Has your child ever come out of the bathroom in tears, saying, “Mommy, it hurts when I poop?” The likely cause is constipation, a very common problem in children.
Sometimes a constipated child might actually appear to have diarrhea, which can be confusing. What’s happening here is that a large formed stool has gotten stuck in your child’s rectum, and somewhat liquid stool gets passed around it.
When a child is constipated, he has less frequent bowel movements, and when he does “go,” his stool is dry, hard, and painful to pass. There are many possible causes for constipation, including:
- Withholding stool. This means that your child is trying to hold his bowel movements in -- maybe because he’s stressed about potty training, maybe because he doesn’t want to use the toilet in certain places (like school), or maybe because he’s afraid of a painful bathroom experience. (Constipation can become a vicious cycle -- if it hurts to “poop” once, the child may be more fearful of going the next time.)
- A diet that’s low in fiber or doesn’t include enough liquids (or both)
- Side effects of certain medications
There are three primary treatments for most cases of constipation, and they usually work hand-in-hand:
- A stool softener to clear the bowels. These are safe in children, but should be used under the supervision of your pediatrician.
Two common mistakes that parents make when giving their child a stool softener for constipation is not using a large enough dose, or stopping it too soon. For example, you might think that you can stop giving a stool softener after your child’s first normal-looking bowel movement, but stopping too soon may just set your child up for another bout of constipation. Some children may need to stay on a stool softener for a few weeks. Your doctor can advise you on the right dosing schedule for your child.
- A high-fiber diet with plenty of fluids. This means loading your child’s plate with plenty of fresh fruits and vegetables, high-fiber cereals, whole grain breads (look for at least 3-5 grams of fiber per serving), and a variety of beans and other legumes, like chickpeas and lentils. Two good sources of fiber that kids are often happy to eat are trail mix (let them make their own) and popcorn with minimal salt or butter. Foods containing probiotics, like yogurt, can also promote good digestive health.