Care
Constipation
By the editors of Parenting magazine, Parenting
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Overview

Among the wonders of motherhood is just how much you grow to care about poop  -- your child's, that is. And a top concern is constipation. Parents often worry when their little ones don't have a bowel movement every day, but what's normal varies widely from child to child  -- some go as often as five or six times a day and some only once every few days. The causes of constipation also vary, from dietary changes to potty-training pressure. And while your child may feel uncomfortable, constipation is rarely a sign of a serious problem. And there are plenty of things you can do to help.


When your baby can't go

Babies develop quickly, and the frequency of their bowel movements can change accordingly. How to tell when your child is constipated, and what to do:

Signs of constipation
* Your baby's cranky and crying, and draws his legs up when he passes stools.

* Bowel movements are hard, compact, and sometimes large.

* There's a little bit of blood in his diaper (hard stool can tear the rectal wall a bit as it passes).

Causes of constipation
In babies, the most common culprit is a dietary change, such as switching from breast milk to formula, switching formulas, or starting solids. Introducing something new can often be rough on a baby's digestive system.

How to treat it

Offer extra liquids.

If your baby's less than 6 months old, ask your pediatrician whether you can give him a little plain water. Older babies can have two to four ounces of water daily. If he's still constipated after a couple of days, try giving him a mixture that's half water and half fruit juice, such as apple, pear, or prune.

Consider changing formulas.

If your baby's on formula, ask your doctor about changing to another type that may be more intestine-friendly.

Serve fiber-rich foods.

A jar a day of peas, beans, apricots, prunes, peaches, or pears can help stave off constipation, as can barley cereal. If your child is eating finger foods, offer whole-grain cereals, peas, beans, or small cubes of fig, prune, peach, pear, or plum.

Cut back on "binding" foods.

Rice cereal, applesauce, bananas, and cheese can make your child even more constipated.

Add a natural laxative.

Ask your doctor about adding a small amount of malt extract, corn syrup, or flax oil to formula, breast milk, or foods your child eats.

Get physical.

Bicycle his legs while he's on his back, and if he's ready for it, give him more space and time to crawl, cruise, or walk. It's not clear why movement helps, but it does!

Ease the passage.

Over-the-counter glycerin suppositories can help your child pass hard stools with less strain. Ask your doctor if they're a good idea for your child.


Treating toddlers on up

If your child goes a few days without a bowel movement, and then passes a hard, dry stool with pain or difficulty, chances are she's constipated. The most common cause of constipation is not getting enough liquids or fiber. For toddlers and preschoolers, it may be stress from starting potty training. A child who's nervous or not ready to potty train may withhold bowel movements because she doesn't want to go in the potty, and withholding makes stools harder and more difficult to squeeze out.

How to treat it

Change his diet.

As with babies, give your child more liquids and high-fiber foods. Stick with plain water or a mixture that's half water, half fruit juice (apple, pear, or prune). And give your child plenty of fruits, veggies, beans, and whole-grain cereals. (You can also ask your pediatrician about adding a small amount of malt extract, corn syrup, or flax oil to your child's food or drink.)

Teach your potty-trainee to listen and respond to his bowel signals.

To discourage the withholding of bowel movements, watch for signs that your child needs to go  -- some kids push against a wall, wiggle in their seats, or sit on their heels when the urge strikes. Gently guide your child to the bathroom or, if he isn't fully trained, put him in a diaper and reassure him that he'll feel better once he's finished. Little boys are particularly oblivious to their bathroom signals. Remind him that it's important to stop what he's doing and go to the bathroom whenever he feels the urge.

Go back to diapers.

If your child continues to withhold during potty training, consider putting him back in diapers. You can try again in a few months. (Go to our Potty Training guide for more information.)


When to see a doctor

Contact your doctor if your child's constipation is severe or is accompanied by stomach distention, poor appetite, or failure to gain weight.


Summary

Constipation is common in young kids, especially if they're transitioning from one type of diet to another, or from diapers to the potty. It's rarely a serious problem, but because constipation can lead to a cycle of painful stools and withholding, you'll want to treat it early. More fluids and fiber, and diet adjustments should do the trick. If potty training is to blame, try offering more reassurance to keep your child from holding back his bowel movement, or switch back to diapers until he's ready.


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