Constipation in infants and children
Constipation in infants and children occurs when they have hard stools or have problems passing stools. A child may have pain while passing stools or may be unable to have a bowel movement after straining or pushing.
Irregularity of bowels; Lack of regular bowel movements
Constipation is common in children. However, normal bowel movements are different for each child.
In the first month, infants tend to have bowel movements about once a day. After that, babies can go a few days or even a week between bowel movements. It's also difficult to pass stools because their abdominal muscles are weak. So babies tend to strain, cry, and get red in the face when they have a bowel movement. This does not mean they are constipated. If bowel movements are soft, then there is likely no problem.
Signs of constipation in infants and children may include:
Make sure your infant or child has a problem before treating constipation:
Constipation occurs when the stool remains in the colon for too long. Too much water gets absorbed by the colon, leaving hard, dry stools.
Constipation may be caused by:
Medical causes of constipation may include:
Children may ignore the urge to have a bowel movement because:
Lifestyle changes can help your child avoid constipation. These changes can also be used to treat it.
Stool softeners (such as those containing docusate sodium) may help for older children. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives may help your child have regular bowel movements. Electrolyte solutions like Miralax can also be effective.
Some children may need enemas or prescription laxatives. These methods should be used only if fiber, fluids, and stool softeners do not provide enough relief.
Do NOT give laxatives or enemas to children without first asking your provider.
When to Contact a Medical Professional
Call your child's provider right away if:
Also call your child's provider if:
What to Expect at Your Office Visit
Your child's provider will perform a physical exam. This may include a rectal exam.
The provider may ask you questions about your child's diet, symptoms, and bowel habits.
The following tests may help find the cause of constipation:
Kwan KY. Abdominal pain. In: Olympia RP, O'Neill RM, Silvis ML, eds. Urgent Care Medicine Secrets. Philadelphia, PA: Elsevier; 2018:chap 19.
National Institute of Diabetes and Digestive and Kidney Diseases. Constipation in children. www.niddk.nih.gov/health-information/digestive-diseases/constipation-children. Updated May 2018. Accessed August 19, 2018.
Nurko S, Zimmerman LA. Evaluation and treatment of constipation in children and adolescents. Am Fam Physician. 2014;90(2):82-90 PMID: 25077577 www.ncbi.nlm.nih.gov/pubmed/25077577.
Sreedharan R, Liacouras CA. Major symptoms and signs of digestive tract disorders. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 306.
Review Date: 8/5/2018
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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