Constipation Pediatric Care Plan

By David Shafran, MD
Medically reviewed
January 5, 2021

What Is Constipation?

Constipation is diagnosed when a child has a hard time or it hurts to pass stools. Different children haven’t different stooling frequencies. Constipation is really more determined by what the stool looks like than how often a child goes. If it’s hard, blood streaked, or toilet clogging, think constipation. If a child stools every 3 days but the stool is soft, easily passed, and doesn’t clog your toilet, it’s probably not constipation.

Other symptoms of constipation include:

  • Stomachache
  • Nausea and loss of appetite especially in the morning
  • Soiling (stools stains in the underwear)
  • Irritable and cranky

In the absence of an underlying medical issue, constipation is usually due to a diet that is low in water and fiber found in fruits and vegetables. Intake of too much cheese and milk can also cause constipation. Often children withhold their stools either because of a painful stooling experience or because they’re at school. This, too, frequently leads to constipation.

Constipation can be treated as follows…

First and foremost, children should drink lots of water, limit milk consumption, and eat lots of fruits and vegetables. Fruit juices don’t count! Cut back on snacks, bread, and other carbohydrates. Increase whole grain foods such as whole wheat bread, brown rice, and oatmeal.

Stools softeners such as miralax can help make it easier for your child to stool. One half or full capful in 4 to 8 ounces of water is a good place to start. Suppositories such as glycerin and enemas such as Fleet should be reserved for times when your child is in severe discomfort. Additionally, have your child stool at regular intervals such as after meals. Stooling in the squatting position, with the knees above the level of the hips, can make stooling easier.

If constipation continues to be a problem despite these treatments, your provider might refer your child to a specialist called a gastroenterologist.

Check in with K if…

  • You would like discuss your child’s condition or you need guidance with regard to treatment options

See a doctor in person if…

  • Your child is having bad stomachaches
  • Your child has not stooled in a week despite changes in diet
  • You see blood in your child’s stool
  • Your child’s appetite is affected or they feel nauseous
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.