In this article, we will explain the causes of constipation in babies and children, how to prevent and treat it. Since it is one of the most common problems in both babies and children, we tried to prepare a comprehensive article. What is constipation in our article? What are the causes of constipation? What are the symptoms? What symptoms do you see in a child should you take steps for constipation? How is it diagnosed? Is there a test that can be done to diagnose it? What tests can be done? We will seek answers to these questions.
What is constipation?
Constipation: In the simplest terms, it is when a child defecates very hard and poops less frequently than usual. It is a very common intestinal problem.
What symptoms do you see in a child, you should suspect constipation and what should you do?
Constipation is normally defined as defecating less than 3 times a week, but we can see much different in children. If your child is pooping less often than usual, that is, if your baby is pooping more than 5 times a week, he may also be constipated. Because the number of bowel movements can be different for each child, you might think of it as pooping less often than usual.
Passing a hard and sometimes large stool or having difficulty in pooping or having a painful stool will also mean constipation for the child.
What causes constipation?
The main reason is a 3-stage vicious circle. The large intestine is a water-retaining organ and its purpose is to conserve water in the body. As the substance passing through absorbs the water, it transforms into a harder poop. And in normal state, there is no problem in this and it is actually a mechanism that protects our body. However, if the child has constipation, the muscle movements of the colon, namely the large intestine, are much slower. This causes the stool to move very slowly in the colon, increasing the time it spends there, and this causes too much water to be absorbed.
And as a result, the stool becomes hard and dry. When a child is constipated, the problem can worsen quickly and it can be painful to push hard dry stools out. Thus, the child may stop using the bathroom as the pain increases. And over time, the colon does not feel that the stool is there, and thus the vicious circle has begun.
And quickly this work will become chronic, that is, the process will take longer. And it will become even more difficult to fix. That’s why every point we write here is important. As parents, do not think that only I will take care of the treatment, after returning to normal, the continuation of normal is actually very valuable for us.
Apart from this, there are some reasons that trigger constipation:
Diet & Nutrition
Eating too many foods high in fat and low in fiber is another cause of constipation. Examples of these are fast food and junk food. Not drinking enough water and not taking other liquids will also increase constipation. If there is a change in diet, for example, when babies start to transition from breast milk to formula and start eating solid foods, such problems are often encountered.
The most common periods of constipation are 7-8-9 days when solid food is started. Months and the period of 2 to 3 years, which is the period of separation from the diaper. In general, the basis of the problem of constipation is laid during these periods.
Lack of Exercise
Lack of exercise is also among the reasons that trigger constipation. Children who watch too much TV or play video games, spend time with tablets or phones, and are unable to exercise, will be deprived of the digestive effects of digested food. Therefore, there will be a trigger for constipation.
For example, your child may not want to go to the toilet outside and may start to cause constipation after defecation. Feeling pressure during toilet training and making the difficult time for a child even more difficult can also cause the child’s constipation to start and progress rapidly.
At the other stage, observing an uneasiness between parents between parents or experiencing a different kind of difficulty at school or in the nursery can cause the child to enter the constipation process quickly. So don’t think of constipation as just a child’s poop and something related to the child. Do not ignore the emotional dimension of the event.
Child’s involvement in play
Another reason that can trigger constipation is that busy children do not heed the signals their bodies give them to have bowel movements. And they keep playing games or doing other things. They forget or delay going to the toilet.
New School Term
Constipation can also be a problem when starting a new school year, and it most often starts during this period. Because when they need to, when they think about going to the toilet, they think that this may be perceived negatively by their teachers or other friends and they should not do it in this way, they delay the process a little and have to change their bowel routines. A change in routine is also a sufficient reason for a business to fail.
Certain diseases and physical problems
Although rarely, constipation can be caused by larger physical problems, friends. As we know, if there is any problem with the intestinal tract, the rectum, the anus, that is, the child’s butt, if he or she has any of the nervous system diseases such as cerebral palsy, if there are hormonal disorders such as hypothyroidism, or if he or she uses certain drugs such as iron therapy, antidepressants or special painkillers, narcotics. As side effects, these children can cause constipation.
What are the symptoms of constipation? In what situations do you need to take action?
Symptoms may occur differently in each child and they are usually as follows; Absence of defecation for a few days and the child’s habit of not pooping within 48 hours of starting solid food. So 48 hours should be emphasized here. Because when he can’t poop for more than 48 hours, there is an alarm situation here. If the child cannot poop during this period, the stool will absorb water more intensely in the large intestine, causing a harder, drier stool. And then it will cause him to experience abdominal bloating, muscle cramps and aches and to withdraw himself again.
