diagnosing constipation

Recognizing and Diagnosing Constipation

How do I know if my child is constipated?

The American Academy of Pediatrics outlines normal frequency of bowel movements for children.

Age Bowel Movements Per Weeka Bowel Movements Per Dayb
0-3 Months    
Breast-fed 5-40 2.9
Formula-fed 5-28 2
6-12 Months 5-28 1.8
1-3 Years 4-21 1.4
More than 3 Years 3-14 1

Adapted from Fontana M, Blanch C, Cataldo F, et al. Bowel frequency in healthy children.
Acta Paediatr Scand 1987;78;682-4.
a Approximately mean 2 SD.
b Mean.
Source: North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Some kids will be able to tell you when they're constipated, but others won't because they're either not talking yet or they're embarrassed or scared.

Luckily, there are physical symptoms to look for, which may include:

  • Less than three bowel movements a week

  • Hard stools that are difficult to pass

  • Cramps, stomachaches or nausea

  • Rectal bleeding (this symptom might be a sign of a serious condition, consult your pediatrician)

  • Urinary incontinence, frequent urination or bed-wetting (these symptoms might be signs of a serious condition, consult your pediatrician)

  • Soiling (often confused with diarrhea)

In addition to physical symptoms, look for changes in behavior such as a decrease in appetite. Chances are they'll be cranky. And while they might act like they need to use the bathroom – crossing their legs, making faces, wriggling and squirming – they're often trying to hold it in to avoid the pain of going.

Once you've determined your child is constipated, let them know it's very normal and happens to people all the time. As you know, being constipated can be painful and scary. Having problems pooping when you're 5 is as embarrassing as when you're 35. As the parent, anything you can do to let them know they are OK and it will be OK is the right place to start.

If you suspect your child may be suffering from constipation for the first time, consult your physician.

What Causes Constipation?

Constipation can occur for a variety of reasons. Here are some of the most common:


Poor diet, changes in diet and not getting enough fiber are all leading causes of pediatric constipation. In addition to diet, not getting enough fluids is another leading cause.


Sometimes illness can cause constipation because of loss of appetite, changes in diet and dehydration. Constipation can also be a side effect of certain medications.


Pediatric constipation often occurs because kids “hold it in too long” because they don't want to stop what they're doing to go to the bathroom. Kids may also withhold to try and avoid a painful bowel movement or because they are in an unfamiliar environment and are embarrassed.

Other Changes:

Routine is the key to regular bowel movements. Changes such as travel or stress may affect your poop pattern – and it's the same for your child.