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When you’re a mum, you go through a lot of highs and lows with your children. A particular low is seeing them in pain and not being able to take it away. One of those very causes is constipation. Having a child go through severe constipation is absolute agony. Speaking from experience, my eldest (2 years old) has unfortunately suffered from constipation nearly her whole life. Some weeks, she is absolutely fine, has no symptoms whatsoever, no problems emptying her bowels and runs around playing like every other toddler. But then we will have a bad week, which I still cannot find the answer for. Within this week, she is unable to empty her bowel other than maybe two rabbit dropping sized stools. She will try to avoid her nappy being changed, fidgeting and unable to keep still, she is off her food and when her body tells her she needs to go to the toilet, she stands bolt upright, clenching to ensure everything stays put. These symptoms throughout that particular week will gradually increase to the point she hasn’t gone all week and is screaming. A moment that will always stay with me, is when she was just a few months old, she literally screamed her heart out for 45 minutes, just to release a pebble-sized stool. I remember having to ask my husband to video whilst I comforted our daughter as best as I could in order to show the doctors just how bad it was. As a parent, it is heartbreaking and you can feel completely and utterly helpless.

Constipation is not uncommon among children. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, 2018.), 1 in 20 visits children make to the doctors is because of constipation. On top of this, 1 in every 3 children who are constipated, experience long-term, persistent constipation (Dr R. Henderson, 2016.)

By Cheryl Holt (Pixabay).

Constipation itself is when an individual has difficulty emptying their bowels, experiences pain when passing a bowel movement, goes less frequently than normal and their stool will be hard. There are a number of reasons children can become constipated such as:
– not drinking enough fluids
– not eating enough fibre
– anxiety or fear, perhaps using the toilet other than at home or that it will be painful
– fear over potty training

This is not an extensive list of reasons for constipation. It is important that if you are concerned and your child’s constipation persists, to consult your doctor.

Being constipated, particularly if over a period of time, can become incredibly uncomfortable. Your child may display a number of symptoms which may alert you to suspect they are constipated. Some of these symptoms, as I have mentioned above in my personal experience, can include:
– change in bowel movement – amount, consistency or pattern
– tummy ache
– lose of appetite
– changes in behaviour – irritable, ‘whiney’, frustrated
– restless and constantly changing position due to discomfort
– feeling sick
– clenching their bum, dance-like movements, standing on tip-toes – any action to prevent a bowel movement
-swollen tummy
– stool in their underwear/nappy that looks like diarrhoea

If your child has been constipated for a while, they may be experiencing what is called stool holding. When children have persistent, long-term constipation (1 in 3), this can be quite common. Stool holding, as it says, is where someone feels the urge to go to empty their bowels, but resists doing so. Children enter a vicious cycle of needing the toilet, resisting the urge and their stools become bigger and harder, making them more difficult to pass. The more difficult a stool is to pass, the more likely a child will experience discomfort and it will become painful when they cannot hold it any longer. Their stools will also start to back up into the bowel and they end up with impaction, where the bowel is blocked by a large amount of hard stool (Dr R. Henderson., 2016.) This takes a longer time to fully empty the bowel and return to normal bowel movements, as the rectum has become enlarged and weakened. Your child may need laxatives to help keep their stools loose whilst the rectum returns to a normal size.

As each child is different, it is important if you think your child has constipation, to consider what is a ‘normal’ bowel movement routine for them e.g. if they go every day or every three days. But, do not fear, there are things, as a parent, you can do that can help. Here is a list of a few ways you can relieve children’s constipation and prevent it from happening in the future:

Diet

Altering your child’s diet can be the most natural way to help alleviate and prevent constipation. By increasing a child’s intake of water, not only will it help keep them hydrated, it will also help to loosen their stool and make it softer and easier to pass. Water is the best drink to provide your children, as it does not contain high levels of sugar. However, if your child is experiencing constipation, it can be beneficial to encourage them to drink some fruit juices as they have a natural laxative such as prune, pear or apple juice. Another key point is to increase their daily fibre intake. Fibre is a great natural way to encourage bowel movements. Not only does it help speed up waste foods moving through your gut, it also helps your stool to retain more water, making them softer and easier to pass (Orenstein, B., 2011.) There are many different foods that are a great source of fibre, such as beans, dried fruit (apricots, raisins and prunes), porridge or high fibre cereals (e.g. Weetabix), fruit, nuts and whole grains. Please be mindful of little ones to chop up small items such as nuts to prevent choking and be careful of allergies. (If your child is not yet eating solids or under 6 months of age, please do not suddenly encourage them to eat more foods. Try increasing their water intake through drinking sips in between bottle or breastfeeds).