Your child does not feel hungry because he feels a lump in his stomach and may also cause loss of appetite. In other words, what we call loss of appetite is not just the child’s lack of vitamin, let’s give something appetizing. At the same time, if the child has another problem, he should also be eliminated. On the other hand, the signs of trying to hold the stool, such as clenching teeth, crossing legs, pressing their hips together, and blushing, are again an expression of the child having difficulty.
If a child has small traces of liquid or soft stools on their underwear or diapers, or if your child pretends to pass stools like goat poop, your child is already in a period of constipation. If you have one or more of these, do not forget to contact your pediatrician and start taking steps if necessary.
How is constipation diagnosed?
Your pediatrician will ask about the child’s symptoms and health history. And then, together with a detailed physical examination, he will learn what is happening and what steps should be taken regarding the child. It is important how many days old it is when your child has his first stool. There is a disease called Hirschsprung. And the first and most important symptom of this disease is that the child does not poop in the first 48 hours.
On the other hand, how often your child defecates is also very important. If your child has a routine, what is it? It is very important whether your child complains of pain when defecating, if you have a toddler recently and whether this child is toilet trained or not.
On the other hand, what foods does your child routinely eat or not want to eat? Have you had a stressful event in your child’s life lately? This could be school or home. How often do you find poop in your child’s pants or diapers? Your doctor may also order some tests after these questions to see if there are any problems.
Can perform rectal examination. What we call rectal examination is to feel the child’s bottom with a finger and try to understand if there is anything abnormal inside. And here the age of the child and the psychological state of the child are very important. In the second step, an X-ray may be taken of the abdomen. This is an imaging method that checks whether and how much stool is present in the large intestine.
At the other stage, the large intestine, rectum and lower part of the small intestine, which we call barium enema, are seen on the x-ray. A metallic liquid called barium is given to the child from the bottom of his back. And it is tried to understand what is or is not in the area related to the x-rays taken. If there is a blockage or stricture, or if there is a problem, especially with the barium enema, they will be detected. However, not everything we write here may apply to you. What we have written here are brief information about some of the possibilities that can be done.
At another stage, a test called anorectal manometer can be done that checks the strength of the muscles and nerve reflexes in the anus, and it is a study that feels the child’s rectum is full, that is, whether the rectal manipulation and bowel movements are correct, and whether the child perceives this.
On the other hand, there may be hereditary diseases or genetic diseases. By performing a rectal biopsy, it can be investigated whether the nerve cells there are working correctly or their presence.
At the other stage, a test called sigmoidoscopy can be performed. This test can examine part of the large intestine to visualize and what is causing diarrhoea, abdominal pain, constipation, abnormal growths or bleeding. But the event here may also change according to the age and gender of the child and the psychological state of the child at that time.
Colonel transition study
What is called a colonel transition study is an examination with x-rays to see how the child’s food moves through the intestines. And here the capsule is swallowed. X-rays are then taken at regular intervals. And in these x-rays, it is tried to understand what is the rate of passage of the intestines or whether there is any problem with it.
On the other hand, there is a condition called a colonoscopy. Think of it as endoscopy done from the buttock. A tube with a light and a camera at the end is inserted from the inside of the child’s bottom to examine whether there is any problem in the large intestine. If a piece of the large intestine needs to be taken and examined, it is an application that can be done easily without causing more trouble to the child.
On the other hand, several tests can be done as laboratory tests. Some minerals and vitamins can be tested for signs of poisoning, especially celiac disease, urinary tract infection, thyroid problems, metabolic problems, especially lead in blood.
Treatment of Constipation
Treatment of constipation varies depending on the child’s symptoms, age, and general health. Treatment is also tailored to how severe my condition is and how long it’s been going on. Treatments mostly include diet and lifestyle changes. Making changes to a child’s diet will often help with constipation. In particular, giving foods containing more fiber to the child will help him get rid of constipation more easily. For this;
- Giving more fruits and vegetables
- Giving more whole grain bread,
- Giving foods containing more fiber more intensely than packaged foods,
- Ensuring more frequent fluid intake, especially water,
- Limiting high-fat fast foods and junk food
- To offer more balanced and nutritious foods and snacks,
- Limiting drinks containing caffeine such as cola and tea
- Limiting whole milk as directed by your child’s health care provider, namely your doctor.
