Kids and Constipation

For children, there's a wide range of what's regular

As an adult, you're no doubt very familiar with your own bowel movements (BMs). You know when something changes—you aren't going as often as usual or your poop takes on a different shape or color. And you certainly are aware when you're constipated. But what's normal for you isn't necessarily going to be what's normal for your child. If she has a bowel movement just once or twice a week, for example, does this mean she's constipated or simply that her digestive system is on a different clock from yours?

It's not uncommon for a child to become constipated, but at the same time, how often she needs a poopy diaper changed or heads to the bathroom on her own isn't the best indicator. Here's what parents need to know about kids' bowel movements

Kid Poop: A Primer

Children's bowel movements and what those BMs produce evolve with age and differ according to diet. For example, a ​breastfed newborn may have as many as seven or more very loose stools each day, while an infant who's being given formula may have somewhat firmer stools much less frequently. A toddler can have a bowel movement as many as three times a day. The same is true of older kids, but it can be just as normal for them to go only three times a week.

Because normal can differ so dramatically from child to child, if you're worried about your kid's bathroom habits, it's more helpful to look for changes in her personal patterns than to compare them to yours or other kids. If she goes from having two bowel movements a day to going to the bathroom just twice a week, it could be a sign something's wrong.

Determining What Is and Isn't Constipation 

A better indicator a child may be constipated than how often she goes to the bathroom is what her stools look like. If they're soft and formed, it's doubtful she's constipated—even if she poops only every two or three days. But if her BMs are large and hard, she has trouble passing them, and it hurts when she does, most likely she's constipated. Sometimes the effort to push out a hard poop can cause tiny tears in a child's anus, so a bit of blood can be normal as well. (Lots of blood may indicate a serious medical problem, so check with your child's doctor right away if you see this.) The same is true if her stool looks like little balls or pellets. 

Evading Encopresis

One potential complication of painful bowel movements parents should be aware of is a condition called encopresis. When a child holds her stool—either because she's already dealing with irregularity and it hurts to poop or for some other reason (she's resisting being potty-trained, for instance, or she's uncomfortable using the bathroom away from home), her bowel movements can become so hard and so large she simply can't relieve herself. Instead of having real BMs, less formed stool may leak out around the build-up, which parents may mistake for an actual bowel movement or as soiling.

Either way, a child with encopresis may either go untreated because it appears nothing is wrong or be punished for making a mess. Meanwhile, she may stop gaining weight at a healthy rate, and the pressure on her rectum from the increasing mass of stool may temporarily damage the nerves there. At that point, a kid may not be able to sense when she needs to poop even after the constipation is resolved.

The sooner a child who's truly constipated gets help, then, the better. If you think this is the case for your kid, see the pediatrician. Relief may be just some extra dietary fiber away, in the form of more fruits and vegetables, or a supplement.

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Article Sources
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  3. Stanford Children’s Health. Encopresis.

  4. Harvard Medical School. Encopresis (fecal soiling). Updated November 2018.