Toddler constipation can be a frustrating experience for both the toddler and parents, and chronic constipation could lead to other problems such as impacted stool, delayed potty training, or even damage to the large intestine.
If your toddler is experiencing constipation, you’ll want to discuss this with your healthcare provider (or pediatrician) as soon as possible, as it may take days, weeks, or even months for your toddler to return to a pattern of healthy bowel movements.
What is Constipation?
Constipation means that your toddler isn’t having enough bowel movements or that the stool has become too hard. While each toddler’s number of bowel movements may vary, toddlers should have a bowel movement every day or two, and generally no less than three bowel movements per week.
Signs and Symptoms of Constipation in a Toddler
A toddler is a child that is between 12-36 months of age. It is during this time that children are developing their primary teeth and eating new foods. Unfortunately, this transition from eating mostly breast milk (or formula) to a diet heavy in new, solid foods can lead to constipation problems in some toddlers.
If your toddler becomes constipated, you may notice some of the signs and symptoms below.
A Change in Stool Consistency and Amount
You’ll want to examine the consistency of your toddler’s stool. If your toddler is passing small, pebble-like stool, it could be a sign of constipation. In addition, lumpy and sausage-like stools with a clay consistency could also be a sign of constipation.
In some cases, constipation may even present as watery diarrhea or liquid smears of stool in the diaper/underwear. You may notice that your toddler keeps passing small amounts of this watery diarrhea several times per day, resulting in excessive diaper changes or even diaper rash.
This often occurs due to encopresis, which is when stool has become impacted in the large intestine, allowing only small amounts watery diarrhea to pass through.
Encopresis often confuses parents because it seems as though the child is having small amounts of diarrhea (and too many bowel movements), when in reality, the child may be unable to clear a large mass of stool due to constipation.
Constipated Toddlers May Avoid Bowel Movements or Express Discomfort
If your toddler is constipated, you may notice that they hold their “poop” in and refuse to have a bowel movement at all.
If they do attempt a bowel movement, you may notice the toddler squirming, crying, shaking, or shifting around on their tippy toes.
This occurs because the stool is too hard and/or bulky, leading to discomfort as the toddler attempts to pass it.
Constipation May Lead to Nausea or Vomiting
In severe or chronic constipation, your toddler may even feel nauseous and/or vomit, especially if the stool is impacted and the toddler cannot have a proper bowel movement.
Constipated Toddlers May Be Cranky or Lose Their Appetite
Constipation can also lead to a decreased appetite or increased crankiness or tantrums.
Distended Stomach and Palpable Mass
Toddlers often have that cute pot belly, which is a normal part of toddler development. However, constipation can lead to more dramatic abdominal distension than normal.
If you palpate the lower abdominopelvic region, you may notice hard masses of stool in the large intestine. This may feel like a lumpy mass that has a grainy/sandy consistency as you palpate it.
What Causes Constipation in Toddlers?
Many things can cause constipation in a toddler. Below are some of the most common causes.
- Holding in stool – As toddlers begin eating many solid foods, their stool will develop more bulk. Some toddlers will find the sensation of passing larger stool odd, and begin holding it in.
- Food allergies – Food allergies can also be a potential cause of constipation in toddlers. Common food allergens include dairy, wheat, corn, fish, eggs, nuts, or soybeans.
- Medications – if your toddler is on any type of medication, see if constipation is one of the known side effects.
- Dehydration – If your toddler isn’t consuming enough fluid, he or she could be dehydrated.
- Low Fiber Diet – If your toddler isn’t getting enough fiber, it could lead to constipation.
- Breastfeeding – Breast milk is extremely healthy for babies/toddlers, and the World Health Organization recommends breastfeeding for up to two years (or longer), if possible. However, a toddler could develop constipation issues if the mother is consuming any troublesome foods while breastfeeding (such as dairy).
In rare cases, a more serious G.I. issue could lead to constipation, which is why it’s important to work with your healthcare provider. For example, a toddler may have an intestinal tumor that prevents the passage of stool.
Toddler Constipation Relief & Remedies
If your child does experience constipation, especially chronic (long-lasting) constipation, it can take time find a solution, retrain the bowels, and regain a healthy bowel movement pattern. Don’t be discouraged if it takes days, weeks, or even months to get things back to normal.
Below are some common treatments, dietary changes, and home remedies that your pediatrician may recommend for your child’s constipation.
NOTE: Always consult with your healthcare provider before trying any treatment, supplement/medication, or dietary changes, to ensure that it will be safe and appropriate for your toddler.
Toddler Constipation: Foods to Avoid
Your pediatrician may recommend avoiding foods from the “BRAT” diet, which stands for bananas, rice, apples, and toast. These foods may lead to constipation in some toddlers because the BRAT diet is known to add bulk to the stool.
In addition, dairy is often a culprit, as are highly processed foods such as French fries, fast food, snacks, etc.
Foods to Eat: Toddler Constipation
Your healthcare provider may recommend that your toddler include more foods that are high in sorbitol, which helps draw water into the colon, and fiber, which helps stool maintain a proper consistency.
Foods such as cooked broccoli, spinach, strawberries, peaches, avocado, oatmeal, or prune juice may be suggested as a way to keep your toddler’s stool soft and moving, assuming they can safely tolerate and chew those foods.
Keep Your Toddler Hydrated
It’s important to keep your toddler hydrated. A great way to do this is to fill up a sippy cup and encourage your toddler to take sips throughout the day and during meals.
Toddlers should generally have no less than 2 cups of water per day.
Probiotics for Constipation Issues
Your pediatrician may advise you to try a probiotic supplement for your toddler, such as Culturelle for Kids. Probiotics are “healthy bacteria or yeast” that could help keep your toddler’s digestive system healthy.
Laxatives May Help Constipation
Your pediatrician may recommend a laxative, such as MiraLAX. However, it is important to discuss this with your doctor, as they can advise a proper dosage based on your child’s age and weight.
Liquid Suppositories
If your child has severe constipation and hasn’t passed stools for many days, your doctor may recommend a liquid suppository such as Pedia-Lax to initiate a bowel movement. Many over-the-counter liquid suppositories require that your toddler be at least two years of age. Consult with your pediatrician on proper use and age requirements.
Constipation Relief and Recovery: What’s the Goal?
When your child is constipated, the goal is to get the child back into a pattern of healthy bowel movements.
Generally speaking, the toddler should be passing stool every day or two (more than three times per week). Stool should be an appropriate amount (more than just a pebble or diarrhea-like smear), and it should have the consistency of soft-serve ice cream.
Alleviating constipation issues is often a journey, not an event. The parents or caretakers must be diligent in helping the toddler through this tough period.
The key is to remain diligent and to consult with your pediatrician early on so that you can implement the best treatment options for your growing toddler.