09/14/2023
I talk about p**p on the regular in my office, usually many times a day! This is a great overview of childhood constipation. Check it out for your kids or grandkids - it will surely be useful!
Lots of kids battle with constipation, which means dealing with firm, dry, infrequent, painful, or difficult-to-pass stools. 💩
Constipation is very common in toddlers and school-aged children. Signs include painful/infrequent stools, clogging of the toilet, re**al tears, stomach aches, belly bloating, cramping, nausea, and even stooling accidents (called encopresis – more on this below). 😩
Babies less than 6 months rarely get constipated. Yet, parents often worry about it for a couple of reasons. One reason is a change in stooling frequency. ⏰ Every baby is different, and their normal pattern can change over time. Some babies will stool with every feed whereas others may go a full week in between. This is totally fine as long as they are still passing soft, mushy poo!
Another common occurrence in little babies is called dyschezia. This is when a baby appears to strain, turn red in the face, and “cry out in pain” prior to a bowel movement. This is actually normal. It happens because p**ping requires the coordinated act of relaxing the pelvic floor while bearing down to flex the abdominal muscles. 💪 Babies are still learning this tricky feat. They may appear to struggle when really they're just trying to generate pressure. As long as they are passing soft, mushy stools – it’s all good.
Introduction of solid foods to your baby’s diet around 6 months of age may lead to true constipation. Stools may turn into formed little pellets or large hard cylinders. 😳 If this happens, you can try giving 2-4 ounces of pear or prune juice daily. Choose high-fiber foods such as beans, peas, broccoli, avocados, berries, and pears. Try "bicycling" leg exercises. Infant glycerin suppositories could be used initially to remove a hard ball of stool, but you don’t want your baby to become reliant on suppositories over time. Do not increase your baby’s water intake without chatting with your provider first.
Starting school can also trigger the onset of constipation. Some kids don’t want to interrupt play time to go use the bathroom. ⛹️♂️ Others will try to avoid the embarrassment of using public toilets by holding it in. If the stool is held for too long, it will hurt to pass! A painful stool teaches the child that p**ping hurts, and this may further encourage holding behaviors (potty dance, crossing legs, etc).
If your child is a major holder, try scheduling a dedicated potty time every morning after breakfast and every evening after dinner, even if they "don't have to go." Just let them sit on the potty with something entertaining (book, toy, handheld game) for 5-10 minutes without ANY pressure to p**p. If they just so happen to have a bowel movement while sitting on the potty, CELEBRATE! Give positive encouragement and reward them with a sticker chart or cheap toy. Providing positive reinforcement will go much further than scolding or punishing them ever will. Ignore negative behaviors such as holding.
It is wise to address the issue of constipation as soon as possible to prevent stretching of the colon over time. As counter-intuitive as it sounds, constipation can actually be confused with "diarrhea" once it progresses to the point of stooling accidents. This is called encopresis, as I mentioned earlier... The colon gets SO full of hard stool that the new stool leaks around onto your child’s underwear. 😫 Kids often don’t even realize that it’s happening, so scolding them will only teach them to hide the evidence. Encopresis requires a thorough bowel cleanout, often followed by daily medications to help establish a healthy stooling pattern while the colon shrinks back down to size. Crazy, right?
Here are a few more tips for healthy p**ping: Provide a potty step-stool (such as the "Squatty Potty") for your kids to press their feet on – this makes the act of bearing down a lot easier. Exercise helps with healthy digestion. A warm beverage such as hot cocoa or apple cider can sometimes get the gut moving. Avoid consuming too much milk or cheese, as these really tend to constipate.
The more you can keep your child's stool nice and soft (think peanut butter or soft-serve consistency), the less likely they are to get constipated and have a traumatic stooling experience. Encourage your kids older than 1 year old to drink plenty of water. Again, give them high-fiber foods such as beans, peas, vegetables (broccoli, carrots, cauliflower), fruits, and whole grains (whole wheat, brown rice, oatmeal, whole-grain cornmeal, whole oats, wild rice). 🍐
Fun reminder: fruits starting with “P” help you P**p including Pears, Prunes, and Peaches (with skin left ON). Give them a try. You’ve got this!
