The Why’s, What’s and How’s of Toddler Constipation

Constipated Toddler

One of the most common childhood conditions faced by parents of toddlers is constipation. There are myths and mysteries around this topic and most parents do not completely understand it until their child actually experiences constipation. The American Academy of Pediatrics defines constipation as “both a symptom and a chronic condition (which) refers to the infrequent elimination of large or hard stools that may cause pain on defecation.” In other words, it means that a constipated child may have pain when he/she passes or attempts to pass large, hard stools. This may be extremely frightening for a child who does not understand what is happening to his or her body and can lead to worsening of the condition. Most toddlers who are experiencing constipation will exhibit the following symptoms and behavior:

  • Crying while passing the stool or trying to pass the stool

  • Hiding when having the urge to defecate or to attempt to defecate

  • Becoming clingy and crying excessively for what seems like no reason to the parent or caretaker

  • Becoming combative and irritable

  • Becoming more impatient and cranky

  • Complaining of stomach aches and pains

  • Vomiting

  • Not passing stools for over 24-48 hours

Children who have had one or more bad episodes of constipation, will usually try to avoid defecating which can start a vicious cycle. The child remembers the experience and most of the time will not or cannot communicate it to the parent or caregiver. Instead, the child will naturally withhold stool or avoid defecating. When this occurs, even more water is absorbed from the stool and new intestinal contents into the body. As a result, the stool becomes hard and impacted. Thus the vicious cycle continues.  As one can imagine, this can become a very difficult problem to solve.

Diet & Constipation

A toddler’s diet largely contributes to the start of constipation. An average toddlers diet consists of the following foods that have been found to be constipating:

  • Dairy products such as milk, yogurt, cheese
  • Bananas
  • Apples - especially applesauce
  • Some low fiber cereals
  • Carbohydrate rich snacks
  • Bread
  • Rice
  • Pasta

Most toddlers would rather eat carbohydrate rich foods like pasta and rice versus fiber rich fruits and veggies such as raspberries, broccoli and brussel sprouts….who wouldn’t! Fiber rich foods help bulk up the stool and allow it to absorb more water, easing the passage through the digestive tract and reducing constipation.

Another possible contributing factor is that sometimes toddlers prefer to drink milk when they are thirsty versus having water. Dairy products like milk are very binding and do not allow the absorption of water in the stool. Toddlers also confuse hunger with thirstiness and keep drinking to satisfy the hunger. If milk is in their sippy cup, this could be a big source of their constipation problems. In any case, keeping an eye on your toddler’s food and type and quantity of fluid intake may be half the battle in managing his or her constipation.        

Exercise & Constipation

A second factor is exercise, or lack thereof.  While toddlers are known for their top-speed, always-on-the-go energy, some can get less energetic and more lethargic when they are battling constipation. Subconsciously, they are afraid to move around a lot for fear of defecating and bringing on that pain. This “always being on guard” feeling makes them tired. Instinctively, their bodies rest more and they may take more naps.  Unfortunately, this can contribute to the constipation problem because exercise helps to keep the gut moving.

Feeding Changes & Constipation

A third factor is the change of caregivers and possibly as a result, change of feeding habits during the course of the day. When caregivers aren’t aware of what the child is used to eat, they may worsen the cycle of constipation. Sometimes there is a birthday party at the daycare and the workers feel badly not giving your toddler a cupcake… or the relative feels that only one extra bowl of pasta won’t hurt while the parent is gone and the child is crying. Of course, these caregivers do not mean any harm but this innocent, caring action could be enough to set off the cycle of constipation. During the times where the parents are not available, it is imperative to increase awareness about what the child’s feeding habits.

These are just some factors that can start and contribute to constipation. Caregivers can make sure the child is well hydrated with water and eating vegetables and fruits. If a child is constipated, pastas and rice should be avoided. If constipation is an acute problem and needs to be remedied, giving the child prune or pear juice can help. If that does not resolve the constipation then the use of Pedia-lax® products such as the chewable tablets or glycerin suppositories can be used as directed.

As always, it is important to consult with your family pediatrician when dealing with constipation or any medical condition. They know your child’s medical history and will be able to give you the most suitable recommendations.