Understanding Red Flags of Constipation in Children
Constipation is a common issue that can affect children of all ages. It's important for parents and caregivers to be aware of the red flags of constipation in order to identify and address the problem early on. Let’s discuss the red flags of constipation in babies, toddlers, and potty-trained children.
Red Flags in Babies
Extra-large Poops: Huge poops are a common sign of constipation in babies. If your baby's stools seem unusually large, it's likely they are constipated.
Poops Formed Like Rabbit Pellets or Logs: If your child's poop resembles small pellets or logs, it's a sign of constipation. Dry and firm stools indicate constipation, while moist and soft stools are healthy.
Straining or Crying to Poop: Straining and crying during bowel movements can be a normal occurrence in newborns (infant dyschezia), but if the baby continues to strain beyond a few weeks, they may be constipated.
Bloody Stool or a Bloody Bottom: Passing hard or large stools can cause anal tearing and result in bright red blood in the stool or on the diaper. Softening the baby's stool can help heal the tearing.
Infrequent Pooping: While pooping frequency is not the best indicator of constipation, if your child isn't pooping daily, it may be a red flag. Babies under age 1 should poop on average 2.2 times a day, while children between ages 1 and 3 should poop around 1.4 times a day.
Red Flags of Constipation in 2-3 Year-Olds during Potty Training
During the potty training phase, there are several signs that may indicate constipation in 2-3 year-old children. These red flags include:
Hiding to Poop: Some toddlers may seek privacy when they need to poop, hiding in various places like closets or behind curtains. This behavior is often misunderstood as a sign of readiness for potty training, but it can actually indicate constipation.
Skid Marks or Itchy Anus: Poop smears in diapers or underwear, commonly known as skid marks, and the itching they cause are signs of constipation that are often overlooked by parents. These smears indicate that the child hasn't fully emptied or has been trying to hold in their poop.
Belly Pain or a Distended Belly: Children with constipation may complain of belly pain or have a distended abdomen. The child's stomach may appear bloated or protruded due to the accumulation of stool.
Decreased Appetite: Some constipated children may have a decreased appetite, feeling bloated and uncomfortable from carrying around a large amount of stool. This lack of appetite often goes unnoticed until the constipation is resolved.
Diarrhea: Surprisingly, loose and watery stools can be a sign of constipation. Fresh poop may ooze around the hard stool, giving the appearance of diarrhea. It's important not to dismiss constipation based on the consistency of the stool.
Pooping More than Once a Day: While infants may poop multiple times a day, for toddlers and older children, pooping more than once a day can indicate that they are not fully emptying their bowels. It's normal for children to have a single daily evacuation, and frequent pooping may suggest constipation.
Reluctance to Poop in the Toilet: Children who are constipated may show reluctance to poop in the toilet. This reluctance is often mistaken as a sign of readiness for potty training, but it may actually be a result of their fear of painful bowel movements or other sensory issues related to the toilet.
Red Flags of Constipation in Potty-Trained Children
A child who experienced constipation as a baby remains at risk for recurrence. Some children may start having daytime pee accidents in later years, surprising their parents who may have forgotten about their previous constipation. Changes in circumstances, such as restrictive restroom policies or dietary changes, can trigger constipation to return, leading to new and more severe symptoms. It's crucial to be aware of the red flags of constipation in older children, as constipation can run in families, and parents may not realize that their older kids are also constipated.
Urinary Frequency: The child frequently asks to use the bathroom, even in short intervals.
Urinary Urgency: The child experiences an overwhelming need to pee immediately.
Bedwetting: The child wets the bed, which can be caused by constipation rather than other common explanations.
Daytime Pee Accidents: The child has accidents during the day, which can be a result of a bladder gone haywire due to constipation.
Chronic Urinary Tract Infections (UTI): The child repeatedly experiences urinary tract infections due to holding poop and holding pee.
It's important to note that these signs may indicate constipation in potty-trained children, and appropriate care should be sought if constipation is suspected. It's also essential to rule out any underlying medical conditions that may contribute to constipation.
There are also certain medical conditions that need to be ruled out, such as:
Hirschsprung's disease: affects the colon and rectum due to the absence of nerve cells. Symptoms include a swollen belly, pencil-thin stools, explosive and bloody diarrhea, and vomiting.
Congenital anorectal malformation: anus or rectum doesn't develop properly, resulting in serious pooping problems and may require surgical correction.
Spinal cord abnormalities (spina bifida and tethered cord syndrome): affect nerve function in the lower spine, leading to abnormal bowel movements. It's important to consult a healthcare professional for proper diagnosis and treatment.
Being aware of the red flags of constipation in children can help parents and caregivers take the necessary steps to address the issue and prevent further complications. One bad experience can cause a child to withhold stool, leading to pain and a cycle of constipation. This cycle is a major factor in potty training difficulties, poop anxiety, tantrums, and potentially pelvic floor dysfunction. Prevention is key, so it is important to recognize the signs, treat constipation early, and address any poop anxiety.
Please note that this information does not substitute professional medical advice, and it is always advisable to consult with a healthcare professional for proper diagnosis, treatment, and guidance tailored to your child's specific needs.
To learn more about how to navigate the challenges of pre-training or potty training, and to address any concerns related to constipation or pelvic floor dysfunction in children, it is recommended to consider taking a pre-training/potty training workshop or booking an online consultation with Dr. Lea, a Pediatric Pelvic Floor Therapist.
Dr. Lea specializes in helping children and their families with potty training difficulties, poop anxiety, and pelvic floor dysfunction. By seeking expert guidance, parents and caregivers can gain valuable insights, strategies, and support to ensure a successful and healthy potty training journey for their child.
Remember, early intervention and appropriate care are crucial in addressing constipation and promoting a child's comfort and overall well-being during the potty training process.
Written by Dr. Lea
