12 Signs Your Child is Constipated (And What To Do)

Constipation is extremely common among children. It’s the number-one source of belly pain for kids! Here’s something else that might really surprise you: Constipation can be a hidden cause of bedwetting.

If you don’t think your child is constipated, you might want to think again, says Steve Hodges, MD, a pediatric urologist and co-author of the book It’s No Accident: Breakthrough Solutions To Your Child’s Wetting, Constipation, Utis, And Other Potty Problems. “The most common misconception is that if your child poops every day or every other day, he’s not constipated,” says Hodges. He and co-author Suzanne Schlosberg are on a mission to educate parents about kids and constipation–not only because it’s so common, but also because it’s such a commonly overlooked cause of bedwetting, urinary tract infections, and other potty problems. On a personal note, reading It’s No Accident   two years ago was a lightbulb moment for me, because I realized my younger son’s bedwetting was likely due to constipation–something I’d never considered before. Once I resolved the constipation, the bedwetting stopped.

Here are 12 signs your child is constipated. Do any of these sound familiar?

12 Signs Your Child is Constipated

What causes constipation in kids?

According to Dr. Hodges:

  • The typical Western diet (especially one that includes a lot of “kid food” like chicken nuggets, pizza, and mac-n-cheese) is seriously lacking in fiber. As a result, poop becomes firm and painful to push out.
  • Potty training can also trigger constipation. Young kids don’t understand that they need to go when they feel the urge–instead, they learn how to “hold it” until it’s an emergency (or their parents make them go).
  • Holding can get even worse when kids go to school and may have limited access to the bathroom or simply be too afraid or shy to use it. All that holding can lead to a clogged system.
  • Lack of exercise.

How does constipation lead to bedwetting?

When kids are constipated, their intestines can become packed with stool. The bladder ends up getting squeezed out of the way and not able to hold as much urine, says Dr. Hodges. Enlarged intestines can also irritate the nerves that control the bladder, leading to bladder contractions (and accidents).

What should you do for a constipated kid?

“The key is to get ahead of the constipation,” says Dr. Hodges. “Get the poop soft again so they don’t develop the habit of holding. And get rid of the backed-up poop that they haven’t emptied.” He recommends: 

  • A serious intestinal clean-out, usually with MiraLAX (or the generic equivalent). Unlike other kinds of laxatives, you can use MiraLAX long-term. It’s easily mixed into liquid and is tasteless. Dr. Hodges provides guidelines and dosing suggestions in his book It’s No Accident
  • Asking your child to sit on the toilet for five minutes after breakfast and dinner (the reflex for emptying the bowels is usually strongest in the morning)
  • Getting more fiber in the diet (see below).

What are the best foods to ease constipation?

Kids’ diets should include lots of foods that are naturally rich in fiber to help keep poop soft. Whole grains, nuts and seeds, and beans are high in fiber. Fruits and vegetables are especially great because they’re high in fiber AND fluid–and fluid is vital for keeping stool moving through the system.

Some high-fiber fruits and veggies include:

  • Berries
  • Pears & apples (with the skin)
  • Bananas
  • Oranges
  • Spinach
  • Brussles sprouts
  • Potatoes (with the skin)
  • Broccoli

For a free download of the chart above–plus a kid-friendly, illustrated “poop chart” to help you and your kids keep tabs–go here.

To learn more about this issue, the book, and the authors, visit their website.

It's No Accident

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Comments

  1. Emily says

    Sally – thank you so much for this post! I read a little blurb about this in a parenting magazine a year or two ago. I took it to my daughter’s pediatrician (she’s almost 7 and still wetting every night), but got the normal “she’ll grow out of it”, “she’s a heavy sleeper, ” etc. So, I let it go. But seeing your post makes me think this could really be the issue, esp. after noticing several of her symptoms on the chart you posted. I have not ordered the book, but I did read on some of the Amazon reviews that he recommends enemas every day for a month in addition to the Miralax. Did you do all of that, or was Miralax enough? My husband would like us to try the Miralax before ordering the book and trying enemas. Do you feel comfortable giving me the dosage amount that he lists for an almost 7-year-old? Thanks again – your posts are always so great!!

    • says

      Thanks for your comment Emily! I only did the MiraLAX; I did not do the enemas. But I know Dr. Hodges recommends those when kids are very backed up. I’m going to refer your question to Dr. Hodges and his co-author so one of them can answer your question specifically. So stay tuned!

  2. says

    I do recommend the enemas, and I if course recommend the book! But if you’d like to try the miralax first the therapy is based on weight. How much dors she weigh?

  3. Emily says

    Dr. Hodges – thank you so much for your help. It really is a relief to think we might finally be able to resolve this problem! I do hope to buy the book – I just need to convince my husband – he’s a little wary of the enema idea! The last time she was weighed was Oct. 2013 (we don’t have a scale at home), and her weight then was 43.6 lbs.

  4. says

    Perfect – washout is 7 capfuls in 32 oz of Gatorade, or whatever she’ll drink, and then a daily dose to maintain poop mushy (usually about a capful). You can repeat washout monthly

  5. Emily says

    For the washout, should she drink that amount in one day and then the next day start the daily dose? Also, do we need to do an x-ray to confirm constipation first, or is it safe to just go ahead and try the miralax? Really – thank you so, so much for your help. It’s a burden off our shoulders.

  6. says

    Emily — I’m Dr. Hodges’ coauthor and just thought I’d chime in from experience. My 4 y.o. was wetting the bed (and having daytime accidents), and an x-ray showed he was stuffed w/poop — even though he pooped daily and had no belly pain. We did both enemas (to get things started) and Miralax (for maintenance). My suggestion is to be really aggressive with this. When parents try Miralax and a ton of poop comes out, they think the problem is solved — when, in reality, there’s a lot more poop hiding in there and/or the holding habit is so ingrained that the problem comes right back. You should really read the bedwetting chapter in the book — esp. the history of how the connection between bedwetting and constiption was discovered, by a Canadian doctor whose 5 y.o. was wetting the bed. This is the doctor who came up with the enema regimen we recommend in the book. You can always get the book from the library if you don’t want to buy it. Good luck and stay vigilant!

    • Emily says

      Thank you, Suzanne! Your input is very helpful, especially since you’ve experienced it first-hand with your own child. I will look forward to reading the book and hope to see some positive change soon.

  7. Jutine says

    Just wanted to comment that Dr. Hodges (and Suzanne Schlosberg) have written an extremely important and helpful book – it completely alleviated my worries of using Restoralax (Canada’s version of Miralax) for my toddler’s constipation. The book takes a very serious and emotional topic, and infuses some much needed humour and comfort! Thank you, thank you to Dr. Hodges for being such an important resource for parents and for sharing your knowledge!

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