If your toddler or preschooler is constipated, you'll give a knowing sigh when I talk about difficulties with toilet training, preschoolers who will only poop at home, toddlers who are are afraid of pain while pooping, and all the common (and helpful!) interventions: laxatives, fiber, and prune juice. Constipation in toddlers and preschoolers can be tackled on many fronts. And in most cases, toddles and preschoolers benefit from adding multiple pieces to their constipation treatment regimen. Here are some methods of dealing with constipation that are helpful to my younger patients and their families.
Fiber in food. As a dietitian, of course I mention this first. But it is a big one. When I talk about eating more fiber, I don't mean having the occasional vegetable or slice of whole wheat bread. Ideally, we want almost all of our kids carbs to be the higher fiber version. That means getting into a routine of only purchasing whole wheat bread and pasta, serving legumes a few times per week, eating nuts every day, having a whole grain cereal like oatmeal daily, and offering fruit for snack regularly.
Fiber supplements. Supplements like Metamucil or the generic psyllium husk fiber can be so helpful! Discuss with your doctor or registered dietitian the appropriate amount to take. Usually we start with a small amount once a day, but some kids will take fiber supplements up to three times per day. They key partner of fiber is adequate water, but cause without enough water, it won't help.
Adequate water intake. Whether or not your child takes fiber supplements, water is crucial to keeping stool soft. Some preschoolers like to have a water bottle that they can take with them. This can help remind them to drink throughout the day.
Medications. Some toddlers or preschoolers really benefit from using a medication such as a laxative. Ask your pediatrician what would be appropriate for your child. There are medications that are very safe to use regularly, and for many kids, are a mainstay to keeping them regular.
Physical activity. Being active can help stimulate the urge to defecate. Some of the best ideas for physical activity are activities that harness gravity and moving the hips (massaging the colon) to help move poop along. Anything that involves walking or running, such as playing on a playground works. Riding a bike or tricycle also uses the same hip movements that massage the colon.
Scheduling potty time. Most kids (and adults!) will poop at the same time every day. Dedicate adequate and unrushed time for pooping. To keep your child patient on the toilet, some families use this time for screen time or reading together.
Position on the toilet. When the angle of the hips to the body is smaller, the muscles that close the rectum are easier to relax and open. Have your toddler place their feet on a step stool while they are on the toilet for better positioning.
Physical therapy. Some kids need help learning how to relax the right muscles and engage the right muscles while pooping. Most physical therapists will also give you exercises that you can do with your child at home.
Constipation in toddlers and preschoolers is tough. But know that there are solutions to improve the problem. Talk to your pediatrician and see if any of these ideas will work for your child. Many toddlers and preschoolers need multiple strategies to improve their constipation, and you can see what will work for you.
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