Toddler Constipation: What To Do

Medically Reviewed By Mia Armstrong, MD
Was this helpful?
2

Toddler constipation may cause stools that are infrequent, dry, hard, painful, or difficult to expel. It is quite common in young children, is usually temporary, and is easily treatable at home. However, more severe symptoms may need medical attention. Toddler constipation can occur when stool is not passed as usual. These changes in bowel movement habits may result from many factors, including lifestyle, medication, and other underlying causes.

Toddler constipation is common, and it rarely happens because of a serious medical condition. However, it can still be worrying to parents and caregivers.

Read on to learn more about causes, symptoms, treatments, and medical care associated with toddler constipation.

Causes of toddler constipation

Toddler stands in bathroom wearing diaper
Jessica Byrum/Stocksy United

There are a number of reasons that toddler constipation can happen. These include:

  • Diet: If the child eats a diet low in fiber or consumes a lot of milk or cheese, they may experience constipation.   
  • Dehydration: Not drinking enough fluids can result in dry, hard stools that are difficult to pass. However, dehydration alone typically does not lead to toddler constipation and usually works in combination with other factors.
  • Illness: If the child is unwell, they may experience a change in appetite or diet that could affect their digestive system. This change could lead to toddler constipation.
  • Certain medications: Taking certain medications could result in constipation as a side effect.
  • Change in routine: When a child’s routine is altered, it could affect their digestive system. These changes are not necessarily negative in nature. They could include family vacations, changes in weather, or a new home or school.
  • Emotions: As with all humans, toddlers experience emotions that could have physical impacts on their bodies. This includes stress while potty training and embarrassment about using a public restroom, both of which could lead to toddler constipation.  
  • Holding it in: Many toddlers avoid having bowel movements, which can lead to constipation. Their reasons vary but include not wanting to use the toilet or a reluctance to potty train, refusal to take time out for the bathroom, and discomfort passing a stool.
  • Underlying condition: Toddler constipation can also result from an underlying condition or physical problem. However, these causes are less common.

Signs and symptoms

There are several signs and symptoms that could indicate that a child is experiencing toddler constipation. These can include:

  • painful, dry, or hard stools
  • 3 or more days without passing a stool, except for in breastfed children over 1 month old
  • changes in the child’s typical bowel movements, such as the appearance of their stool
  • efforts to hold in a bowel movement, such as clenching the bottom, dancing on tiptoes, or rocking back and forth on the heels
  • crying while passing a stool
  • bleeding from the bottom
  • bloating or a swollen abdomen
  • cramping
  • stomach pain or nausea
  • stains on underwear that look like diarrhea or little lumps of feces
  • daytime or nighttime wetting accidents

What constitutes typical bowel movements and habits will depend on the age and diet of the child or infant. There can be a lot of differences in normal bowel movements according to different factors.

If you are unsure what should be normal for a toddler, any change from their typical bowel movement routine — such as a change in the appearance of their stool — can also indicate that they are experiencing constipation.

Learn more about children’s digestive systems here.

Treating constipation in toddlers

There are several at-home treatment options that can help relieve toddler constipation. These include:

  • Changing the diet: Ensuring that the child eats fiber-rich foods can help alleviate and prevent constipation. Avoiding processed and pre-prepared foods low in fiber may also help. According to the American Academy of Pediatrics, some children should have at least 5 servings of fresh fruits and vegetables per day — in addition to other foods rich in fiber, such as whole grains and beans — depending on their age. These fruits can include peaches, pears, and prunes, which people commonly use to relieve constipation.
  • Keeping them hydrated: Drinking plenty of fluids can help promote healthy bowel function, but not all fluids are the same. Water, clear soups, and naturally sweetened fruit or vegetable juices such as prune juice can help prevent toddler constipation. However, drinking too much milk could result in further constipation.
  • Exercising: Getting regular exercise helps maintain normal bowel function so that stools move through the system as they should. 
  • Stretching: You can help a baby by holding their knees to their chest, as it can be hard for them to pass a stool lying down. With younger children, caregivers can “bicycle” the baby’s legs by moving their knees to their chests in an alternating fashion to help massage the belly and produce a bowel movement. Older children can try squatting with the knees above the hips.
  • Stopping potty training: You may need to put the child back in diapers for a short time and focus on praising passing stools. Also, avoid any negative associations with going to the toilet.
  • Promoting healthy bowel habits: Changing the child’s habits and behaviors may help relieve their constipation. Some things you can try include:
    • sitting the child on the toilet for a couple of minutes after meals, even if they do not have the urge to go
    • praising behaviors such as sitting on the toilet with or without passing stool, such as by giving rewards
    • making sure that the child has the right equipment for using the toilet comfortably, such as an inset seat for an adult-sized toilet or a footstool
    • removing any negative associations with going to the toilet, such as by checking the toilets they use at school or child care to see if they are comfortable or keeping a favorite book near the toilet

Over-the-counter medications

Many over-the-counter (OTC) medications and treatments exist that may relieve constipation. However, you should not give these treatments to a child without discussing it with their doctor first. These treatments often include laxatives, fiber supplements, enemas for toddlers, and suppositories for toddler constipation.

If necessary, the child’s healthcare practitioner will first advise you regarding which treatment to use, the dosage, and the time period for administering the medication or treatment.

Researchers have also found that probiotics for toddler constipation may be useful in improving stool frequency. However, more investigation is necessary to confirm positive results in a wider profile of children.

When to contact a doctor

Although toddler constipation is often treatable using home remedies, there are times when you should get in touch with their doctor.

If the symptoms do not go away with at-home treatment, or if they last for longer than 2 weeks, contact their usual medical practitioner.

If the child experiences any of the following symptoms, contact the child’s physician right away:

  • bloating
  • blood in the stool
  • bleeding from the bottom
  • frequent or painful urination
  • vomiting
  • constant abdominal pain
  • weight loss
  • fever
  • constipation that does not improve with dietary changes or treatments

Diagnosis

If you have contacted a doctor regarding toddler constipation, they may ask about the child’s medical and family history or conduct a physical exam.

It is also common for doctors to order a diagnostic test to help determine the cause of the toddler’s constipation. These can include:

  • Laboratory tests: Blood, stool, and urine tests can help reveal an infection, disease, or condition that is contributing to a toddler’s constipation.
  • Imaging tests: Ultrasound, X-ray, and CT scans can search for problems in the child’s abdomen that could cause constipation.
  • Rectal biopsy: A doctor could use this test to eliminate Hirschsprung’s disease as the cause of the child’s constipation.

Summary

Toddler constipation is a common condition in children that leads to difficulty passing stool.

At-home treatments can help alleviate toddler constipation, and dietary changes can help prevent toddler constipation.

You should not use any OTC medical treatments, such as laxatives or enemas, for toddler constipation without consulting a doctor.

If approved at-home treatments do not have the desired results within 2 weeks, or if the child is presenting more serious symptoms, call their doctor to schedule an appointment for further evaluation.

Was this helpful?
2
Medical Reviewer: Mia Armstrong, MD
Last Review Date: 2022 Feb 28
View All Children's Health Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.