Constipation in Kids: Causes, Types & 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). Bananas are fine in moderation but may cause issues for some. The main cause of difficult bowel movements varies by person but not enough fiber-rich fruits and vegetables or fluid in your child's diet causes constipation most frequently.

What foods help with constipation?  

A diet full of fresh fruits and vegetables and high-fiber foods helps support healthy bowel movements. GI Kids¹ 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, fruit, oat products can help soften stool
• High-fiber foods such as whole grains and vegetables 

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 (per GI Kids, 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. 

Many people do not poop every day but stooling two times per week or less in toddlers and older children is considered abnormal. 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.²

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.³ 

Can constipation lead to bigger problems with overall health? When should I seek help from my doctor? 

Long-term constipation may lead to soiling or encopresis, stool impaction and abdominal pain. In some extreme cases, symptoms of constipation get in the way of normal growth and nutrition. Contact a doctor if you see any worrisome signs, including constipation starting shortly after birth or in the first month of life, a large distended abdomen, severe pain, difficulty eating or growing, vomiting and abnormal appearance of the anus or lower back/buttocks.² 

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Sources: 

1. GIKids.org, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition 
2. Hyams JS, et al. Gastroenterology, 2016;150:1456-1468 
3. Williams KC, et al. J Pediatr, 2018;195:148-153.e1.  

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