Everyone poops. But sometimes we don’t go when we need to or often enough.

Adults usually know when they’re getting constipated and how to handle it. We load up on fiber-rich foods and sometimes take a fiber supplement or a laxative.

Young kids often can’t tell you when they’re constipated. They don’t realize that it only gets worse if they don’t go. And as it becomes more painful to pass stool, children often withhold it more, which creates a vicious cycle.

How often should my child be pooping?

Just like bowel patterns vary in adults, they do in children as well. What’s normal for your child may not be what’s normal for another child.

According to the American Academy of Pediatrics (AAP), most children have bowel movements 1 or 2 times a day. Other children may go 2 to 3 days or longer before passing a normal stool.

She’ll go eventually, won’t she?

You may think that your child will poop eventually. But that’s not always the case. If your child goes for days and days without having a bowel movement, the stool can become dry, hard and get stuck in the colon. The longer the stool stays inside the bowel, the larger, firmer and drier it becomes. These large stools can stretch the rectum and your child may no longer feel the urge to pass stool.

Impacted stool blocks the way for new waste to leave the body, causing it to back up. Sometimes, only liquid can pass around the stool and leaks out onto your child's underwear. The stool that is stuck may become too large to pass without the help of an enema, laxative or other treatment. This problem is called encopresis.

How can you tell if your child is constipated?

Constipation is a common problem in children. A constipated child may have stools that are hard, dry and difficult or painful to pass. These stools may occur daily or be less frequent. Symptoms of constipation may include:

• Many days without normal bowel movements
• Hard stools that are difficult or painful to pass
• Abdominal pain, such as stomachaches, cramping or nausea
• Rectal bleeding from tears, called fissures
• Soiling
• Poor appetite
• Cranky behavior

Constipation is rare in infants, but may become a problem when your baby starts solid foods. One way to tell if your baby is constipated is if she has firm stools less than once a day.

Constipation in toddlers and older kids is more common. They may have episodes of crampy abdominal pain that goes away after a large bowel movement. You may also notice your child crossing her legs, making faces or clenching her buttocks.

What causes constipation?

Constipation may result from your child not getting enough fiber or fluid in her diet, or from changes in her diet. For instance, if your child was recently sick and didn’t have an appetite, it can throw off her system.

Constipation may be a side effect of some medications, or it may result from certain medical conditions, such as hypothyroidism. Any changes in your child's routine, such as traveling or stressful situations, may also affect how her bowels function.

Another cause of constipation that can be more difficult to address is withholding. Your child may withhold her stool for a variety of reasons. She may want to avoid pain from passing a hard stool, or she may not be comfortable using the toilet when away from home. Some kids simply don’t want to take a break from play. Children between the ages of 2 and 5 often withhold because they are dealing with issues about independence and control.

How is constipation treated?

If you suspect your child is constipated, talk with your child’s primary care physician first. Do not use an over-the-counter laxative without asking the doctor first, as laxatives can be dangerous to children if not used properly.

Constipation is usually temporary and can be treated. Your child's doctor may suggest adding higher-fiber foods to your child's diet and drinking more water. Fiber is an important nutrient that keeps things moving in the digestive tract. Fiber recommendations are based on your child’s age and weight.

If the situation is more complicated, your doctor may refer you to a pediatric gastroenterologist. In some cases, your child may need to have a medical test, such as an X-ray, before the doctor can recommend treatment. Sometimes a laxative or stool softener is recommended.

How can you prevent constipation in your child?

You can help your child develop proper bowel habits:

• Make sure your child drinks plenty of water and eats high-fiber foods. Good sources of fiber include vegetables, fruit, beans, peas, nuts, fiber-rich whole grain breads and cereals.
• Help your child set up a regular toileting routine. For example, bring your child to the bathroom about 20 minutes after a meal.
• Become familiar with your child’s normal bowel patterns so you stay on top of constipation. Ask your doctor what to do if your child hasn’t had a bowel movement in a few days.
• Encourage your child to exercise, as regular physical activity keeps things moving along.

Need a primary care doctor for your child? Edward-Elmhurst Health has hundreds of board-certified physicians to choose from. You can schedule online today to set up your first appointment.

Learn more about children’s services at Edward-Elmhurst Health.