Constipation is one of the most common pediatric GI problems — and one of the most misunderstood. Many children suffer for months because families try “more fiber” alone, or stop treatment too early.
Red flags (seek medical assessment urgently)
- Vomiting with belly swelling
- Severe pain with fever
- Blood in stool with significant illness
- Poor growth, weight loss, persistent diarrhea
- Constipation starting in early infancy with severe symptoms
Myth 1: “My child stools every day so it’s not constipation”
Evidence: Children can stool daily and still be constipated if stools are hard, incomplete, painful, or there is withholding/soiling.
Myth 2: “It’s just behavioral”
Evidence: Withholding often begins after pain. Stool builds up, the rectum stretches, and children may lose normal sensation (soiling/overflow can happen).
Myth 3: “More fiber fixes it”
Evidence: Fiber helps, but many children need a structured plan including stool softening to break the cycle. Fiber without softening can worsen pain.
Myth 4: “Laxatives are dangerous or addictive”
Evidence: Common stool softeners used under guidance are widely used in pediatrics. The biggest risk is undertreating and stopping too soon.
What actually works (a practical plan)
1) Make stools soft (key goal)
Aim for soft stools that pass without pain. Many kids need medication support for a period (your clinician will guide dosing and duration).
2) Routine toileting
- Sit 5–10 minutes after meals (gastrocolic reflex)
- Feet supported (stool under feet)
- Calm, no pressure
3) Fix diet and drinks
- Water routinely
- Fruits/vegetables/whole grains
- Limit excess milk/juice if it’s crowding out meals
4) Treat long enough
A common reason for failure is stopping as soon as things improve. The rectum needs time to recover.
When to see a specialist
- Severe constipation despite a good plan
- Soiling/encopresis persists
- Growth concerns or red flags
- Suspected underlying disease
Free Printable for Parents
Get our pediatrician-approved Constipation Action Plan (PDF) by email.