PAMF Health Blog

Be Well, Be Well Informed

Constipation in Children: What to Do

Posted on Sep 1, 2013

A child is constipated if it hurts to pass a bowel movement. While it may be normal for many children to go two to three days without a bowel movement, going four or more days can be considered constipation, even though this may cause no pain in some children and even be normal for a few children. (Note: Large bowel movements are not necessarily constipation.)

Constipation is usually caused by a lack of fiber (such as fruits, vegetables and whole grain foods) in a person’s diet. Fiber makes stools larger, softer and easier to pass. Another common cause of constipation is the repeated postponement of the urge to go the restroom because of embarrassment about public toilets or long waiting times for the home bathroom. After your child feels better, be sure to keep him or her on a high-fiber diet to prevent constipation.

Diet Treatment for Infants

  • Young infants: If your baby is only taking formula or breast milk, add fruit juices (like grape or prune juice) to his or her diet twice a day. However, use no more than two ounces of juice a day.
  • Older Babies: If your baby is more than four months old, add strained peas, beans, apricots, prunes, peaches, pears, plums or spinach twice a day. It is also helpful to soak your child in a bath of warm water several times a day to relax the anus.

Diet Treatment for Older Children

  • Eat fruits or vegetables at least three times a day, particularly raw produce with the skin or peel. Peas, beans and dates are also good choices.
  • Increase bran in the diet. Bran is an excellent natural laxative, since it has high fiber content. Your child should eat bran daily through sources including cereals, bran flakes, bran muffins, shredded wheat, graham crackers, oatmeal, brown rice or whole wheat bread.
  • Decrease foods that cause constipation, such as milk, ice cream, cheese, white rice, apple sauce, bananas and cooked carrots.
  • Drink more water.
  • Increase daily activity and exercise. If your child tends to be inactive, encourage him or her to join a sports team or find an enjoyable physical activity.
  • Establish regular toilet habits. Encourage your child to establish a regular bowel pattern by sitting on the toilet for 10 minutes after meals, especially breakfast. If your child is resisting toilet training by holding back, temporarily discontinue the training.
  • Natural laxative medicines: If diet alone doesn’t work, a good natural laxative is Maltsupex (a malt extract from barley). No prescription is needed. It comes in liquid or powder and is best mixed with any beverage. Follow the dosage information below:
    • Infants – 1/2 tablespoon twice daily
    • Children – 1 tablespoon twice daily
    • Adolescents – 2 tablespoons twice daily (or two tablets)
  • Unprocessed (unmilled) bran is another product that can be mixed with foods and is available in most health food stores. The starting dosage is 1/2 to 1 teaspoon twice daily, depending on age. Try this for one week and then only as necessary.

Common mistakes:

  • Don’t use any suppositories or enemas without your physician’s recommendation. These products can cause irritation or fissures (tears) of the anus, resulting in pain and stool holding.
  • Do not use strong laxatives by mouth without asking your physician because they can cause cramps and become habit forming.

You should contact your child’s physician during the following situations:

  • For immediate advice about an enema or suppository if your child is in extreme pain, or if the pain is constant and has persisted for more than two hours.
  • More than six days have passed without a bowel movement
  • You are giving your child suppositories or enemas
  • The anal area has any tears (fissures) that are deep or won’t heal, or that have bled more than twice
  • Constipation is a recurrent problem for your child
  • Three days of dietary changes does not produce a bowel movement
  • Toilet training questions
  • If you have other questions or concerns