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Constipation in Toddlers: What to Do and When to Worry
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  • Constipation in children is a common problem, according to Mayo Clinic. “Fortunately, most cases of constipation in children are temporary.” Here’s what you should know if you think your child is constipated and when to worry:

    What’s normal 
    “Normally, children older than one pass stools one to two times a day, and majority will go every other day,” Dr. Karen Calixto-Mercado, a specialist in pediatric gastroenterology, hepatology, and nutrition, told Smartparenting.com.ph. “Normal bowel movement frequency differs from child to child. But more important than the frequency is the quality of the stool. If it is long, soft, and adequate in amount, then you know the child is regular.”  

    Signs of constipation
    The opposite can be said about children who are constipated. “One suspects a child to be constipated when bowel movements are less frequent than usual or when stools are either painful or too hard to pass. Stools appear hard, lumpy, and are bigger in caliber than usual or may be small, hard pellets,” said Dr. Calixto-Mercado. 

    Two days longer than usual can already be a sign of constipation, added Dr. Cricket Chen, a pediatrician who specializes in natural medicine. Plus, if you find traces of stool in your child's underwear, this can also be a sign that stool is backed up in your child's rectum, according to Mayo Clinic.

    What other parents are reading

    Causes of constipation in children
    1. Your child isn't getting enough water and fiber in his diet
    These two help bowels move properly, according to KidsHealth, the parenting health resource site of the Nemours Foundation. “Eating a healthier diet with high-fiber foods like fruits, vegetables, and whole grains can keep stool from getting hard and dry.”

    2. Your child ignores or resists the urge to poo
    It can be difficult, and even painful, to poo when stools are hard and large, which is why some children who are already constipated resist the urge to go to the toilet to avoid repeating the distressing experience.  This is a problem as holding a stool in can make it even more difficult to pass. 

    “It is the job of the colon to absorb water, and if the stool that is meant to come out is retained for whatever reason, the colon absorbs more water from the stool, heralding their child’s constipation problem,” explained Dr. Chen. 

    Sometimes, children also withhold their stools because they are uncomfortable with using public toilets, are shy to tell an adult that they need to go to the bathroom, or do not want to be interrupted from play. Potty training too early can also cause a child to resist the urge to poo. 

    3. Stress caused by changes
    “Kids can get constipated when they're anxious about something, like starting at a new school or problems at home,” said KidsHealth. 

    4. Too much formula milk or cow’s milk

    “There’s only a certain volume of milk our gut can take. Going above that means not giving the digestive tract the chance to digest,” says Dr. Chen. “Milk cannot replace food. Protein in milk is very different from food. It can settle, ferment, and bubble inside.”

    What other parents are reading

    What to do
    1. Add more fiber and fluids to your child’s daily meals
    Make sure your child is getting enough water in a day. To meet his daily fluid intake, aim for a 120 to 150 ml serving of fluid per meal for your toddler, as per advice from the British Nutrition Foundation. 

    A diet full of fatty, sugary, or starchy foods can slow the bowels down. Counter this with fiber-rich foods which include fruits like apples, pears and oranges, beans, oatmeal, whole-grain bread, and popcorn. “When adding more fiber to your child's diet, do so slowly over a few weeks and make sure your child also drinks more fluids,” said KidsHealth

    2. Get your child moving

    Exercise and physical activity help the digestive system move along. Instead of screens and gadgets, let your toddler dance to music or play catch with you. 

    3. Create a toilet routine

    If your child intentionally avoids going to the bathroom, creating a routine might help. “Have your child sit on the toilet for 10 minutes after a meal on a daily basis, advised Dr. Calixto-Mercado. “Their feet should not be hanging and must be planted firmly on a footstool so they can bear down and are positioned well. Giving children some unhurried toilet time after a meal allows them to heed this reflex to defecate.” 

    4. Don’t pressure
    “Parents and yayas should be supportive and encouraging especially when a child is in pain or afraid of the anticipated discomfort,” said Dr. Calixto-Mercado. Getting frustrated at your child's toilet mistakes will only make it more difficult for her. “They feel so bad, they hold it in,” said Dr. Chen. “Allow the child to loosen up, laugh, have fun.” 

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    When to worry
    “If your toddler has been experiencing hard stools and difficulty for two weeks and you’re not making progress, it’s time to consult a doctor,” says Dr. Calixto-Mercado.  

    According to Mayo Clinic, signs your child needs to see a doctor immediately include: 

    • Fever
    • Vomiting
    • Blood in the stool
    • Poor appetite and weight loss
    • Abdominal swelling (unusually big tummy)
    • Painful tears in the skin around the anus (anal fissures)
    • Intestinal protrusion out of the anus (rectal prolapse)  

    For any concerns about your child’s health, always consult a medical professional. 

    What other parents are reading

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