Remain Calm and Encourage

When your children experience discomfort and pain, as I mentioned above, it is awful. You wish you could take it away, give them a big hug and make it all better again. But, unfortunately, it isn’t as easy as that. Even though we find it challenging as parents, we mustn’t display our upset and distress in front of them. It only makes the situation worse and can actually cause more stress to your children as their worries and fears are reinforced seeing your reaction. Instead, remain calm and reassure them if they are in discomfort. Don’t make any fuss or turn it into a ‘big deal’. If I know my daughter is trying to make a bowel movement, I personally confirm to her by asking ‘Are you doing a poo?’. This demonstrates to her I have acknowledged she is trying and I then continue to talk to her in a calm, reassuring tone. I will make encouraging comments such as ‘You are doing really well. Keep trying. Well done for trying to do a poo.’ This way, it turns what could be a very negative situation into a positive one, with positive reinforcement whether or not she manages to do a bowel movement.

Praise and Reward

Praise is brilliant for all children of all ages and can work wonders to help encourage them to empty their bowels. Praise and reward is a great combination, especially for children who have anxiety or fears over going to the toilet and knowingly hold their stools. Reward systems can be tailored to suit your child and what they love. For example, my daughter loves stickers and stamps. A sticker or stamp would be a perfect method of encouragement and positive reinforcement for when she has tried to go to the toilet and has emptied her bowels. Other reward examples could be an episode of their favourite program, their choice of game, their choice of a healthy snack or a visual chart they can add stickers or ticks too.

Movement

Keeping your child active can naturally help bowel movements. When children are constipated, there are ways you can gently help stimulate their bowels. You can help them to lay on their backs and move their legs in a cycling motion, gently push their legs back and forth towards their tummy or make clockwise circular movements across their tummy (please ensure this is clockwise and gentle as their tummies may be swollen and clockwise encourages movement in the natural direction).

When experiencing constipation, especially if it has been for a few days, it can become quite uncomfortable. With this and the fact that children often try to prevent a bowel movement through anxiety or fear of it hurting, their bodies can become quite tense. By helping children to relax, helps their bodies to relax also and lets them naturally have a movement. You can do this with a warm bath. This helps to soothe any soreness from passing a hard stool and also helps soothe any related tummy aches. Another great method is through massage. I do personally recommend attending a class if you are considering massage on younger children/babies. Many local children’s centres have baby massage classes you can book and are around 6 sessions (most are classes you need to pay for). These classes teach you about how different parts of the body are linked and can help with a number of things such as colic, sleep and constipation. Plus its a wonderful opportunity for some relaxing mummy and baby bonding time.

I hope some of these suggestions help alleviate any constipation related discomforts your children may be experiencing. Remember, constipation is quite common in children, particularly between the ages of 2 and 4 years. No two children are the same, as each child has their own natural bowel movement pattern. However, please do consult your doctor if symptoms persist, there are dramatic changes or you are concerned in any way.

IMPORTANT NOTE: I am NOT a doctor nor do I hold any medical qualifications. The information included within this post has been obtained from the following links or is based upon my own personal experiences. Please consult your doctor for professional medical advice and any concerns you have relating to your children’s health.

Beth W. Orenstein. (2011). https://www.everydayhealth.com/digestive-health/fiber-and-constipation.aspx
Dr Roger Henderson. (2016). https://patient.info/health/constipation/constipation-in-children#nav-2
NHS. (2017). https://www.nhs.uk/conditions/constipation/#babiesandchildrencauses
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). https://www.niddk.nih.gov/health-information/digestive-diseases/constipation-children/treatment