Kids Love Dr. Barton

Constipation



by Dr. Douglas Barton, M.D., Pediatrician 11/04/2009



            Some medical topics are just not much fun to talk about at all and yet they come up on a regular basis in conversations with patients.  Probably one of the most frustrating ones for parents is their children’s bowel habits.  It seems that no matter where a young parent turns, there is someone telling them that their child’s habits are not right.  They are either too frequent or not frequent enough, they are too watery or they are too hard.  So what’s a parent to do?
            In the newborn period, bowel habits are extremely variable.  Formula fed babies tend to be a little more regular, usually stooling between 3 times a day and every other day.  Their stools tend to be a little firm and can vary in color from dark brown to light tan with occasional green shades thrown in.  Breast fed babies tend to be far more unpredictable, with periods of up to 7 days between bowel movements being normal.  As long as your infant is not spending an hour or more straining to have bowel movements and is generally happy, there is no reason to try to alter things.
            For toddlers and young children, every day or two is fairly normal with some days having two or three stools.  It can be much more difficult to tell with this age group as they are starting to toilet train and don’t want someone checking on their every trip to the bathroom.  Unlike other age groups, constipation at this age can sometimes come from control issues as parents try to force toilet training and the child is resisting.  Generally speaking, when I see control issues, I recommend backing off of toilet training and allowing the child to enjoy their sense of control.
            For most children and teens, trouble with bowel movements is trouble with diet.  The American diet tends to be relatively low in the vegetables and whole grains that provide us with the majority of the fiber we need for adequate bowel health.  Most experts recommend that children receive 5 plus their age in grams of fiber a day.  Thus an eight year old should receive 13 grams of fiber a day.  Normal adult intake should be around 30 grams a day.  For most individuals, adequate fiber means adequate stool patterns.  For some children, we will recommend alternatives that may be dietary and may involve supplements.  If your child loves vegetables and whole grains, but still can’t stool regularly, check with your pediatrician for some alternatives.
            Finally, severe abdominal pain, abdominal pain that wakes your child at night, black stools or blood in the stools are all abnormal and should prompt you to discuss your child with his or her pediatrician.

 

 

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