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Constipation in children
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Problems with diet | Holding in stools | Changes in daily routine | Not being active | Constipation in your family | Medications
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Risk factors for constipation in children

The factors listed here can increase your child's chances of getting constipation. But keep in mind that even if your child has one of these risk factors, it doesn't mean they will get constipation for sure. It just means your child's more likely to get it than a child who doesn't have the risk factor.

Problems with diet
What you child eats or drinks can affect their chance of getting constipation.

  • Not drinking enough water and not eating enough high-fiber foods: These things make stools harder, drier and more difficult to push out. However, there isn't any evidence that drinking more water or eating more
     
     
     
     
     
    fiber
    Fiber is all the parts of your diet that your body can't absorb. This is why foods that are high in fiber make you have more bowel movements. When your body can't absorb something, it leaves your body in your stools. Foods high in fiber include wholemeal bread and cereals, root vegetables and fruits.
     
     
     
     
     
     fiber will ease your child's constipation. (This might be because the right kinds of studies haven't been done yet.) To learn more, see Eating more high-fiber foods.
  • Drinking too much milk: If toddlers drink too much they may feel full and not want to eat solid foods. If they don't have enough bulky food in their bowels, they may not get the urge to pass a stool.
     
     
     
     
     
    Source:
    Rogers J.
    Childhood constipation and the incidence of hospitalisation.
    Nursing Standard. 1997; 12: 40-42.
     
     
     
     
     
     1 Some parents think their child's constipation is from an
     
     
     
     
     
    allergy
    If you have an allergy to something, your body overreacts when you're around it. The thing you are allergic to is called an allergen. Most allergens are harmless to most people. But if you're allergic to something, your body's system for fighting infection (your immune system) is too sensitive to that allergen. It triggers changes that we call allergic reactions. For example, pollen is an allergen for many people. If you're allergic to pollen, you'll sneeze and have runny eyes when pollen is in the air.
     
     
     
     
     
     allergy to cow's milk, and there's evidence that this might be the case for some children.
     
     
     
     
     
    Source:
    Iacono G, Cavataio F, Montalto G, et al.
    Intolerance of cow's milk and chronic constipation in children.
    New England Journal of Medicine. 1998; 339: 1100-1144.
     
     
     
     
     
     2
  • There's not enough evidence to know whether bottle-fed babies are more likely to get constipated than breastfed babies. But bottle-fed babies may get constipated if they don't drink enough water. And breastfed babies often have delays of many days before passing normal stools.
     
     
     
     
     
    Source:
    Abhyankar A, Carcani I, Clayden G.
    Constipation in children.
    October 2006. Clinical Evidence. (Based on June 2005 search) Available at http://clinicalevidence.bmj.com/ceweb/conditions/chd/0303/0303_background.jsp (accessed on 19 March 2009).
     
     
     
     
     
     3
  • Children who are very overweight (obese) are more likely to have constipation and soiling.
     
     
     
     
     
    Source:
    Fishman L, Lenders C, Fortunato C, et al.
    Increased prevalence of constipation and fecal soiling in a population of obese children.
    Journal of Pediatrics. 2004; 145: 253-254.
     
     
     
     
     
     4(Soiling is when liquid stools leak out into the underwear of children with constipation, but they don't realize it.)
Holding in stools
Putting off passing a stool can increase the chances that your child will get constipation. Your child may try to hold in stools because they:

  • Had pain when passing a stool
     
     
     
     
     
    Source:
    Partin JC, Hamill SK, Fischel JE, et al.
    Painful defecation and fecal soiling in children.
    Pediatrics. 1992; 89: 1007-1009.
     
     
     
     
     
     5
  • Have a sore or cracked
     
     
     
     
     
    anus
    The anus, which is at the end of the rectum, is where a stool leaves your body when you go to the bathroom. Part of the anus is a muscle that helps you hold in the stool until you are on the toilet.
     
