Constipation in Infants and Children
Constipation is a common problem in children of all ages, but children with disabilities are at greater risk of having constipation. A child with constipation may have bowel movements less frequently than normal, hard bowel movements, or large, difficult and painful bowel movements. There is normal variation in how often children have bowel movements.
Babies tend to have more frequent bowel movements than older children. Some babies will have a bowel movement after each feed. However, it is also true that some typical babies might have bowel movements once or twice a week. Babies on certain formulas will have more formed stool while on breast milk or other formulas, babies have normal loose bowel movements. Your baby also may normally strain and get red in the face when having a bowel movement because they have not yet learned to coordinate the muscles to have a bowel movement. However, if your baby is having hard bowel movements or persistently straining with pain when attempting to have a bowel movement, talk to your baby’s health care provider about constipation.
In older children, frequency of bowel movements also varies. However if your child is having hard or painful to pass bowel movements, bleeding with bowel movements, frequent streaking of bowel in their underwear or very large bowel movements then you should discuss the possibility of constipation with your child’s health care provider.
Some toddlers and older children may develop a condition called “encopresis.” This means they are so constipated for so long that they now are having difficulty feeling and controlling their bowel movements. This results in frequent accidents and/or leakage of small amounts of stool into the underwear throughout the day. This stool can even be liquid (making the family confused to think the child has diarrhea) because the liquid stool is flowing around the child’s impaction. Evaluation and intervention is critical because this situation rarely resolves on its own.
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North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN)