Article

Constipation in Children

happy children sitting at a lunch table at school eating Having a child who is constipated can be stressful. It is often hard to know what to do. Constipation can cause your child to have stomach pain, bloating, gas, poor appetite and crankiness. Depending on how long your child has been constipated, there are different ways to help. Read on to learn more about what to do if your child is constipated.

What is constipation?

Constipation is when your child does not have bowel movements regularly. When they do not have a bowel movement, it is often dry, hard, difficult to pass and may be painful. Regular bowel movements for a child can vary. The bowel movements should be soft and easy to pass.  

What causes constipation in children?

There are many different reasons why children become constipated. Some reasons may include:

  • Not enough fibre or fluids 
  • Not enough physical activity
  • Changes in toilet routines (for example, when going on vacation)
  • Not going to the washroom when your child has the urge
  • Not enough time to go to the bathroom
  • Holding stool in because of pain during a bowel movement
  • Not using laxatives properly 
  • Some medications or supplements 
  • Higher stress levels  

The most common cause of constipation in children is holding stool in because of pain during a bowel movement. 

How is constipation in children treated?

Acute constipation:

Acute constipation is when your child has not had regular bowel movements in the last 2 weeks.

Treatment: Follow Canada’s Food Guide and add more fibre and fluids to your child’s diet. Consider reaching out to a dietitian for guidance and monitoring.
 
It is also important to set up a regular toilet routine. Encourage your child to sit on the toilet after meals. Allow enough time on the toilet and do not rush.

Chronic constipation:

Chronic constipation is when your child has not had regular bowel movements for more than 8 weeks. About a third of children with acute constipation will develop chronic constipation. The most common reason why children get chronic constipation is because it is painful to have a bowel movement. Children will hold their stool in to avoid the pain of a bowel movement. 
 
Treatment: See your child’s doctor. The doctor will likely:

  • Prescribe laxatives
  • Suggest your child sit on the toilet at the same time each day to set a routine
  • Suggest you write in a diary when your child has a bowel movement
  • Review your child’s diet or recommend you see a dietitian for personalized dietary advice

Chronic constipation requires medical treatment. Diet changes alone will not likely fix the problem. In some cases, your doctor may suggest seeing a specialist if there is a need.

Tips to increase fibre in your child's diet

Try the tips below to add fibre to your child’s diet:

  • Choose whole vegetables and fruit instead of juice
  • Add fresh or frozen berries to cereal and yogurt like in this fun and tasty yogurt banana split
  • Choose whole grain breads that have at least 2 grams of fibre per slice 
  • Use high fibre cereal like bran with at least 4 grams of fibre per serving
  • Add dried fruits to yogurt, salads and homemade muffins like in this apple cinnamon oatmeal muffin
  • Add lentils or beans to soups, casseroles and salads like in this fresh black bean and couscous salad

Children should get extra fibre from foods only. Fibre supplements should only be given if recommended by your dietitian or health care provider.
 
Remember to slowly increase the amount of fibre-rich foods your child eats. Offer plenty of fluids and encourage physical activity every day.
Read Focus on Fibre for tips on how to add more fibre to your child’s diet. Read Facts on Fluid to find out how much water and fluids your child needs.

Should I take dairy out of my child’s diet?

In general, no one food causes constipation. Taking dairy out of your child’s diet should only be done if it is recommended by a healthcare provider. Removing foods from your child’s diet without replacing them with alternatives may cause them to be low in important nutrients like calcium and vitamin D. Get advice from a dietitian.

Should I give my child probiotics for constipation?

No. Currently, there is not enough research to show that probiotics help with constipation. However, foods like yogurt, milk and cheese with probiotics are safe for most people, including children, and fit into a healthy diet. 

Should I give my child laxatives?

It is important to speak to your doctor or pharmacist before giving your child laxatives. If it is recommended that your child take laxatives, always follow the instructions for the dose and the amount of time your child should be taking them. Make sure you are giving your child enough fluids as well.

Should I give my child prunes or prune juice?

You may offer your child one or two fresh or canned prunes a day to see if they help. However, many other foods also contain fibre and can help with acute constipation. Fruit juice is not recommended for children because it is a sugary drink. Having too many sugary drinks has been linked to an increased risk of cavities in children.  

When should I bring my child to the doctor?

It is important to bring your child to the doctor if you are concerned about your child’s constipation. Below are some things to look for that may mean you should bring your child to the doctor: 

  • No improvement in your child's constipation after following Canada’s Food Guide and adding more fibre and fluids to your child’s diet 
  • Large stools that block the toilet
  • Pain while trying to pass stool
  • Actions that look like your child is holding stool in

How can a dietitian help?

A dietitian can work with you and your family to help choose foods that are higher in fibre and your child will still enjoy. They can give you ideas for school lunches and snacks, and teach you important things to look out for on food labels, like how to spot whole grains. A dietitian can also help make sure your child is getting enough fluids and other important nutrients.

Many employee health benefit plans cover dietitian services. Connect with a dietitian today!

Bottom line

Children can have constipation for many reasons. Acute constipation can often be eased by following Canada’s Food Guide and adding more fibre and fluids to your child’s diet. Chronic constipation needs medical treatment and may include the use of laxatives. Always see your child’s doctor if you are concerned about your child’s constipation. 

You may also be interested in:

Focus on Fibre
Facts on Fluid
Understanding Food Labels in Canada
Canada’s Food Guide
 
This article was written and reviewed by dietitians from Dietitians of Canada.

Last Update – November 19, 2021

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