Constipation in Toddlers and Preschoolers
Constipation is also a big concern for parents of toddlers and preschoolers. As Lisa Carmen*, mom of two in Massachusetts, says, "I felt like every time I turned around my daughter was constipated when she was a toddler! We had to give her prunes every single day!" Common causes of constipation at this age include:
- Not enough fruits, vegetables, and whole grains in the diet
- Low fluid intake
- Withholding stool during potty training
- Ignoring the urge to have a bowel movement because the child is too busy playing
When a young child passes a hard stool, it is painful and can be frightening. Most of the time, all the child needs is a lot of positive reassurance and an improved diet and liquid intake to prevent future problems. If you suspect that your child often holds his stool because he is too busy playing, have your child sit on the toilet for at least 10 minutes at about the same time each day, preferably after a meal. You can reward your child for sitting on the toilet with a favorite activity or stickers on a chart. Try to avoid using food as a reward.
It is worth mentioning that a small number of children respond to an episode of hard stool by trying not to have more bowel movements. "They might go on tiptoe, clench their buttocks, dance around, and even hide," says Dr. Baker. "Sometimes parents understandably mistake this for their child trying to have a bowel movement, when really they are trying not to have one."
If this behavior goes on long enough, more and more stool collects and becomes impacted in the rectum. Eventually, the child may have some leakage in the underwear. "It's very important for parents to understand that the child has no control over soiling once impacted, and [the child] absolutely should not be punished for it. It is not willful and defiant behavior," says Dr. Baker. The only way to resolve this situation is with medication to clear out the impaction, so if you suspect this problem, have your child see the doctor.
*Name has been changed