Let’s talk about poop – Constipation

When it comes to bathroom habits, what is normal for kids? According to Dr. Mark Corkins, chief of pediatric gastroenterology at Le Bonheur, normal has a broad range, and variations in stool (frequency, consistency, etc.) are common. In the second of a two-part series, Dr. Corkins weighs in on two common poop issues – diarrhea and constipation. Today, he tackles constipation.

What defines constipation?

Keep in mind that what’s normal for you, might not be normal for your child. Constipation in kids is defined by:

  1. two or fewer stools per week
  2. and/or one episode of stool leakage per week

What causes constipation?

Our digestive systems (stomach, colon, etc.) are designed to use saliva, stomach acids, liver and pancreas juices to digest food and absorb nutrition. Colons absorb water, and when too much is absorbed, this results in constipation. The key to a healthy digestive system is a balanced diet. Keep in mind that our “output” (urine and stool) is affected by our “input” (what we eat and drink). Fruit and veggies are known to cause softer stools, and dairy causes firmer stools. The more balanced a diet you eat, the more “normal” or healthy your stools will be. Constipation often results from a poor, unbalanced diet.

How can you relieve or prevent constipation in kids?

Again, ensuring your child eats a balanced diet is key. Sometimes, a stool softener (not laxative) can help, but check with your child’s pediatrician first. Giving your child some juice can also help to soften stool and make your child go. Some myths about constipation include:

  • My child isn’t getting enough water.
    Make sure your child is getting enough water, but extra water is not a good solution. More water just leads to more urine.
  • My child should eat more fiber.
    Too much fiber can create larger, bulkier stools, which are evening harder for children to pass. Your child needs the normal amount, not too much.

I don’t think my child is constipated. She just refuses to go and says it hurts. What should I do?

Stool withholding was the No. 1 cause for referrals to our clinic last year. In the second year of a child’s life, he or she develops control over their anus. Here’s how it happens: a toddler will experience an uncomfortable stool and will refuse to go again. The more they withhold the stool, the more water the colon absorbs, learning to a bigger, firmer stool – which makes it even more painful and reinforces withholding.

“Duty dance” is the recognized term for the sign a child is withholding. The child with stiffen, stand on tiptoes and often hide. Most parents think they are trying to go (and are constipated), but in reality, they are trying to hold it in. Sometimes, a stool softener can help make it easier for a child to go and learn to stop withholding.

There are basically three softeners on the market: MiraLax, Milk of Magnesia and Mineral Oil. Of the three, MiraLax is far and away the best to get kids to take. All three are safe for a child. Remember stool softener means it keeps water in the stool to keep the stool soft. None of these are “laxatives,” which stimulate stooling and the bowel can get addicted to.

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