Constipation in Toddlers

According to the American Academy of Pediatrics, a typical toddler or child should have the following Bowel Movements per day and week.

Constipation refers to infrequent (less than 3 BMs per week) or incomplete bowel movements. The term is also used to refer to stools that are hard or difficult to pass.

Bear in mind, the consistency and frequency of stools changes day to day as these are directly dependent on what we eat.

The information presented here are general guidelines and are meant to provide you the parent with some knowledge and information, so that you can have a more informed conversation with your physician or your child's pediatrician.

How do you know if your child / Toddler is constipated?

Because each child is different and hardness is a relative term, the easiest way to know if your child / toddler is constipated is to look for the following symptoms:

• He has fewer than three bowel movements a week.
• The stools are hard, dry and unusually large.
• The stools are difficult to pass.
• Your child / toddler seems to be straining hard to have a bowel movement.
• Hiding to have a bowel movement.
• Grunting and squatting to help move the stool out of his system.
• If having a bowel movement is painful – suspect this if your child / toddler seems to be trying to hold the bowel in (e.g. by crossing the legs or sitting up on the heels) or if your child / toddlers seems frightened of using the toilet
• Passing an excessive amount of gas or belching frequently.
• Leakage of small amounts of soft stool resembling diarrhea.
• More frequent urination because of pressure on the bladder.

To be certain about whether your child is constipated or not, it is best to consult with your pediatrician.

How does constipation get started?

Constipation can result after a major event or a significant change in a child's / toddler's life such as:

•  Potty training

•  Illness or medications

•  Some stressful event

•  Change in routine or diet

•  Unavailability of toilets

•  Because a child / toddler is too busy playing

Any of the above can lead to withholding or delaying the BM. When a child / toddler decides to hold back on the urge to have a BM, the stool sits in the colon. When stool sits in the colon, the water in the stool is reabsorbed back by the body and the stool tends to become hard. When the stool becomes hard, it can be very painful to pass.

When the child / toddler decides to go ahead and have the BM, or can no longer hold it, it ends up being a painful --- a negative experience. Therefore, the next time the child / toddler has to urge to have a BM, he withholds, and the cycle starts again, leading to constipation and other problems related to issues of resistance to BM training, even potentially bed wetting.