Constipation in children is fairly common, affecting up to 1 in 3 children. The definition of constipation in infants or toddlers can vary. However for toddlers a safe indicator of constipation is if your child passes a stool less than 3 times a week or if they find it painful to defecate. Another indicator can be when a hard mass can be felt in the abdomen. If your child experiences problems with regular faecal incontinence after they have been toilet trained, or if they pass very large stools, they may also be constipated.
Normal bowel function in infants
Usually, meconium is passed in the 24-48 hours following the birth of a child. This is a dark green mucus and bile that has built up in the infant’s bowel. However once this has occurred normal bowel function can be different depending on whether the infant is fed breast milk or a formula. Newborns that are fed breast milk may defecate up to 5 times a day, with the majority defecating at least 3 times per day within the first few weeks. However only 1 in 3 newborns that are fed with a formula defecate at this rate in the first few weeks. Babies who are fed with a formula are more likely to be constipated but infants fed on breast milk can also go without passing a stool for up to three days, which is normal. As the child gets older, the frequency of defecation reduces. Once the child is around 4 months old, they are likely to go only twice a day whether they are fed breast milk or formula.
Newborns with constipation should be examined by a medical professional. Once solid foods are introduced at around 6 months, the stool will become firmer. Constipation may become more of a problem at this point but it may be avoided by including plenty of fibre in the childs diet. Foods high in fibre include cereals and fruit and vegetables. Keeping the babies fluid intake up is also important. If your baby does become constipated, a home treatment is to lay it on its back and gently move the legs as if it was riding a bike. Other baby constipation remedies include gently massaging the stomach, and a warm bath might assist in relaxing the baby and helping to pass a stool. Finally, you could try applying a little water based lubricant to the anus to make passing stools easier. Do not attempt any other treatment such as enemas or laxatives – a medical professional should be consulted if the problem persists or if the child is also vomiting or seems cranky.
Behavioural modification
For toddlers and young children, many cases of constipation can be behavioral rather than due to a medical problem. If the child had problems with painful passage of stools when younger they may become reluctant to pass stools at all. However a doctor should be consulted to assess the reason for the constipation. Your doctor will be able to help you come up with a management plan for the condition, which might include a laxative or stool softener as well as encouragement or other intervention.
