Toddler constipation is a fact of life; that is, most infants and toddlers experience the condition not just once but in most cases on a number of different occasions. Chronic constipation or a severe case of constipation could signify in some cases a problem requiring medical attention, but such situations are not very common. Most bouts of constipation are brought on by the toddlers themselves, which means there isn’t always a great deal one is able to do to completely avoid the problem.
There are of course some things that can be done to avoid constipation before having to resort to laxatives, castor oil, enemas, or any of those things that can sometimes make the ‘terrible twos’ even more of a challenge to deal with. Giving a toddler a daily dose of castor oil was at one time part of the daily household routine, but the practice had fallen out of favor, at least in the eyes of the medical community. Castor oil is a powerful laxative, but if taken too often, it can actually damage the bowel muscles and nerves since its presence in the digestive system makes it more difficult for the body to absorb a number of important nutrients.
Since the use of castor oil to prevent toddler constipation has somewhat become a thing of the past, the next best approach is to make sure a child’s diet is a healthy one. The problem with that is a toddler doesn’t have the slightest idea of what is meant by a healthy diet, one that contains sufficient fiber and plenty of liquids that will aid the movement of stools through the colon. To a toddler, a healthy diet and a diet consisting of food that tastes good are the same thing. To a toddler, when it comes to eating what tastes best, more is often better, an exception being those finicky eaters who believe otherwise. The bottom line is that if you let your child choose what to eat and what to not eat, you better keep a supply of laxatives on hand.
Anything that affects the consistency of the stools can bring about bouts of constipation. Processed foods are quite often a cause, but any change in the diet that your child is faced with can result in constipation as well. Babies sometimes become constipated with switching from mother’s milk to cow’s milk or formula, and a toddler will at times experience changes in his or her diet that, while well meaning, can sometimes cause constipation.
What Having Less than Daily Bowel Movements Might Indicate
Most toddlers have one bowel movement a day and the timing of that bowel movement can sometimes be more or less like clockwork. This is not true of infants of course, who can go sometimes through several changes of diapers during their waking hours, but once out of the diaper stage or over one year old, most toddlers will settle into a fairly predictable routine. While one bowel movement a day is usually considered the norm, not all toddlers subscribe to that norm. Some will have only two or three bowel movements a week, which by the way is still perfectly normal and is nothing to worry about. Other toddlers will more or less stick to a particular schedule, but not necessarily like clockwork. For some children, it can be easier to tell if constipation is becoming a problem than with others since the most common sign of constipation is the lack of a bowel movement over a period of time during which you would expect several to have occurred. It is therefore not so much the usual bowel movement pattern the child has that should be a cause for concern but rather a significant departure from that usual pattern.
Leading Causes of Constipation in Toddlers
1) Lack of fiber in the diet – A lack of fiber in a toddler’s diet isn’t so much a cause of constipation. What this lack of fiber can tend to do however is to increase the risk of constipation from occurring. There are other things besides fiber that can help keep stools from becoming hard and clogging up the plumbing, although fiber and water are the two main elements that keep stools firm but relatively soft. If the child is getting plenty of fiber and still experiences bouts of constipation, it could be something other than his or her diet that’s at the root of the problem. If the constipation appears to be chronic, it is always advisable to see a pediatrician or a doctor.
2) Dairy products can cause constipation – Some infants experience constipation for the first time when they make the switch from mother’s milk to cow’s milk. Most of the time this is a temporary thing, but if an infant or a toddler has lactose intolerance, foods such as milk and ice cream can often cause constipation. Most young people can drink milk or eat dairy products in small amounts even if they have lactose intolerance, but some cannot.
3) Eating indigestible foods – Toddlers are not as quite bad as dogs when it comes to eating foods that are indigestible. Little ones do sometimes eat indigestible items however or foods that are essentially healthy but are not always that easy to digest, and eating either of these can sometimes cause constipation. In this case, it is not necessarily just stools that are blocking the intestines, but if what has been eaten has only been partially digested or not been digested at all, once it has moved into the intestines, it is apt to get stuck. Gum is a prime example of this although not too many toddlers chew gum.
4) Lifestyle changes – Lifestyle changes can frequently cause constipation in adults. As far as toddlers are concerned, they are usually not thought of as part of the population that experiences lifestyle changes, which for most adults would mean a vacation, a new job, or a trek into the wilderness – things that can sometimes upset the digestive system. Toddlers can however become constipated if their daily routine is significantly altered, whether that change is for the better or for the worse. Toddlers, like adults, have their comfort zones, and they don’t always like to be taken too far beyond those comfort zones.
5) Holding it – Just as is the case with parents and other adults, any toddler can at times just be too busy doing important things to visit the toilet. Eventually, the pressure will become too great and the urge to go will become too strong to ignore. One would assume that the intestinal tract is somewhat self-regulating in that respect and the urge to go will steadily increase until it has been emptied. What will sometimes happen however is that a child may get into the habit of holding it. This can cause the signals that say it’s time to go to become weaker over time. If the habit of holding it persists and the urge is not as strong, the result is apt to be constipation, or even chronic constipation in some instances.
6) Underlying diseases – Constipation in toddlers and infants is rarely caused by an underlying disease. If constipation appears to be chronic, there is of course always a possibility that some type of disease is involved. However, almost all instances of toddler constipation are idiopathic; that is, the cause is unknown, which, in the case of constipation, usually means a disease is not the cause. Diseases that are common causes of constipation, such as hypothyroidism, cystic fibrosis, and various neurological conditions, are not very common in infants and toddlers. If a child is ill and is on medication, there is however always a possibility that the medication could either be the source of the problem or be acting as a contributor.
Treating Constipation in Toddlers with Laxatives Is Most Effective
The most common form of treatment used, when treatment is needed, is the use of laxatives. At first glance, this may seem to be a poor choice, but it must be remembered that there are both strong or harsh laxatives and mild laxatives. Your doctor or pediatrician would be able to tell you which strength would be appropriate given the child’s situation. There are a number of laxatives on the market that are especially designed for children’s use. It’s still advisable to get medical advice before using any of these over-the-counter laxatives although they are for the most part quite safe. Ironically, one of the mistakes parents make when giving their children laxatives is not giving them large enough dosages. Another mistake they often make is stopping to give their children laxatives too early. It’s very usual that children require a laxative or stool softener every day for a week or two, and sometimes even longer.
When laxative treatment is stopped too soon, the problem can easily return. One of the reasons for this is impaction. Impaction occurs when a number of hard stools block the rectum. This blockage can create a good deal of pressure on the walls of the rectum, causing them to expand. Once the impaction has been removed, it takes some time for the walls of the rectum, which may have become weakened, to return to their normal shape and strength. It’s important that the stools be kept soft until this is allowed to happen by continuing to give the child a laxative, or impaction is likely to occur again.
Changing the Toddler’s Diet Is Less Effective
Changing a toddler’s diet to cure constipation is not likely to be very successful if for no other reason any improvement a change in his or her diet might bring about would normally take too much time to be effective. Dietary changes can however be quite effective when it comes to taking steps to prevent constipation from occurring in the first place. Changing a toddler’s diet for this reason is often easier said than done if the child is a finicky eater, as many children are. If the purpose of the dietary change is that of providing the child with more fiber, the best chances for success would be to give the child a cereal he or she likes that is rich in fiber and/or to increase the amount of fresh fruit in the diet. Raisins can be particularly effective in preventing constipation and can always be given as an occasional treat.
The bad thing about toddler constipation is that it is often a fact of life. The good thing is that it rarely represents anything serious. It is usually a condition that is easily treatable although the treatment will often require some patience on the part of both the parent and the toddler.