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Helping A Child Who’s Having a Hard Time Pooping

Jennifer Olay, MD, DPPS, DPSGHAN
Pediatric Gastroenterologist

4 mins to read Dec 11, 2020

Is your child having a hard time pooping? The bowel movement patterns may differ for every child. Oftentimes, kids may pass stools 1 to 2 times a day while others may go every 2 to 3 days.1

Functional Constipation

A child with constipation usually experiences delay or difficulty in bowel movement. The symptoms may last for 2 or more weeks causing distress to your child. You might also notice your little one having less frequent bowel movement, with stools that are hard, dry, large and painful to pass.2

Constipation is quite a common problem in children. Majority of cases of childhood constipation is considered functional, which means that it is not caused by a medical condition. It’s good to know that most cases of constipation in kids are temporary and not a cause of concern.3 However, there are some signs that you need to watch out for in cases of constipation. Consult your pediatrician if you observe your little one experiencing belly pain, abdominal swelling, vomiting, weight loss or failure to gain weight, blood in the stool, and other unusual symptoms.3

Causes of constipation

Functional constipation is caused by stress, changes in the diet such as the introduction of solids or cow’s milk, illness, and changes in routine. Your child may instinctively avoid passing hard stools because of pain or social reasons. He may feel embarrassed to use a public toilet or he might be trying to avoid getting distressed over the painful experience of defecating. It can be difficult for a constipated child to stop playing to use the toilet. Particularly, using a computer or other electronic devices and playing outside contribute to withholding or waiting to defecate. Children can also be in a hurry when defecating and, therefore, do not spend enough time to completely pass all stools.4

Caring for constipated children

Your little one’s pediatrician can recommend medications for constipation such as laxatives, which can help remove the blockage of accumulated fecal material. Laxatives can also be used as maintenance therapy. Keep in mind to follow your doctor’s instructions and proper dosage for laxatives.5

Constipated children can also benefit from dietary changes including giving high fiber diet of fruits, vegetables, and whole grains as well as encouraging drinking of plenty of water. Regular physical exercise also helps build a strong foundation for a healthy body.1

Probiotics and constipation

In one study, it shows that probiotics called Lactobacillus reuteri can help relieve constipation. In the research, L. reuteri in milk given to little ones with functional chronic constipation reduces constipation by increasing bowel movements and the frequency of passing stools.6 In another study, L. reuteri was compared to the effect of lactulose treatment in children with constipation. Results showed that the L. reuteri group improved in frequency of defecation per week as well as in symptoms of abdominal pain, painful defecation, and stool withholding behavior.7

Constipation is a common health concern in children which is temporary and can be treated. Including fiber and lots of water in the diet may help, along with regular exercise. A proven nutritional solution with L. reuteri can support improvements in bowel movement, stool frequency and stool consistency in childhood constipation. L. reuteri has also been shown to improve abdominal pain symptoms and in maintaining normal bowel movement. Always remember to watch out for warning signs like tummy pain, vomiting, and poor weight gain. To learn more about precise nutritional solution for childhood constipation, please consult your pediatrician.


1. American Academy of Pediatrics. Constipation in Children. Accessed 10 November 2020. Available from:

2. Bajaj et al., Berman’s Pediatric Decision Making, 5th edition

3. Youssef, N., & Di Lorenzo, C. Childhood constipation evaluation and treatment. 2001.Journal of Clinical Gastroenterology 33(3):199-205.

4. Philichi L, Management of Childhood Functional Constipation. Journal of Pediatric Health Care. Pharmacology Continuing Education.2018;32(1): 103-111.

5. Tabbers M, et al. Evaluation and Treatment of Functional Constipation in Infants and Children: Evidence-Based Recommendations from ESPGHAN and NASPGHAN. JPGN 2014;58: 258–274.Coccorullo et al., Lactobacillus reuteri (DSM 179378) in infants with functional chronic constipation : a double-blind, randomized, placebo-controlled study. J. Pediatr 2010; 157:598-602

6. Olgac M.and Ozcay S. Comparison of probiotic and laculose treatments in children with functional constipation and determination of the effects on constipation. Cocuk Sagligi ve Hastaliklari Dergisi 56(1):1-7.