Constipation in children

Constipation can be an unpleasant experience at any age, but it is all the more worrying when it happens to children. Little ones can feel bloated or uncomfortable, or even be in pain, which can, in turn, make them irritable. So, what causes constipation and what can be done about it? Paediatric gastroenterologist Dr Andrew Fagbemi explains.

How long can you go without pooing and what is the regular amount to go?

For most people, it is normal to go about once a day. Ideally, if you don’t go every day, physiologically you’re supposed to go at least three times a week. Anything less than this suggests that you are constipated. Young children and babies usually need to go more frequently.
 

Constipation can be defined in three ways:

• The number of times you go
• The consistency of your stool
• If there is any straining while passing the stool

What causes constipation and how does it feel?

Causes of constipation can vary in children (my specialty). In most cases, the cause is dietary. How often you poo tends to be related to diet in terms of the amount of fibre and water you take in. An unbalanced diet, with not enough fruit, vegetables, or other sources of fibre and a low water intake can lead to constipation.

Rarely, small babies (neonates) can be born with a congenital condition called Hirschsprung’s disease, which can cause problems with passing stool.

Constipation causes abdominal discomfort, with the patient often feeling quite bloated. There can be pain when trying to pass stool because of straining and because of the stool’s hard consistency. Some children have a long-standing condition we call “overflow”, which could cause accidents in their pants because liquid poo goes around the hard poo. This can result in the child having both diarrhoea and constipation simultaneously.

What are the quickest ways to relieve constipation?

The quickest ways aren’t necessarily the best way. Rather, the best ways to treat constipation would be to improve diet. My advice would be to try and encourage the drinking of lots and lots of fluid and eating lots of fruit and vegetables. I would also advise not to rely on milk as a main source of nutrition, as excessive milk intake can cause constipation.

You can use medication too. Consult your doctor, and in some cases, they may recommend regular laxatives to help make sure that the child is going regularly.

When would I need to take my child to see a doctor and how can they help?

I would recommend taking your child to see a doctor in the following circumstances:

- Your child is visibly struggling to pass stool, is in constant pain, and the stools are hard.

- You find blood in the stool. This could be caused by hard stool, blocking the bowel, which can cause severe pain. This could also make the child hold their poo in, because of the pain, leading to a vicious circle. Doctors can recommend laxatives to help the child pass stool without pain.

- If a newborn or very young baby hasn’t passed a poo for 48 hours, I would recommend seeing a specialist.

- If constipation has happened early in the child’s life and has been ongoing for a while. This includes if they have also had accidents.

If you are concerned that your child has constipation, visit Dr Fagbemi’s Top Doctors profile to book an appointment.