Constipation in children

Constipation in children

Constipation in children can be very painful for the child, and as a parent you can become very distressed. However, there is a lot of good advice and tips that can be tried.

What is constipation?

Children who are fully breastfed do not normally get constipated. Constipation occurs more frequently if the child receives formula or solid food. Constipation in children occurs most often in those between 2 and 4 years of age.

If your child has stools less often than normal, the stools are hard and the child seems bothered by them, it could be constipation. Taking the child's normal stool pattern as a starting point when assessing whether your child has constipation may be appropriate.

In order for the large intestine to function and pass faeces towards the rectum, there must be a certain volume inside the large intestine. Constipation can therefore come from there being too little volume in the bowels or too little liquid in the bowels to keep the stool soft.

Good tips when children have constipation

• Find possible causes: The most important thing is to think through what the cause of the constipation could be. It may be a good idea to talk to the child, if the child is old enough to understand. Some children forget to go to the bathroom when they are busy playing and having fun. One idea could then be to make toilet habits a fixed routine. Children can, for example, be trained to go to the toilet after dinner. The intestine will eventually regulate itself according to the dot time and digestion will start.

• Diet: Diet in children is important to prevent constipation. Drinking enough water and eating a varied diet with lots of fiber is good for avoiding constipation. Certain foods, such as sour milk or yoghurt (Biola), bran, linseed, prunes and malt extract, speed up digestion. Other foods, on the other hand, can have a stopping effect. Examples of such foods are bananas, sweet milk, puff pastry, cakes and biscuits.

Treatment of constipation in children

If the stool becomes hard or if more than 2 days pass between each stool in infants receiving breast milk formula, measures should be taken to prevent constipation in children.

• Malt extract contains a hard-to-digest sugar (maltose), which can soften the stool. 1 teaspoon of malt extract 2-3 times a day (can be mixed in the milk) can be tried.

• Lactulose causes the volume in the large intestine to increase and the stool to become softer. It takes a couple of days for lactulose to work, but it is effective and safe to use, even over a long period of time. Lactulose can be given from infancy.

• Mini enemas can be tried if the constipation is painful or has lasted for several days. The enema works quickly and produces a bowel movement within 5-15 minutes. For children under 3 years of age, only half the enema tip should be inserted. Enemas should not be used regularly, only in individual cases.

Causes of constipation in children

In most cases of constipation in children, the cause of constipation is not known. But there are a number of factors that can increase the risk of constipation:

• If the child does not want to go to the toilet (for example at school).

• The child may forget to go to the bathroom.

• Transition from nappy to potty or toilet.

• Children who receive formula can become constipated more easily than children who receive breast milk.

• Little physical activity.

• Stress, travel and practical difficulties with going to the toilet (for example outdoor toilets).

• New eating habits.

• Low fiber diet.

• If the child drinks too little.

Signs of constipation in children

• Pain and discomfort in connection with defecation.

• Stomach pinch.

• Small, dry and hard stools.

• Rare stools compared to the norm for your child.

• Stool pattern

Here are some examples of stool patterns in children.

Infants who receive only breast milk may have stools several times a day or only once a week, both are equally normal.

• Infants receiving formula often have daily bowel movements. Infant formula is somewhat heavier and digestible than breast milk and can lead to constipation.

• Transitioning from breast milk to solid food affects the stools, which become firmer, it is just as common to have stools often as to have them rarely. The transition from breast milk to solid food can lead to constipation.

• When children eat a normal diet, it is common to pass stool several times a week.

Chronic constipation in children

Chronic constipation in children is very common and usually completely harmless. If the symptoms are long-lasting, it is nevertheless important to see a doctor to get help and overcome the symptoms, as well as to be able to rule out any other causes of the chronic constipation.

In collaboration with a doctor, a course of treatment will be drawn up for the child, with the aim of achieving sustained good treatment without relapse. This process can take some time, so it is important to have good motivation and patience.

When should you contact a doctor for constipation in children?

• If the child is under six months and you think they may be constipated.

• If the constipation does not get any better with self-treatment, or the child quickly becomes constipated again when you stop self-treatment.

• If the child seems ill in addition to the constipation.

• If you see blood or mucus in the stool.

• If the child does not put on weight normally or loses weight for no known reason.

• In case of chronic constipation in the child.

Sources: Norwegian electronic medical handbook, Norwegian health informatics for healthcare personnel, Norwegian Apotekforeningen and Helsenorge.no.