Constipation is a very common problem among kids. A child is considered constipated when he or she has fewer than three bowel movements in a week; has difficulty having a bowel movement; or when the stools are hard, dry, and unusually large.

Constipation usually isn't a cause for concern — it's preventable and most cases can be remedied with healthy eating and exercise habits.

Causes of Constipation

Most of the time, constipation is due to a diet that doesn't include enough water and dietary fiber, which both help the bowels move properly. Kids who eat a typical fast-food diet — rich in fats (burgers, fries, milkshakes) and processed sugars (candy, cookies, sugary soft drinks) — may find that they're constipated more often.

Sometimes, medications like antidepressants and medications used to treat iron deficiencies can lead to constipation. In babies, constipation can occur as they transition from breast milk to baby formula, or from baby food to solid food.

Keep in mind that some kids tend to avoid going to the bathroom, even when they really have the urge to go. They might ignore internal urges because they don't want to stop playing a fun game, use a restroom away from home, or have to ask an adult to be excused to go to the bathroom. When they ignore the urge to go, it's harder to go later on.

Stress can also lead to constipation. Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Research has shown that emotional upsets can affect how well the gut functions and can cause constipation, as well as other conditions, like diarrhea.

Some kids get constipated because of a condition called irritable bowel syndrome (IBS), which can occur when they're stressed or eat certain trigger foods, which often are fatty or spicy. A child with IBS may have either constipation or diarrhea, as well as stomach pain and gas.

In rare cases, constipation is a sign of other medical illnesses, so keep your doctor informed if your child continues to have problems, or if the constipation lasts for 2 to 3 weeks.

Symptoms of Constipation

Keep in mind that different kids have different bathroom habits. A child who doesn't have a bowel movement every day isn't necessarily constipated. One child might go three times a day, while another might go once every 3 days. Usually a child is constipated when he or she is going less than usual.

Your child might also complain of feeling full or bloated, or say that it hurts to poop, that he or she has to strain to poop, or that there's a little blood on the toilet paper.

Dealing With Constipation

You can take the following steps to prevent and treat constipation:

• Give your child more fluids. Drinking enough water and other liquids helps stools move more easily through the intestines. The amount of fluids kids need will vary according to weight and age. But most school-age children need 3 to 4 glasses of water each day. If your infant is constipated during the transition from breast milk or into solid foods, try serving just a few ounces of prune juice each day. If the constipation persists or is causing your child distress, it may be due to a health problem, so call your doctor.
• Serve more fiber. Foods that are high in fiber, such as fruits, vegetables, and whole-grain bread, can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along, while a diet full of fatty, sugary, or starchy foods can slow the bowels down. Fiber doesn't have to be a turn-off for kids: Try apples, oatmeal, oranges, bananas, baked potatoes, and popcorn.
• Make sure kids get enough exercise. Physical activity nudges the bowels into action, so encourage your kids to get plenty of exercise. It can be as simple as playing catch, riding bikes, or shooting a few hoops.
• Develop a regular meal schedule. Since eating is a natural stimulant for the bowels, regular meals may help kids develop routine bowel habits. If necessary, schedule breakfast a little earlier to give your child a chance for a relaxed visit to the bathroom before school.
• Get kids into the habit of going. Try having a child who fights the urge to go to the bathroom sit on the toilet for at least 10 minutes at about the same time each day, preferably after a meal.

Talk with the doctor before giving your child any kind of over-the-counter medication for constipation.

In most cases, these small changes can go a long way toward helping your child feel better and getting the bowels moving the way they should.

Reviewed by: J. Fernando del Rosario, MD
Date reviewed: October 2011