     
     
     
     
     anus (doctors call this an
     
     
     
     
     
    anal fissure
    Your anus is the last part of your digestive system. It's the opening between your buttocks, where stools (feces) come out. An anal fissure is a small crack, cut or sore on your anus.
     
     
     
     
     
     anal fissure). This can make going to the bathroom hurt
  • Don't like smelly bathrooms or bathrooms away from home, and may want to wait until getting home
  • Are too busy playing to take a break
  • Have a very active imagination. For example, one study found children didn't want to go because they worried their stool would drown.
     
     
     
     
     
    Source:
    Rogers J.
    Childhood constipation and the incidence of hospitalisation.
    Nursing Standard. 1997; 12: 40-42.
     
     
     
     
     
     1
About 1 in 5 children start to hold in stools when they begin potty training.
 
 
 
 
 
Source:
Taubman B.
Toilet training and toileting refusal for stool only: a prospective study.
Pediatrics. 1997; 99: 54-58.
 
 
 
 
 
 6

Changes in daily routine
Taking a vacation, moving or changing schools can trigger constipation in your child. For babies, it can happen with a change from one formula of milk to another.

Not being active
Not being active enough can make your child's bowels sluggish, so food passes through them more slowly.

Constipation in your family
Constipation can run in families. This might be because of how the bowels work. In some families, people need to have a lot of stool in their bowels before they feel the urge to go.

Medications
Your child can get constipation as a side effect of these medications:

  • Painkillers
  • Certain cough medications
  • Anticonvulsants (drugs to control
     
     
     
     
     
    seizure
    A seizure is a sudden spasm of muscles caused by too much electrical activity in the brain. It results in muscle twitching and other symptoms.
     
     
     
     
     
     seizures)
  • Antihistamines (drugs for treating
     
     
     
     
     
    allergy
    If you have an allergy to something, your body overreacts when you're around it. The thing you are allergic to is called an allergen. Most allergens are harmless to most people. But if you're allergic to something, your body's system for fighting infection (your immune system) is too sensitive to that allergen. It triggers changes that we call allergic reactions. For example, pollen is an allergen for many people. If you're allergic to pollen, you'll sneeze and have runny eyes when pollen is in the air.
     
     
     
     
     
     allergies)
  • Corticosteroids (drugs for treating
     
     
     
     
     
    asthma
    Asthma is a long-term disease of the lungs. It makes you wheeze, cough and feel short of breath. Asthma attacks are caused by iflammation and narrowing of the airways, which makes it hard for air to pass in and out of the lungs.
     
     
     
     
     
     asthma or other problems with
     
     
     
     
     
    inflammation
    If your skin or some other part of your body becomes red, swollen, hot or sore, we say it is inflamed. It means that your body is trying to protect you from germs, from something in your body tissues that can hurt you (like a thorn or sliver), or from things that cause allergies (allergens). Inflammation is part of the way the body heals an infection or injury.
     
     
     
     
     
     inflammation).

Sources for the information on this page:
  1. Rogers J.Childhood constipation and the incidence of hospitalisation.Nursing Standard. 1997; 12: 40-42.
  2. Iacono G, Cavataio F, Montalto G, et al.Intolerance of cow's milk and chronic constipation in children.New England Journal of Medicine. 1998; 339: 1100-1144.
  3. Abhyankar A, Carcani I, Clayden G.Constipation in children.October 2006. Clinical Evidence. (Based on June 2005 search) Available at http://clinicalevidence.bmj.com/ceweb/conditions/chd/0303/0303_background.jsp (accessed on 19 March 2009).
  4. Fishman L, Lenders C, Fortunato C, et al.Increased prevalence of constipation and fecal soiling in a population of obese children.Journal of Pediatrics. 2004; 145: 253-254.
  5. Partin JC, Hamill SK, Fischel JE, et al.Painful defecation and fecal soiling in children.Pediatrics. 1992; 89: 1007-1009.
  6. Taubman B.Toilet training and toileting refusal for stool only: a prospective study.Pediatrics. 1997; 99: 54-58.
This information was last updated on May 12, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
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