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Causes
Natural tendency - some children have slow gut movement which causes
constipation. Most children with constipation have no serious cause found.
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Bowel habits - such as ignoring the urge to have a poo. Many young
children are too busy playing and put off going to the toilet. The poo then
becomes harder and larger. 'Toilet' time should be set aside to allow for regular, undisturbed visits to the toilet.
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Holding-on behaviour after a painful or frightening experience, such as
passage of a hard and painful bowel movement. Holding-on further
hardens the poo and makes the next bowel movement even more painful.
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Change in toilet environment such as new or undesirable school toilets,
or being told to hold-on when they feel the urge to go (typically at school).
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Diet - Many children who are constipated have an adequate diet and
increasing children's fibre and water intake may not fix constipation.
However, some children who have a natural tendency to get constipated
might be aggravated by a very fibre-poor diet.
Children who drink several
bottles of cow's milk per day may also become constipated.
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Anal Fissures - are painful and may cause your child to resist going to the
toilet (or holding on). A vicious cycle can then set up with holding on
making constipation worse and subsequent bowel movements more painful
to pass.
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Disease - In a very small number of children, constipation may be the
result of a physical disease. Diseases such as the absence of normal nerve
endings in parts of the bowel, defects of the spinal cord, thyroid deficiency
and certain other metabolic disorders can cause constipation. All of these
are rare, but your doctor will check your child for them.
Treatment should include:
A healthy diet
Giving your child adequate fibre in their diet might help prevent constipation in some children who have a natural tendency. To add more fibre to your child's diet, you can give your child:
at least 2 servings of fruit each day.
Fruits with the peel left on, such as plums, prunes, raisins, apricots, and peaches, have a lot of fibre.
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at least 3 servings of vegetables each day
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less processed cereals, such as bran cereals, shredded wheat, whole grain
cereals or oatmeal. Avoid refined cereals, such as corn flakes and rice
bubbles.
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wholemeal bread instead of white bread
Reduce cow's milk intake to a maximum of 500ml per day (for children over the age of 18 months) and avoid sweet drinks before meals, to improve your child's appetite at meal times.
Infants
If you think your baby (less than 12 months of age) is constipated you should
consult your family doctor or maternal & child health nurse. Some babies might need their formula changed. For infants over 6 months of age, increased fruit and vegetables in the diet might help. You can give your baby strained, stewed prunes or apricots - up to 3 tablespoons three times each week or prune juice diluted with water.
Laxatives
You may need to give your child a laxative if they are constipated. If you find this does not work, or you need to give it more than a few times in a year, then you should see your doctor.
Key points to remember
There is a lot of difference in the firmness and frequency of poo in normal
children.
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You only need to worry about the firmness or frequency of your child's poo
if it seems to be causing a problem.
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Constipation can cause stomach cramps, reduced appetite and irritability.
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Constipation can usually be controlled with good bowel habits and
medicines.
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Diet is less important in treatment of constipation in children than it is in
adults.
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See your doctor if you need to give your child laxatives more than a few
times a year.