Constipation in Kids: Causes, Symptoms & Treatment

Medically reviewed by Peter T. Osgood, MD, and Emily Santolin, APRN-NP, CPNP-PC, who lead iPoop, Lurie Children's Constipation Management Program.

Difficult or irregular bowel movements are very common during childhood. Luckily, most cases of constipation in kids are temporary and there are many diet and lifestyle changes that can help alleviate symptoms. Our pediatric experts answer some of the most frequently asked questions about constipation in kids, including causes, symptoms and more.

What foods cause constipation? 

There are many foods that can cause constipation, such as greasy or processed foods or excessive dairy intake (24 ounces or more daily). The most common culprit, however, is a diet too low in fiber-rich fruits and vegetables and fluids. Bananas are sometimes blamed too, but they're generally fine in moderation and only cause issues for some kids.

What foods help with constipation?  

A diet full of fresh fruits and vegetables and high-fiber foods helps support healthy bowel movements. GI Kids recommends adding your child's age plus five grams of fiber to calculate the minimum daily fiber need. In addition, here are some foods that help alleviate constipation.

• Fruits with sorbitol, which are considered natural laxatives, such as apples, pears, apricots, and plums
• High-fiber foods such as beans, oats, whole grains, and vegetables, which help soften stool

Does water help relieve constipation in kids?

Yes! Water is absorbed in the large bowel, so kids who don’t drink enough water may have hard, bulky, or painful stools. Here are the daily fluid recommendations (note: 1 cup = 8 ounces) for children:

• 1-3 years old: 45-50 ounces a day 
• 4-8 years old: 55-60 ounces a day
• 9-13 years old: 80-85 ounces a day for males, 70-75 ounces a day for females
• 14 years old and older: 100-110 ounces a day for males, 75-80 ounces a day for females

How often should my baby, toddler, child or teen have bowel movements? 

Breastfed babies have a wide range of stooling habits; they may stool multiple times per day or may stool once every 7 days. Most older children will stool 1-4 times per day and more than 90% of children go at least every other day. 

Not pooping every day isn't necessarily abnormal, but in toddlers and older children, bowel movements only two times a week or less is considered a warning sign. Further, signs of abnormal poops or constipation include large or painful stools, blood on the stool or toilet paper, feelings of not being “empty” after a bowel movement, withholding stools, clogging the toilet, or fecal incontinence in a child who is otherwise potty trained.

How can you encourage a child to poop if they are withholding? 

Discourage obvious stool retention behaviors, like squeezing legs together, crossing legs or clenching buttocks, and encourage your child to sit or squat comfortably to help relax the pelvis. For those with toilet aversion, doing pleasurable activities (reading, listening to music, etc.) is acceptable to help overcome the fear of sitting on the toilet. Make sure that the child’s stools are soft (either by diet or laxatives), so that they learn that stooling isn’t painful. 

Are over-the-counter stool softeners safe for kids? 

Depending on your child’s age, over-the-counter laxatives, like polyethylene glycol (Miralax) and senna or sennosides (ExLax), are very safe. In many cases, your pediatrician or gastroenterologists may advise the use of laxatives for a prolonged period of time to help a child learn to poop normally. No convincing evidence has yet been found to suggest that standard laxatives are unsafe. Laxatives should not interfere with most other medications nor impact a child’s mood, behavior or development. 

Is constipation ever a medical emergency?

Most constipation can be managed with diet changes or a call to your pediatrician, but a few signs mean you should seek emergency care right away. Go to the ER or call 911 if your child has:

• Severe, unrelenting abdominal pain
• A swollen, hard, or rigid belly
• Repeated vomiting, especially if it's green or bloody
• Inability to pass gas or stool at all
• Fever along with abdominal pain

Long-term constipation may lead to soiling or encopresis, stool impaction and abdominal pain. In some extreme cases, symptoms get in the way of normal growth and nutrition. Less urgent symptoms — like occasional hard stools, mild discomfort or infrequent bowel movements without other red flags — are still worth a visit to your pediatrician rather than waiting it out, since catching constipation early helps prevent it from becoming a bigger problem. 

Concerned about your child's symptoms? Book an appointment with a pediatric GI specialist.

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