The vague, crampy discomfort that a child experiences with constipation can occur after meals when the intestines are stimulated to squeeze. Constipation is sometimes called "the silent epidemic" by pediatricians, since kids tend to become secretive with their bowel habits once they achieve independence on the potty. Parents should be suspicious when kids spend a long time on the toilet or make frequent trips to the bathroom with little or no result. In toddlers or preschool children, unusual squatting or stiffening of the legs may also indicate efforts to suppress the urge to have a bowel movement. "Hiding" during potty time may mean the child is associating pain or discomfort with bowel movements.
In most cases, constipation is related to diet or low levels of activity: Kids who spend more time catching cartoons than catching baseballs are likely to be irregular. An older child may experience anxiety provoked by a less-than-private school bathroom stall, and so "hold back" the urge to move her bowels.
Once it's identified, constipation usually isn't difficult to deal with. When diet's the problem, it may be the result of getting too much of a good thing. Excessive milk is a frequent culprit; temporarily keeping your child's intake to two glasses a day may get her back on track. This should be fine for any youngster who's 2 years or older. As long as her diet is reasonably well-balanced otherwise, she'll get ample calcium and protein. Make sure she drinks plenty of water and limit the amount of "low residue" foods, such as cheese, pasta, and some types of bread; substitute with high-fiber fruits, fresh vegetables, and whole-grain breads and cereals. For the child with discriminating tastes, natural fiber supplements, such as Metamucil, are a safe alternative.
Most children with constipation can be helped in a matter of days simply through the addition of extra fluid and fiber to the diet. (A little less time in front of the TV, and more time playing, won't hurt.) If your child doesn't respond within two weeks, consult your pediatrician. Chronic constipation can make toilet training difficult. In school-age kids, it may lead to soiling their underwear. Although in general laxatives should be avoided for children, stool softeners, such as milk of magnesia, are safe for long-term use under the supervision of your pediatrician.