Constipation means having fewer poops (bowel movements) than usual, or having dry, hard, or difficult-to-pass poops.

“Chronic” means your child has been constipated for a long time or gets constipated often. Kids with chronic constipation can go several days without pooping, have very large poops, or have pain when pooping.

Treatment begins by “cleaning out” the bowels with medicine. Afterward, you need to continue treatment to make sure that your child's poops stay soft so they can poop about once a day (or every other day). Over time, the bowels will start working normally, and your child will have regular poops.

Here's how to care for your child.

• Give the prescribed medicines for the cleanout (sometimes called a disimpaction) as directed by your healthcare provider. This may include one or more of the following:
  • Laxative, a medicine taken by mouth that helps “push” out the poop (This is used most often.)
  • Stool softeners, medicine taken by mouth that brings liquid into the bowels and softens the poop
  • Enema, liquid medicine put into the rectum (lower part of the bowels) to soften the poop
• After the cleanout, it's important to continue treatment to prevent further constipation and ensure that the bowels can return to working normally:
  • Give your child the stool softeners and laxatives for as long as directed by your healthcare provider.
  • Your child might need to take the medicines for months to keep the poop soft and prevent the constipation from coming back.
  • After the bowels are working normally, your child can slowly stop taking the medicines, over a few weeks or months.
• Increase fiber in your child's diet by offering high-fiber foods, such as: 
  • Apples, pears, beans, oatmeal, oranges, ripe bananas, whole-grain breads, and popcorn (To prevent choking in toddlers and young kids, cut up fruits and vegetables into very small pieces or cook them to make them softer.)
  • Fruit smoothies with added flax meal or bran

• Encourage your child to drink plenty of water. Have them keep a water bottle with them so they can sip on it throughout the day.
• Follow your healthcare provider's recommendations for:
  • Any foods your child should avoid (Certain foods, like dairy, can make constipation worse in some kids.)
  • Making any other diet changes
  • If your child should drink prune, pear, or apple juice
  • When to follow up
• Being active can help with constipation. Going for a walk together, playing games like tag and hide-and-go-seek, and going to a playground are all great ways for your child to be active and have fun.
• Stress can lead to constipation. To help your child cope with stress, be sure they get enough sleep, have time to relax, and don't spend too much time on screens (phone, TV, or tablet).
• Talk to your healthcare provider before giving your child any supplements or herbs.
• If your child is toilet training, you may need to take a break. You can try again after your child is no longer constipated.
• Create a bathroom routine:
  • Encourage your child to sit on the toilet or potty for about 5–10 minutes a few times a day, especially after meals (since they are more likely to poop after a meal).
  • If your child feels the urge to poop, they should go to the toilet or potty and sit for 5–10 minutes to see if they can poop.
  • While using the toilet, have your child prop up their feet about 6–9 inches on a stool so their knees are higher than their hips. This can make it easier to poop.
  • Give a small reward like a sticker for sitting on or pooping in the toilet or potty. You can also make a sticker chart and put it up in a place where they can see it and feel proud of their progress.
  • Teach your child if they hold in the poop, more and more poop can build up inside, which can make it harder and more uncomfortable to go later.
  • If your child is uncomfortable using the bathroom at school because there are a lot of people around, work with the school nurse to find a bathroom that's more private.

Your child:

• Doesn't poop within 2–3 days after following your healthcare provider's instructions
• Isn’t pooping as often as your healthcare provider told you to expect 
• The constipation gets better, then comes back
• Has new or worsening belly pain, diarrhea (watery poop), vomiting, or streaks of blood on the toilet paper, in the toilet, or on their poop
• Soils their underwear (after being toilet-trained)
• Doesn't want to eat or seems to be losing weight

Your child:

• Has severe belly pain or a hard, swollen belly
• Is vomiting again and again
• Has a lot of blood on the toilet paper or diaper, in the toilet, or on their poop

What causes constipation in kids? In kids, constipation is usually caused by a combination of factors:

• Not getting enough fiber or water in the diet
• Holding in poop because of fear that it will be painful or not wanting to poop in a public bathroom
• Not having enough physical activity
• Stress

Less often, constipation in kids is caused by certain medicines or a medical condition.

What are the symptoms of constipation? Kids with constipation may feel full or bloated, might not want to eat as much, and may strain or have pain while trying to poop. They may also have small streaks of bright red blood on the toilet paper, in the toilet, or on their poop. This happens because the child gets small tears in the skin around the anus (where the poop comes out) from straining to get the poop out. Kids who have constipation for a long time may have soiling when liquid poop leaks out around hard poop that is backed up in the rectum (lower part of the bowels).

Once their constipation is better, how often should my child poop? For some people, it's normal to poop one or more times a day, and for others it's normal to poop a few times a week. If your child's poop is soft and they don't have to strain to poop, that is likely the right amount for them.

How does fiber help constipation? Fiber can't be digested (broken down and absorbed) and stays in the bowels. It increases the size of the poop and softens it. This helps the poop move through the bowels and makes it easier for poop to pass. Fiber works best when it can absorb water, so it's important to drink lots of water.