By Dr. Philippe Collin*

Constipation is a common problem in childhood. Almost every child will experience it at some point. Constipation is when a child passes infrequent hard painful stools over a long period of time. Unfortunately, many times this problem goes unnoticed. Dr Philippe Collin provides some guidelines to spot the problem early on:

How often should my child poo (bowel movement?)

It depends on how old he or she is. In the first weeks of life, most babies have four or more bowel movements each day. They are soft or liquid. In the first three months, some babies have two or more bowel movements each day. Others have just one each week.

By age two, most kids have at least one bowel movement each day. They are soft but solid.

Every child is different. Some have bowel movements after each meal. Others have them every other day.

How will I know if my child is constipated?

Your child might:

- Have fewer bowel movements than normal;

- Have bowel movements that are hard or bigger than normal;

- Feel pain when having a bowel movement;

- Arch his or her back and cry (if still a baby);

- Avoid going to the bathroom, do a “dance,” or hide when a bowel movement is coming. This often happens during potty training and when starting school;

-  Leak small amounts of stool into the underwear (if he or she is toilet trained).

Why is my child constipated?

There are many reasons why children become constipated. Most common reasons are:

- Eating foods that are constipating;

- Not drinking enough;

- Holding on to stool when it is not a comfortable or convenient time to go;

- Being afraid to have a painful stool;

What if my child gets constipated?

In most children with mild or brief constipation, the problem usually gets better with some simple changes. Have your child:

- Eat more fruit, vegetables, cereal, and other foods with fiber;

- Drink some prune juice, apple juice, or pear juice;

- Drink at least 1 litre of water and drinks that aren’t milk each day (for children older than two);

- Avoid milk, yogurt, cheese, and ice cream;

- Sit on the toilet for 5 or 10 minutes after meals, if he or she is toilet trained;

- Stop potty training for a while, if you are working on it.

When should I take my child to the doctor or nurse?

If:

He or she is younger than four months old;

He or she gets constipated often;

You have been trying the steps listed above for 24 hours, but your child has still not had a bowel movement;

There is blood in the bowel movement or on the diaper or underwear;

Your child is in serious pain.

When to Seek Help?

Call your child’s doctor immediately (during the day or night) if your child has severe abdominal or rectal pain. and if any of the following occurs:

- Your child has not had a bowel movement within 24 hours of starting constipation treatment

- Your infant (younger than four months) has not had a bowel movement within 48 hours of their normal pattern (for example, if an infant who normally has a bowel movement every two days goes three days without a bowel movement). You should call earlier if your infant has other symptoms, such as vomiting or pain;

- Your infant (younger than four months) has hard (rather than soft or pasty) stools;

- Your infant or child does not want to eat or loses weight;

- You see blood in your child’s bowel movement or diaper;

- Your child has repeated episodes of constipation;

- Your child complains of pain during bowel movements;

- You have questions or concerns about your child’s bowel habits.

* Dr. Philippe Jean Collin is a French pediatrician with Family Medical Practice Hanoi. He is a member of the French society of pediatrics, American society of nephrologists, and the Pediatric Academy Societies. 

For more advice on any medical topics, visit Family Medical Practice Hanoi on 298 I Kim Mã, Ba Đình, Tel: (04 or 024 from June 17^th) 3843 0748 and hanoi@vietnammedicalpractice.com.

FMP’s downtown HCM City location is at Diamond Plaza, 34 Le Duan, District 1; Other facilities are at: 95 Thảo Điền Street, District 2. Tel: (08) 38227848. E:hcmc@vietnammedicalpractice.com

FMP Danang is located at 96-98 Nguyễn Văn Linh Street, Hải Châu District, Đà Nẵng. Tel: (0236) 3582 699. E: danang@vietnammedicalpractice.com.