Constipation. It is an epidemic effecting a huge population of young children.
Many factors can contribute to childhood constipation in including:
Changes in diet
Not enough fiber-rich fruits and vegetables or fluid in your child's diet may cause constipation. A common times for children to become constipated is when they're switching from an all-liquid diet to one that includes solid foods.
Changes in routine
Any changes in your child's routine -- such as travel, hot weather or stress — can affect bowel function. Children are also more likely to experience constipation when they first start school outside of the home.
Your child may ignore the urge to poo because he is afraid of the toilet or doesn't want to take a break from playing. Painful poops caused by large, hard stools also may lead to withholding. If it hurts to poop, your child may try to avoid a repeat of the painful experience.
Antihistamines, pain medications, calcium and iron supplements, and other drugs can contribute to constipation.
Cow's milk allergy
An allergy to cow's milk or eating too many dairy products (cheese and cow's milk) sometimes leads to constipation.
Early toilet training
If you begin toilet training too soon, your child may rebel and hold in stool. If toilet training becomes a battle of wills, a voluntary decision to ignore the urge to poop can quickly become an involuntary habit that's tough to change.
Children who have family members that have experienced constipation are more likely to develop constipation.
This is rare, but sometimes, constipation indicates an anatomic malformation, a metabolic or digestive system problem, or another underlying condition.
Constipation often goes unnoticed until it starts to effect eating or toileting. In my feeding therapy practice, one of the first questions the dietician and I ask parents is: “What does your child’s poop look like?” Hard and infrequent stools are a sign of constipation. It becomes more challenging as kids become more independent in their toileting abilities. Constipation often goes unnoticed by parents until their toilet-trained toddler starts to have accidents in their pants or their usually good-eater becomes a picky-eater and refuses to eat.
Signs of constipation:
Skid marks in undies
It is super duper important for parents to stay in the “poop-loop” once kids are potty-trained. If your child always hears a kerplunk noise when on the toilet, the stool is too firm. It might be helpful to post a fun poop chart in your bathroom and ask your child, “Did you have chocolate pudding or candy bar poop?”
Think of your gut as a highway. Your mouth is the on-ramp and down-south is the exit ramp. If there is a traffic jam in the colon, at some point, no one is exiting and there is no room for more traffic to enter. This is why we see infrequent pooping and refusal to eat. Your child’s body knows that the food freeway is backed-up…nothing should go in, because nothing is coming out.
What should you do if your child is constipated?
Consult with your pediatrician.
Consider a gut clean out regimen to clear the traffic jam. (I prefer using magnesium citrate dosed at one-ounce per year of age--but not more than 10 ounces--for three days in a row. Mix it with a little Sprite and a little fruit juice... the flavor is undetectable.)
After the gut cleanse, your child should be having soft stools. Next, begin a daily regimen of stool softeners to keep the traffic on the food-freeway moving. (MiraLax works well. I think it is easier to pre-mix a batch of MiraLax (3-capfuls to 12-24 ounces of water in room temperature water and serve from this pitcher for a three days. This method helps with the time involved in dissolving the MiraLax and also makes the MiraLax flavorless -- undetected by even the most sensitive palates.)