- Making appropriate nutritional changes for your child,
- It will be helpful to ensure that your child eats regularly. Because eating will usually cause bowel movements within 30 to 60 minutes and breakfast will somehow start to move in the child’s intestines.
A regular sleep routine is important for your child’s body to balance. In order to ensure sleep hygiene in a child, it doesn’t matter if there is a weekday or weekend, there is school or work or not, having more than an hour between them can be the beginning of many problems, including your bowel movements and moral motivation. That’s why sleep routine is very important.
In addition to all this, trying to do more exercise will help your child to have faster bowel movements and to push the contents of the smooth muscles there more easily. Exercises help the digestive system a lot. Exercise movements can provide this without the need for extra force, such as pushing the intestines forward as they digest food. And non-moving people, whether children or adults, are often constipated.
Your child may have obligations, such as watching TV or doing homework indoors. But do not forget that getting him to go out and play is very important both in terms of psychological and motivation and in terms of ensuring the normal functioning of the body.
Support Your Child
Try to inculcate a regular toilet habit in your child. Have your child sit on the toilet for at least 10 minutes at least 2 times a day. And try to do this right after a meal. You can make it a pleasant time. And it is up to you to direct it in a way that he will enjoy. Don’t get mad at your child for not having bowel movements. Making it fun is different from being angry or somehow obliging or forcing it, friends. Give stickers, treats. Make posters that show your child’s progress. You can give some achievement plaques. And these situations will cause him to recover quickly both spiritually and physically.
Remember your thoughts will change your hormones, and your hormones will change the balance in your body. Therefore, it is one of the most important situations to take a step by thinking positively. Be sure to talk to your child’s doctor first when these things happen. And if necessary, do not neglect to support them physically with a change in motivation, a change in physical movement and at the same time with drugs.
Constipation can be short-term acute or long-term, ie chronic. Children with bowel movements may also have problems with chronic constipation. But in most cases, constipation is a short-lived condition and remember that if your child has chronic constipation, you should work with their healthcare professional. The right plans created for your child together and the plans that will not disrupt your child’s motivation always work.
When Should You Go to the Doctor?
If there is one or more of the things we mentioned above, in this case, it is necessary to go to the doctor without prolonging the work. But if you have any questions or concerns, especially about bowel habits or an underlying condition, call your pediatrician and get the answers to your questions.
You should contact your doctor if the following situations exist;
If you have constipation that lasts for more than 2 weeks and you are afraid of doing normal activities due to constipation, if you hesitate, postpone, have pain during normal pushing or defecation and liquid or soft stools leak from the anus, small painful tears in the skin around the anus, that is, if there are things called anal fissures, painful If you have defecation, red swollen veins, that is, hemorrhoids, abdominal pain, fever and vomiting, it is time to go to the doctor.
Let’s complete our article by making the last reminders;
Constipation is when a child has hard stools and fewer bowel movements than usual. Constipation can be caused by a child’s diet, lack of exercise, or emotional issues. You need to think about the situation holistically. When a child is constipated, the problem can worsen quickly and the vicious circle is the cause. In order to break the vicious circle, you need to take steps at each stage. So you may not have a chance to eliminate constipation just by correcting the child’s food.
Making diet and lifestyle changes can help treat and prevent constipation. The most important thing is not to treat. It is prevention. Because the child’s being sick again and again after being sick will mean that your child will experience this stress again. Trying to get the same treatments over and over, going to the doctor, using drugs is really boring.
On the other hand, never give your child an enema, such as a stool softener or any medicine you heard from your neighbor at work, unless your doctor recommends it. Let your child’s doctor discuss the next steps in the best way possible and make sure that you go by making plans. Before going to the doctor, write down the questions you want answered. When you go to visit, write down the names of medicines, treatments, tests as your doctor gave you.
Either let your doctor write this or record audio if necessary, ask for some notes about it if necessary, and be guided in the right way. If your child has a follow-up appointment, write down the date, time, and purpose of that visit and apply them exactly when you go. Learn how to contact your child’s doctor after office hours, and if necessary, have space for your own specific maneuvers to take such steps with your children.
Also, click here to read the article of the American Academy of Family Physicians (AAFP) on constipation.
If you like this article, click to read our article about “Do Babies and Children Need Vitamin D Supplements?” which we prepared for your child’s healthy nutrition.