Constipation occurs when stools become hard and difficult to pass. Parents are worried if the little one does not have a stool every day, but the frequency of defecation is less important compared to the way the stool is eliminated: easily, spontaneously, without pain vs. difficult and accompanied by cramps.

What does a normal intestinal transit in children mean?

Babies fed with milk formula can have a normal intestinal transit with a stool every 2-3 days, if they feed well and have no discomfort when defecating. In general, those who are breastfed have more frequent stools, approximately equal to the number of sucklings. After the age of 1-1.5 years, the number of stools changes, so that at 3-4 years old, children can normally have from 3 stools daily to 3 stools per week.

When does constipation occur?

Occasional constipation it is self-limited and occurs in certain situations - the child drinks too much milk or does not drink enough fluids, plays a lot and refuses to go to the toilet, changed the environment, was on vacation and traveled, started kindergarten or school, changed the person who takes care of him.

Chronic constipation it lasts for a long time, it cannot be solved with dietary measures, and the child has hard stools, with painful defecation that causes him to refuse to eliminate the stool for fear of pain. If the defecation reflex was imposed in the past, the child develops emotional problems, holding the stool in the anus. This constipation must be evaluated by a doctor, in order to differentiate it into functional or organic constipation.

Useful questions in the case of constipation in children

• How long has your child been constipated?
• What is the consistency and size of the chairs?
• What is the frequency of stools?
• Is defecation painful and accompanied by blood in the stool?
• Does the child have abdominal pain? Are they persistent?
• Constipation is accompanied by decreased appetite, weight loss or stagnation?
• Does the child use the toilet at kindergarten or school?

What can you do to regulate your child's defecation reflex?

Here are some steps I encourage you to follow to try to regulate your child's bowel reflex:

• Because the gastrocolonic reflex is triggered after meals, after the main meals, put the child on the potty or toilet for about ten minutes, but without forcing him, following a small ritual
• Encourage the child to drink liquids and natural juices, prepared at home (fresh oranges, pears, plums)
• Reduce the amount of refined sweets in the child's diet (candy, pastries, rice, pasta, white bread)
• Put a few spoons of bicarbonate in the child's bath water and let him play for 10-15 minutes in the warm water, in a sitting position
• Put a warm compress on the anal region to stimulate bowel movements
• Reward him verbally and/or gesturally after each successful defecation

Text: Dr. Cristiana Mirica , primary pediatrician