Constipation 101

By ParentsCanada on February 28, 2019

 

Take it from parents who’ve been there—it’s all fun and games until your kid can’t poop. While the toddler and preschooler set are all about releasing their bodily functions (and who among us doesn’t giggle when our littles toot?), poop is where things can get, well, crappy.

Successful toilet training involves not just learning how to use the potty, but how to wait until getting to the bathroom before letting loose. Dr. Bob Issenman, the director of the Centre for Child & Youth Digestive Health at McMaster’s Children’s Hospital in Hamilton, Ont., puts it this way: “Step one is holding back, but step two is letting go. Certain kids become champions at step one, and not so good at step two.”

The issue, of course, is when kids hold it in too long, they usually end up constipated—that is, bowel movements become less frequent, stool becomes hard and dry and it becomes painful to pass. Because it hurts, kids end up hesitant or even afraid to poop. Some may start “soiling,” which happens when they can’t control their bowel or are leaking fecal matter. It’s super common but that doesn’t make it any easier on kids, or parents, who just want a magic elixir and a quick fix. Here’s the thing: Constipation is a pain in the rear, but it’s preventable and treatable.

Causes

The Hospital for Sick Children says constipation can be caused by six main things: not drinking enough fluids or dehydration; genetics (kids can inherit their parents’ bowel issues); certain medications; anal fissures (small tears at the opening of the bowel); poor bowel routines; and a lack of fibre (and too much junk) in the diet. Constipation can also be the result of toilet intimidation (some are actually afraid of flushing, which makes them hesitant to poop) or distraction (they’re not listening to their body’s urges when they’re immersed in play).

How to help

Keep track of what they’re drinking...

Most kids get plenty of fluids but not all drinks are equal when it comes to keeping us regular. Tots who drink too much milk can end up constipated, as it can displace the high-fibre foods they’re consuming. Limiting milk to about three cups a day (or 750 mL) can help.

…and eating

In babies between two and four months, you can offer 1 oz. of apple, prune or pear juice once or twice daily. After the four-month mark, try high-fibre, strained foods, including cereals, plums, prunes, apricots and peas. Toddlers one year and older should get several servings of fruit and veggies each day (including dates, prunes, broccoli, raisins, etc.), and plenty of fibre. SickKids says the child’s age plus 5 g of fibre a day is sufficient—so if you have a three-year-old, aim for 15 g per day. Bran cereals, muffins, graham crackers and oatmeal are go-tos for parents (bran is a natural stool softener). Low-fibre foods (white rice, bread) and treats (chips, candy) can contribute to sore tummies, so try to limit those.

Make poop routine and fun

When you’re potty training, get your kiddo to the toilet for five minutes or so right after mealtimes so it becomes habit. Whether there’s a bowel movement or not, the act of going will establish a pattern. Make sure the toilet is comfy—their knees should be up (to help stool pass easier) and a foot stool keeps legs from dangling. Stickers, songs,  games and other positive reinforcements will keep it fun and as stress-free as possible. It’ll also be a much more pleasant experience for everyone if you’re patient and keep your cool. (Easier said than done, we know.)

Medication

If they’re still not able to go after you’ve tweaked their routine and added more bran, fibre and water to their diet, talk to your pharmacist or healthcare provider about stool softeners (which draw water into the bowel to help flush out stool). There are many brands that are safe for kids and available without a prescription. (Tip: Tasteless options that dissolve in drinks are awesome. Take a page out of our book and call it “Poo Potion.”) Doctors might suggest more potent medications if needed, and don’t consider suppositories without your doctor’s OK.

When to seek help

Problems pooping is rarely a sign of a serious health problem, so you can rest assured that your tot will eventually go. You should talk to your healthcare provider if you suspect anal fissures (if you notice blood in stool, diaper or underwear), your kiddo can’t control bowel movements (soiled underwear) or if constipation becomes a recurring problem.

Originally published in the Spring 2019 issue. Photo by iStockphoto.


By ParentsCanada| February 28, 2019

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