Toddlers are, by nature, a finicky bunch. Their moods and whims can change on a dime.
Even something as basic as going to the bathroom can get tricky. While some toddlers go to the bathroom every day like clockwork, other kids can go two, three, or even more days without having any bowel movements.
Seeing an empty toilet day after day might fill parents with panic, but constipation in toddlers isn't usually a sign of any serious disease. Most often it's caused by a problem that's easy to solve, like diet or ignoring the urge to go.
So how do you know if infrequent bathroom visits are normal for your child, or if you really have a constipated toddler? Read on to find out when toddler constipation is a problem, and how to treat it.
Is My Toddler Constipated?
The average toddler (if there is such a thing) makes a bowel movement once a day. Usually, a child who has a bowel movement fewer than three times a week (or less often than they typically do), and whose stools are hard and difficult to pass, is constipated. Also, according to the American Academy of Pediatrics, any child with stools that are large, hard, dry, and accompanied by painful bowel movements, soiling between bowel movements, or blood on the outside of the stool may have constipation.
Don't be worried if your child has a bout of constipation -- it's perfectly normal once in awhile. But if your toddler's constipation lasts for two weeks or more it's called chronic constipation, and you should see your pediatrician.
Your doctor may ask you to keep track of your child's bowel movements -- how often they occur, how big and hard they are, and if there is any blood in your toddler's stool. You should also look for other symptoms that can occur along with constipation, such as:
- Loss of appetite
- General crankiness
- Crying or screaming during bowel movements
- Avoiding the toilet (signs that your child is doing this include clenching the buttocks, crossing the legs, turning red, sweating, or crying)
- Smears or bits of liquid stool in the diaper or underwear (soiling)
What Causes Toddler Constipation?
A variety of things can cause constipation in toddlers, from diet to medication. Here are a few of the most common causes:
Diet. The culprit in many cases of toddler constipation is a diet that's too heavy in processed foods, dairy, and sweets, and too light in fiber (like whole grains, fruits, and vegetables). Not getting enough fluid can also lead to constipation, because it makes the stools harder. Any change in diet -- such as when your toddler transitions from breast milk or formula to cow's milk or starts eating new foods -- can also affect the stools.
Holding it in. The average 2-year-old is far more interested in playing with toys than going to the bathroom. Some children are embarrassed or afraid to use the toilet, especially when it's a public restroom. Toddlers who rebel against the toilet training process sometimes express their power struggle in a refusal to go.
Fear of discomfort. Constipated toddlers who've had painful bowel movements in the past sometimes avoid using the bathroom out of fear that it will hurt again. Not using the bathroom can turn into an uncomfortable cycle. Stool begins to build up in the lower part of the bowel, getting bigger and harder until it's even more difficult and painful to pass.
Change in routine. Going on vacation and being away from their normal toilet can make some toddlers unwilling to go to the bathroom.
Illness. Changes in appetite due to a stomach bug or other illness can affect your child's diet, leading to constipation.
Medication. Some medications or supplements can lead to a constipated toddler, including high-dose iron supplements or narcotic pain medication. The low-dose iron in baby formula does not cause constipation.
Physical conditions. In rare cases, an anatomical problem with the intestines, anus, or rectum can cause chronic constipation. Cerebral palsy and other nervous system disorders can also affect a child's ability to go to the bathroom.
Treatments for Toddler Constipation
When toddler constipation is a problem, you can try one of these remedies:
Diet. To soften the stools and make them easier to pass, increase the amount of non-dairy fluid and fiber your child gets each day. High-fiber foods include fruits and fruit juices that contain sorbitol (prune, mango, pear), vegetables (broccoli, peas), beans, and whole-grain breads and cereals. Limit foods that can increase constipation, such as fatty foods that are low in fiber. Limit milk to 16 ounces per day.
Exercise. Make sure your toddler gets out to play for at least 30 to 60 minutes a day. Moving the body keeps the bowels moving, too.
Improve bowel habits. Encourage your child to use the bathroom at regular times during the day, especially after meals and whenever they feel the urge to go. Let your toddler sit for at least 10 minutes at a time. Put a small stool under your child's feet -- the leverage will help them push. Reward your toddler for using the toilet with a special story or a sticker so it becomes a positive experience.
Medicine. Your health care provider may recommend medication to treat your toddler's constipation, especially if it's chronic. You may also need to discuss stopping or changing a medication your child is taking, if that is causing the constipation.