Constipation, the passage of infrequent, hard, and painful stools, is a common problem, affecting 3 percent of preschoolers and 1 to 2 percent of school-aged children. But pooping once every few days is not abnormal if that is your child's usual pattern. In fact, 96 percent of children ages 3 to 4 show tremendous variety in pooping patterns: anywhere from three stools a day to three a week.
What Causes Constipation
Overflow Incontinence
What to Do About Constipation
Re-educate the bowel.
Add fiber.
Reward, don't punish.
What Causes Constipation
The original cause of constipation might have been any one of these:
Whatever the original cause, stool sits in the rectum, becoming larger and harder. Each passage hurts, and the problem starts to perpetuate itself as the child resists relaxing and letting nature take its course.
Although uncomfortable (and sometimes even involving small amounts of blood streaked on the outside of a hard movement), constipation does not cause disease. Yes, it can cause cramping and dampen your child's appetite, but your child is not absorbing poisons or doing permanent damage to his intestine.
Overflow Incontinence
When constipation persists for a while, sometimes soft stool coming down the pike leaks out past the old, hard stuff. Smears of semi-liquid stool or even what appears to be diarrhea may turn up in your child's underwear.
This diarrhea-like condiion, known as overflow incontinence, is not a legitimate bowel movement, nor is it in your child's control. It is, however, a sign that something needs to be done, especially if the soiling is affecting your child socially.
What to Do About Constipation
Since there are some physical and medical problems that can involve constipation, it is a good idea to consult your pediatrician or health care provider just to rule those things out. Your child probably won't need extensive tests; mainly the doctor will review the history of the problem and check your child's height and weight and do a general physical examination. Your health care provider may want to check inside the rectum with a finger, but if she does it gently it need not be traumatic or painful.
Re-educate the bowel.
The first step is helping the hard stool come out. There are a variety of options. Your pediatrician may start with a simple glycerin suppository or suggest a pediatric enema preparation. To maintain soft stools, she may want your child to take mineral oil or a stool-softening agent for a few weeks or even months. The goal is to re-educate the bowel: to establish a regular schedule of bowel movements so that the stretched, and lazy, intestinal walls regain their strength and tone.
Add fiber.
Examine your child's diet. Children who drink excessive amounts of milk or who avoid fruits, vegetables, and whole-grain cereals and breads may simply have too little fiber in their diet. Add fiber any way you can: granola bars, oatmeal cookies, whole-wheat bread rather than white, snacks of raw vegetables with a low-fat ranch dip. For finicky eaters, your pediatrician may suggest a fiber supplement.
Reward, don't punish.
Never punish your child or express anxiety or dissatisfaction when you see her withholding stool or being reluctant to try. Instead, establish a series of rewards when she does produce.
Although some cramping and small amounts of blood may be a part of constipation and are nothing to worry about, be sure to consult your health care provider right away if your child's abdomen swells suddenly, if he is both vomiting and constipated, or if there is a significant amount of blood or pain.
