Toddler Constipation

What is toddler constipation?

Constipation in toddlers is very common. Toddlers who are constipated poop (have a bowel movement) less frequently than usual. Every toddler is different, but this usually means they poop less than two times a week. When they do go, their poop (stool) is hard, dry and large in size. Their poop may be difficult or painful to pass.

Toddler constipation usually doesn’t last long. It’s typically not something to worry about. Only rarely, is it a symptom of an underlying health condition.

Who does toddler constipation affect?

Up to 20% of toddlers will experience constipation at any given time. Constipation is more common in toddlers:

• Assigned male at birth (AMAB).
• With developmental delays or behavioral issues.
• Diagnosed with health conditions affecting their anus or rectum.
• Going through toilet training.

How do I know if my toddler has constipation?

Your toddler may not be able to tell you they’re constipated. Look for symptoms of constipation in your toddler, including:

• Pooping less than two times a week.
• Hard, dry or lumpy stools that are large, painful or difficult to pass.
• Unusual postures and movements, such as standing on their tiptoes or dancing. This can be a sign they’re avoiding or delaying pooping.
• Cramping, swelling or bloating in their belly (abdomen).
• Nausea.
• Bloody stools.
• Poop in their underwear that looks like diarrhea.

What causes constipation in toddlers?

Toddlers often become constipated because they hold in their stool. As a result, their colon absorbs too much fluid and their poop becomes dry and hard to pass. Toddlers may hold in their stool because they:

• Don’t want to stop whatever activity they’re doing, such as playing.
• Are embarrassed to use a public bathroom.
• Are worried pooping will be painful.
• Are nervous about learning to use the bathroom.
• Aren’t ready developmentally for toilet training.

Other causes of constipation in toddlers include:

• A low-fiber diet.
• Not getting enough fluids.
• Certain medications.
• Disorders such as Hirschsprung disease or celiac disease.
• Birth defects such as spina bifida.
• Health conditions that affect their metabolism such as diabetes.
• Medical conditions that affect their hormones such as hypothyroidism.
• Illnesses that cause a loss of appetite.
• Stress caused by school or by changes in routine, weather or travel.

How is toddler constipation diagnosed?

To diagnose constipation, your child’s healthcare provider will ask about your child’s symptoms and medical history and perform a physical examination. They’ll ask you about your child’s:

• Bathroom and bowel movement patterns.
• Diet and eating habits.
• Toilet training.
• Health problems (if any).
• Medications (if any).

During the physical exam, your child’s healthcare provider will check your child’s belly. They’ll want to see if it’s swollen, tender or has any masses or lumps. They may also examine your child’s rectum to look for blood or a blockage.

What tests will be done to diagnose constipation?

Your child probably won’t need any tests to diagnose their condition. Your child’s healthcare provider may order tests if their constipation is caused by an underlying health condition. Tests they may order include:

• Abdominal X-ray: An X-ray can show stool that’s still in your child’s colon.
• Blood test: Blood tests, such as a complete blood count, can show signs of certain diseases.
• Stool test: A stool test can show signs of infection or blood in your child’s stool.
• Urine test: A urine test can show signs of bladder inflammation or infection.
• Bowel function test: This test can show how well stool moves through your child’s colon.
• Rectal biopsy: A small piece of tissue from your child’s rectum will be examined under a microscope.

What complications can occur due to constipation in toddlers?

Constipation in toddlers usually doesn’t last for long. But avoiding pooping can lead to:

• Fecal impaction: Hard stool packs your child’s intestine and rectum too tightly for them to push out.
• Encopresis: The inability to regulate the passage of stool, which leads to accidents.
• Anal fissures: Small tears in your child’s anus that cause bleeding, itching or pain.
• Rectal prolapse: Your child’s rectum sticks out of their anus.
• Hemorrhoids: Swollen veins inside of your child’s rectum or outside of their anus.

How is toddler constipation treated?

If your toddler is constipated, you can often help them with home remedies. Home treatments for relief from constipation may include:

• Diet changes: Your child should eat plenty of fruits and vegetables to get extra fiber.
• Hydration: Give your toddler lots of water. Ask their healthcare provider about giving them fruit juices.
• Routine: Encourage your child to use the bathroom regularly, especially after eating. You may want to try a reward system.
• Pause toilet training: You may want to hold off on toilet training until your child’s constipation goes away.

What foods should my toddler avoid if they’re constipated?

Toddlers who are constipated should avoid eating foods with little or no fiber, such as:

• Ice cream.
• Bananas.
• Applesauce.
• Rice.
• Fast food.
• Chips.
• Cheese.
• Prepared foods.
• Processed foods.
• Excessive amounts of whole milk.

What medications can I use to treat my child’s constipation?

Check with your child’s healthcare provider before giving your child any medicines to help with constipation. Under their direction, they may advise the use of:

• Probiotics.
• Fiber supplements.
• Electrolyte solutions.
• Stool softeners.
• Laxatives.
• Glycerin suppositories.
• Enemas.

How can I prevent constipation in my toddler?

The following measures may help prevent constipation in your toddler:

• Diet: Make sure your child is getting enough fiber in their diet. This includes eating plenty of fruits and vegetables. Ask their healthcare provider about switching to lower-fat dairy products.
• Hydration: Encourage your child to drink plenty of water. Ask their healthcare provider about adding other liquids, including juice.
• Routine: Schedule a regular toilet routine.
• Physical activity: Get them moving with regular exercise and playtime.

What is the prognosis (outlook) for toddler constipation?

Constipation is usually temporary and treatable. With the proper diet and fluid intake, your child can have more regular bowel movements.

If it’s not treated, constipation can become worse. If your toddler’s poop stays inside of their colon, it keeps getting larger, firmer and drier. This makes it more painful to pass, and your child will be more likely to hold back their poop.

When should I take my child to their healthcare provider for treatment of constipation?

Take your child to their healthcare provider if their constipation lasts for more than two weeks and home remedies aren’t helping. Your child may need additional treatment.

When is toddler constipation an emergency?

If your toddler has a fever along with constipation, contact their healthcare provider right away. Also, call their provider if they have any of the following symptoms:

• Vomiting.
• Rectal bleeding.
• Blood in their stool.
• Swollen belly (abdomen).
• Constant abdominal pain.
• Weight loss.

A note from Cleveland Clinic

It can be hard to watch your toddler deal with constipation. But thankfully, constipation is usually temporary. With some changes to their diet and routine, your toddler should be passing poops smoothly in no time. But if home remedies don’t help, call your child’s healthcare provider. If constipation lasts longer than two weeks, your child may need additional treatment.