Resolving Toddler Constipation: Do’s and Don’ts

It’s a common toilet-training roadblock: children have no trouble peeing in the potty, but when it comes to poop, well, that’s a different obstacle. Some kids are so averse to pooping on the potty they hold bowel movements, which can cause chronic and sometimes severe constipation.

Over time, hard stools can cause hemorrhoids or small tears in the anus (fissures). Not surprisingly, this makes the child even more afraid to poop, which leads to more toilet trouble and a maddening cycle of pain and frustration all around.

If this is the story in your house, take heart: Children rarely hold their bowel movements just to be difficult. Instead, they’re potty-averse because they’re used to doing their business on the run (in a diaper) or they can’t wrap their minds around the concept of letting their poop loose. Whatever the reason, these basic dos and don’ts can help pave the way toward successful (and seamless) pooping:

DO:

1. Encourage your child to drink plenty of fluids. Stick to water or water with just a splash of fruit juice. Milk can be constipating for some kids.
2. Get your child moving. Exercise stimulates digestion and helps prevent constipation.
3. Stock up on fiber-rich foods. Foods high in fiber and whole grains help keep the bowel happy by moving food through the digestive tract at a steady pace. So make sure your child noshes on fiber-rich fruits (apples and pears are great options), vegetables (especially raw) and whole grains (such as oats, millet and barley).
4. Institute some sort of reward system. A small non-food reward for pooping on the potty, such as stickers or the promise of a special outing, typically boasts big payoffs. No matter which tangible reward you choose, make sure to praise your child wildly when the deed is done. Call grandma and grandpa. Call daddy or mommy at work. Make it a big deal so he (or she) will want to repeat the process.
5. Use petroleum jelly. If your child is constipated, apply a bit of Vaseline or petroleum jelly around the anus. Not only will lubrication make for a smoother passage, the extra stimulation may provoke a bowel movement. And if the constipation has led to fissures (cracks in the skin in and around the anus) dab some diaper cream on them to help the healing process.

DON’T

1. Get angry. Scolding your child or making him feel shame will only create a power struggle — one that kids usually win. Remember he’s not avoiding the potty to make you angry. They’re trying to wrap their minds (and bodies) around a complex process. If your child poops in his pants, calmly lead him to the bathroom, flush the loaded contents and explain that poop goes in the potty.
2. Make your child sit on the potty until she poops. Bowel movements come when the body is ready. Rather than sitting your child on the toilet and forcing them to “try,” take note of the first signs your child makes before she poops. Does she pause during an activity, make a funny face, walk over to a different part of the room? If you notice these pre-pooping signals, you can rush your child to the toilet (or at least to the bathroom) before the bowel movement occurs.
3. Let your child strain. While there’s nothing wrong with a little pushing during a bowel movement, grunting and forcing out poop could spell trouble (both in terms of constipation and anal fissure and hemorrhoids). Instead of forcing it, have your child drink a tall glass of water and eat a piece of bowel-friendly fruit (peaches, pears or prunes!) and then try again about 30 minutes later.
4. Let your child load up on constipating foods. Sugar and refined carbohydrates (like white bread, pasta and rice) are known toddler constipation culprits. Bananas and dairy, too, may lead to toilet troubles.
5. Fret. Nearly every child masters the art of pooping on the potty. If your child is taking his time, encourage him with baby steps. Let him poop in his diaper, but lead him to the bathroom when he has a bowel movement. Once your kid gets used to pooping in his diaper in the bathroom, have him sit on the potty with a loosely fastened diaper. And finally, ditch the diaper altogether and do a happy dance when he lets the poop fall in the toilet.

Still not successful? It might be time to visit the pediatrician for assistance. A stool softener or laxative may be the answer to toddler constipation, but these should never be given to a child without a doctor’s recommendation. Once your child has regular, soft, formed stools, she’ll gain the confidence that she can have a bowel movement without pain.