“My child has hard stools and only has a bowel movement once a week. Is that normal?” This is a familiar question asked by parents to their doctors. Not having a bowel movement regularly is a common concern for all parents. Constipation is defined as having less than three bowel movements a week and hard stools that may also be large. Everyone is different in what is his or her normal stooling pattern is. Some people may have three bowel movements a day and others may have three a week. Anything in between is within a normal range as long as the stools are easy to pass.
As a brand new baby, a stool that is thick and green in color is expected within the first 24 hours called meconium. After a few days the stool turns yellow or brown and has the consistency of glue. If a baby is breast-fed the stool is a mustard seedy color and is looser in consistency. Usually breast-fed babies stool after every feeding but it may be as long as three days in between bowel movements. Formula-fed babies have more firm, yellow to brown stools. Constipation may occur in a breast-fed baby if the mother does not eat enough fiber. Formula-fed babies may get constipated due to the lactose or if there is a change in the formula. The iron in the formula can be constipating but is usually not the cause and is important to be a part of the babies diet.
When your child begins to eat food, watch for how the food affects them and their bowel movements. Some foods, like dairy products, may be more constipating than others. It is important to keep the stool soft in consistency so that it is not difficult to pass. A healthy diet would consist of fruits, vegetables and whole grains. Additionally, it is essential to make sure your child is drinking enough water to keep the stool soft.
Other reasons for constipation include changing your baby’s diet from breast milk or baby formula to whole cow's milk. It may also happen when you switch from baby food to solid food. It is not unusual for constipation to come and go in children. If their symptoms last longer than two weeks though your child may have chronic constipation.
It is critical for children to make time each day for having a bowel movement and be comfortable in doing so. Children who have chronic constipation may ignore the urge to have a bowel movement for various reasons. However, when a child avoids bowel movements, stool builds up and the stool becomes larger and harder. As a result, passing the stool can be painful and makes children avoid having another bowel movement.
How to possibly avoid constipation:
- Drink plenty of water each day. You can also give them prune juice, fruits and vegetables to increase the amount of fiber. Avoid junk foods.
- Establish a regular bowel habit. Ask your child to sit on the toilet for at least 10 minutes at about the same time each day, making sure he or she is as comfortable as possible.
- Medications that treat constipation include mineral oil, lactulose, fleets enemas and Miralax.
Please call your doctor if the symptoms of constipation last longer than two weeks, or if your child along with constipation has a change in appetite, fever, vomiting, weight loss, blood in stool, rash around anus or stomach swelling.