- Inadequate Hydration – Aside from losing fluids by using the bathroom, most children are very active and sweat quite a bit. These “insensible losses” force the colon to draw out more water from digested food leading to incredibly hard poops! Keeping them hydrated especially on warm days is important! Beginning in toddler-hood, kids should be getting about 1 liter a day minimum.
- Stool Holding – Kids are some busy people! They are engaged in school, after-school activities, playing with friends, video games etc. Making the time for them to sit on the toilet is important. Toilets at schools are gross. “Toilet Time” at home is particularly important in toddlers and young children learning to develop healthy stooling habits. The colon is naturally squeezing 20-30 minutes after breakfast and dinner making these good times to encourage sitting.
- Diet – Getting the right proportions of food can be challenging in early childhood. Kids are picky – and lets be honest, most parents don’t have time to plan an elaborate meal. The key to a balanced diet is allowing for adequate fiber in the form of whole grains, fruits or vegetables at least 5-9 servings per day (a serving is the size of your child’s fist). You can also calculate how many grams of fiber your child is getting a day. For children >2 years old, the goal is: Age + 5 = Grams of Fiber Per Day. See my list of fiber rich foods here.
- Milk-Protein Allergy and Other Food Allergies – Food protein intolerances (different from classic anaphylactic allergy) often result in abdominal pain, occasional nausea/vomiting and diarrhea. The constipation is secondary to the limited variety of foods available to those children suffering from allergies. Using food diaries and coming up with a comprehensive nutrition plan with your pediatrician or pediatric gastroenterologist is important to prevent vitamin deficiencies and constipation.
These area some less common but more insidious causes of constipation and cannot be missed! They include: celiac disease, IBS, thyroid disease, medication-related constipation, and anal fissures. If you worry that there may be an underlying reason for your child’s constipation that isn’t listed above, we are here to help!