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Is your child secretly constipated?

Constipation is common in children. A Journal of Pediatrics study found that 18 percent of toddlers and 14 percent of adolescents experience constipation, which means millions of kids every day are dealing with symptoms.

Parents of babies and young children tend to notice when their child is having a problem. However, once kids use the toilet on their own, parents understandably lose track of their child’s bowel habits. They may not know how frequently kids are going or if they’re feeling pain or seeing blood. Because chronic constipation isn’t on their radar, they’re less likely to connect a child’s bedwetting, lack of appetite, or stomach aches to the condition.

To help identify issues and keep kids’ insides healthy, I ask kids about poop during yearly well-child checks. I also encourage parents to tell kids that it’s okay to talk about poop. It’s a normal bodily function.

Encourage kid-friendly foods that relieve constipation

Unsurprisingly, diet is the biggest contributor to constipation. A diet filled with processed foods and snacks—and few fruits and veggies—doesn’t give children the fiber their digestive system needs. Consuming too much milk can also make it harder to pass stools. Specific items, such as bananas and iron-containing vitamins, can be problematic. Yet, there are also plenty of children who eat a balanced diet and still struggle.

Encouraging fruits and veggies and watching dairy consumption can ease constipation, as can offering kid-friendly foods such as pears, applesauce, fruit and veggie puree pouches, fiber-filled breakfast bars, and fiber gummies. Fruit juice, while high in sugar, can also help. It can take time to make dietary changes, and it won’t soften a stool that’s already in transit. However, it can prevent future episodes.

Clean the insides out, start over

Another common cause of constipation is stool withholding. Young kids may avoid going poop because they don’t want to stop playing or they feel nervous because of previous, painful constipation. When kids don’t go when they need to, the stool becomes larger, drier, and harder to pass. Withholding can develop into a cycle that is frustrating and difficult to remedy.

When kids become extremely backed up, it’s often best to completely empty the bowel out and reset it. Polyethylene glycol (MiraLax) is one of the safest and most-studied stool softeners in kids, and is what I recommend almost exclusively. Remember to use this drug with the advice and supervision of a pediatrician. Sometimes kids benefit from using low doses on an ongoing basis.

Ask for help, advice

If you have a younger child who has started having bathroom accidents again or is leaking stool, or a child of any age who is complaining about abdominal pain, lack of appetite, or pain or blood when pooping, talk to your pediatrician. Accurately diagnosing constipation and coming up with a thoughtful treatment plan can make a huge difference in kids’ daily comfort. What’s more, if you haven’t had a recent conversation with your kids about poop, ask how it’s going or make them an appointment.

Dr. Curtis McDonald is a pediatrician at Vancouver Clinic and the father of four children. His goal as a provider is to empower parents with information so that they can make the best choices for their families.