Expert Pediatric Tips for Managing Childhood Constipation

Constipation in children can lead to significant discomfort and frustration for families. Fortunately, understanding and addressing this common issue can simplify management and promote better bowel health. According to Dr. Jaya Punati, a renowned neurogastroenterologist and co-director at Children’s Hospital Los Angeles, the main indicator of constipation is not how often a child bowel movements but the stool's consistency. Healthy stool should be soft and easy to pass, resembling a coil or soft pile—similar to the emoji symbol for poop. Hard, dry stool is a clear sign of constipation.

Children's bowel movement frequency varies widely, from three times a week to three times daily, so focus on stool consistency rather than frequency. Preventive measures start with a balanced diet. Dr. Punati emphasizes the importance of consuming five to six servings of fruits and vegetables daily, each accompanied by a glass of water. Moisture in the diet aids in softening stool and facilitating easy passage, as dry foods often lead to dry, hard stool.

When dietary changes alone don't alleviate constipation, medication may be necessary. Treatments are mainly categorized into "mushers" and "pushers." Mushers, or osmotic laxatives like MiraLAX, work by drawing water into the colon to soften stool, making bowel movements easier. Common options include polyethylene glycol, magnesium, mineral oil, and sugar-based solutions like lactulose. Pushers, or stimulant laxatives such as senna, bisacodyl, and glycerin suppositories, stimulate intestinal muscles to provoke bowel movements. Dr. Punati recommends starting with mushers for a gentler approach.

Though fiber supplements are often advised, Dr. Punati prefers whole foods over supplements, noting that an apple is better than a fiber pill. Supplements can sometimes cause more constipation if not taken with sufficient water, whereas whole foods support a healthy gut microbiome, essential for digestion.

If at-home treatments remain ineffective for over a week, a visit to the pediatrician is advised. While soiling, or involuntary stool leakage, indicates severe constipation, it is manageable without emergency intervention. However, urgent care is warranted if a child experiences severe pain or is unable to pass any stool.

Maintaining a healthy diet, ensuring adequate hydration, and monitoring stool consistency are key steps in managing childhood constipation effectively. If concerns persist, professional medical guidance should be sought to prevent complications and ensure optimal digestive health.

Source: https://medicalxpress.com/news/2025-09-child-constipation-pediatrician-advice.html