What can I do if my child has constipation?

My son opens his bowel once every 3 days, the stools are hard and dry, is it constipation? Why is that so?

Constipation means the frequency of bowel openings is less than usual with dry and hard stool, the common reasons are:

  1. Imbalanced diet
    • That means not enough fiber or too much protein intake, for example, eating too much meat or drinking too much milk will increase the chance of constipation.
    • Not drinking enough water is another common cause
  2. Lack of physical activities
  3. Lack of regular bowel habit

Why are the stools dry and hard?

When the child has the sensation of bowel opening, if he holds back, the sensation will disappear quickly. If the chance of bowel opening is missed, the stool will stay in the bowel longer. The water in the stool will be absorbed more and the stool will become drier and harder. When the dry and hard stool passes through the anus, it will tear apart the anal tissue which causes pain. To avoid the pain, the child will suppress the need to open the bowel further, causing a vicious cycle and making the problem of constipation more difficult to deal with.

How can I prevent my child from having constipation?

In order to improve the consistency of your child’s stool and stop the vicious cycle, you can try the followings:

  1. Help your child to develop a healthy, balanced diet
    • Have half to one bowl of vegetables and half to one middle-sized fruit each day. Try to eat more foods with high fiber content such as potatoes, yams, oats, beans, sesame seeds, apples, bananas and strawberries.
    • Do not eat too many foods that are rich in fat and protein. Two to four tablespoons of meat, fish or egg a day is enough. Your child do not need too much milk at this stage, 360ml of milk a day will provide him with sufficient calcium for growth.
    • Let your child drink more water. It helps the bowel movements, makes the stool softer and easier to pass out. Encourage your child to drink water in between 2 meals, increase the amount of water intake during hot weather and after physical activities.
  2. Increase physical activities will improve the bowel movements and help in bowel openings.
  3. Let your child learn to have regular bowel habit is very important. You can observe your child’s usual bowel habit and take him to the toilet regularly. Usually, it is easier to have bowel openings when waking up early in the morning or after mealtimes. Toilet training cannot be hurried. Starting too early or inappropriate training may make your child nervous and resist toilet training. If you want to know more, you can listen to “When can my child give up nappies?”.

I have tried the methods you mentioned, but the condition does not improve. What can I do?

If the condition does not improve, or there is anal tear, blood in stools or abdominal distension, you need to consult a doctor.

Please remember not to use laxatives or enemas without a doctor’s prescription as this may result in undesirable consequences.