Constipation is common in children

By Lisa Franklin- Banton, Child & baby health

Constipation is a common problem in children. It is characterised by infrequent passage of stool or passing hard, dry stool. Bowel patterns will vary among children and, hence, it is important for you to know your child's frequency and usual consistency stool.

In babies, the passage of stool will depend on whether they are breastfed or formula fed. Babies who get breast milk only very rarely get constipated. During the first month or two of life, they will pass stool very frequently (as often as following each feeding). After this, the frequency may change significantly. In some cases, they may pass stool once every week or once every two weeks. As long as the stool is watery or soft, it is unlikely that the baby is constipated. Formula-fed babies should pass stool at least every two to three days.

In children over one year old, going five or six days without passing stool may suggest that there is a problem. Your child may be constipated if the stool is hard, looking like pebbles, or if it is large, firm and difficult to pass.

Tummy pain

If your child is constipated, you may also notice that she or he complains of tummy pain, blood in the stool or 'accidents' in the underpants. The blood may be caused by tiny tears of the skin of the anus from passing hard stool. The accidental spills occur when liquid stool leaks around the more solid stool that remains inside.

If your child thinks that she/he will experience pain from passing stool, she/he may try to avoid doing so. You may notice the child crossing her or his legs, twisting her or his body or going on tippy toes. The longer the stool remains inside, the harder and drier it becomes, making it even more difficult to pass. If your child withholds the stool, this may cause large stool to form in the rectum, causing it to stretch. They may then no longer feel the urge to pass stool until it is too big to be passed, and at that point it could be very painful.

Give child more fibre

Many factors can contribute to constipation in children, including:

1. Unhealthy diets. Give enough fibre, found in fruits and vegetables.

2. Inadequate amounts of fluid. Drinking water and other liquids keeps the stool soft.

3. Habitually withholding stool. They are sometimes otherwise preoccupied or they may not want to use the bathroom at school.

4. Inadequate exercise. Moving around helps to move food through the digestive system.

5. Early toilet training. If toilet training is done too early, your child may not cooperate and choose to ignore the need to pass stool.

6. Medical problems. Rarely, constipation in children may be caused by a medical problem.

Each child's bowel pattern is different so you should become familiar with your child's normal bowel pattern. If you are concerned about your child's bowel movement, talk to a physician.

Dr Lisa N.C. Franklin-Banton is the president of the Paediatric Association of Jamaica; email: yourhealth@gleanerjm.com.