children s health issues
Constipation in Children
Introduction
Constipation refers to delay or difficulty in passing stool for a period of at least 1 month in infants and toddlers and a period of 2 months in older children (see also Constipation in Adults in adults). Stools are harder and sometimes larger than usual and may be painful to pass. Constipation is very common among children. It accounts for up to 5% of children’s visits to the doctor. Infants and children are particularly prone to developing constipation at three periods of time: When Starting Solid Foods in Infants into the infant's diet During Toilet Training None Around the start of school The frequency and consistency of bowel movements (BMs) vary throughout childhood, and there is no single definition of what is normal. Newborns typically have 4 or more stools per day. During the first year, infants have 2 to 4 a day. Breastfed infants typically have more BMs than formula-fed infants and may have one after each breastfeeding. The stools of breastfed infants are loose, yellow, and seedy. After a month or two, some breastfed infants have BMs less frequently, but the stools remain mushy or loose. After 1 year of age, most children have one or sometimes two soft but formed stools a day. However, some infants and young children typically have BMs only once every 3 to 4 days. Guidelines for identifying constipation in infants and children include No BMs for 2 or 3 more days than usual Hard or painful BMs Large stools that may clog the toilet Drops of blood on the outside of the stool In infants, signs of effort such as straining and crying before successfully passing a soft stool usually do not indicate constipation. These symptoms are usually caused by failure to relax the pelvic floor muscles during passage of stool and typically resolve spontaneously. Parents often worry about their child's BMs, but constipation usually has no serious consequences. Some children with constipation regularly complain of abdominal pain, particularly after meals. Occasionally, passing large, hard stools may cause a small tear in the Rectum and Anus ( 