be taken seriously. The child will subconsciously hold back the stool to prevent a painful evacuation. As they accumulate in the rectum, only watery stools manage to get through, often by accident - the child may appear to have diarrhoea but it is actually caused by "overflow" constipation. This could leave the remaining stools even drier, harder and more painful to pass.
Childhood constipation can be caused by diet, fluid intake, illness or medication, but there may also be emotional reasons:
- Potty-training - trauma at this time can start the habit of becoming nervous or stressed when needing to pass stools
- Nursery or school - it can be quite worrying when starting school to have to use a noisy, unfamiliar school toilet, so it's no surprise when children decide to wait until they get home
How to manage constipation
For whatever reason, a child may refuse to go to the toilet, or lie about having already been. Of course the longer children leave going to the toilet, the more painful it can be when they finally do go, it can even put them off going again. Children pick up parents' anxiety, so it is important not to appear worried.
If your child is affected, try to make the same lifestyle changes as you would for yourself by getting him/her to:
- Drink more water
- Eat fibre rich foods - every parent knows how picky children can be about what they eat, so sneaking high-fibre foods into their diet requires some ingenuity. That said, you should try not to make a behavioural issue out of eating - food should remain a pleasure.
- Take more exercise
- Cut down on high fat and high sugar content foods
- Encourage regular bowel habit - setting aside a specific time of day to go to the toilet, such as after breakfast or the evening meal, will teach your child not to put off bowel movements and may help to establish regular habits. A footstool can put the toilet at a comfortable height, while putting out storybooks or comics may help them relax and take their time.
Good Fibre Foods for children:
- Breakfast - Breakfast cereals containing whole-wheat or bran, Porridge, Toast made with wholemeal bread
- Lunch/Dinner - Sandwiches made with brown bread, Baked beans on brown bread toast, Baked beans with jacket potato, Chilli with brown rice, Wholewheat pasta
- Snacks - Fruit with skins (e.g. apples, pears, grapes, plums), Oat bars, Bananas, Cherry tomotoes, Dried fruits like raisins, apricot
Talking about the problem
It's important to explain to your child why you're changing their diet or giving them a constipation remedy, and to tell them when the remedy might start to work. Most children won't talk about their bowel habits or their constipation, even to close friends. And many parents also keep the subject to themselves. But it's crucial children don't feel constipation is their fault.
Your GP, health visitor, nurse or pharmacist can offer support and will try to reassure you that the problem is very common and that there are practical solutions.