Your child might have functional constipation

What causes constipation in kids?

Constipation in kids can be caused by several lifestyle, behavioral and dietary factors. Understanding these can help you identify the root cause and take steps toward relief. Common causes include:

• Dehydration. One of the most common constipation causes is dehydration. When a child doesn’t drink enough water, their body absorbs more fluid from the intestines, leading to hard, dry stools that are difficult to pass.
• Low fiber intake. Fiber helps bulk up and soften stool, making it easier to move through the digestive tract. Many children simply don’t get enough fiber-rich fruits, vegetables or whole grains in their diet.
• Toilet training issues or withholding behavior. Some kids may avoid pooping due to past pain, fear of using unfamiliar toilets or simply being too busy playing. Over time, this stool withholding can cause a cycle of discomfort and irregular bowel habits.
• Changes in routine. Activities like starting school, traveling or changes in diet can disrupt a child’s bathroom schedule and contribute to constipation.

Constipation signs and symptoms in babies

If an infant strains while defecating, it doesn’t necessarily mean your newborn is constipated. Most infants will strain while stooling, but this straining is normal if stools are soft and mustard-colored. If your infant has hard, bloody or white stools, or didn’t stool in their first 24 hours of life, talk with your pediatrician. In some cases, administering juices containing sorbitol, such as prune or apple juice, can treat infant and baby constipation.

Constipation signs and symptoms in toddlers and older kids

Parents often wonder how to tell if their child is constipated. Here are some common signs and symptoms to watch for:

• Fewer than three bowel movements per week
• Hard, dry or pellet-like stools
• Straining or pain while pooping
• Stomach pain or bloating
• Soiling accidents (encopresis) in potty-trained children
• Avoiding the toilet or showing signs of withholding, like stiffening their body, crossing legs or hiding
• Rectal bleeding, which is a sign that a large, passing stool may have torn the skin around the anus

Other signs might include severe narrow stools (called “ribbon stools”), urinary incontinence and abnormal growth. Constipation can sometimes cause your child to feel full, cranky or less hungry than usual. If your child frequently complains of stomachaches or avoids using the bathroom, it may be time to talk to your pediatrician.

If possible, create a 5- to 7-day constipation symptom and dietary diary for your pediatrician and record stool frequency, appearance and a pain scale. Keeping track of constipation symptoms can help your doctor determine the best constipation treatment and how to find relief.

Foods that can contribute to constipation

Some everyday foods can make constipation worse, especially when they replace fiber-rich options in your child’s diet. Here are a few culprits:

• Dairy products like cheese and milk (in large amounts)
• Processed foods such as white bread, chips and fast food
• Low-fiber snacks like crackers and cookies
• Too much meat without enough vegetables or grains
• Bananas (especially unripe ones), which can slow digestion

Encouraging a balanced diet that includes fiber, water and healthy movement can make a big difference in preventing constipation.

Constipation treatment and how to find relief

The good news is that most cases of functional constipation in kids can be treated effectively at home with lifestyle changes and a bit of patience. Here’s what can help:

• Increase fiber and fluids: Add more whole fruits, vegetables, legumes and whole grains to your child’s meals. Encourage regular water intake throughout the day. Learn more about a high-fiber diet.
• Decrease milk. It’s also important to ensure your child isn’t consuming too much cow’s milk. Excessive consumption of whole cow’s milk (over 32 ounces per day) can slow down intestinal motility and satiate a child, therefore decreasing their appetite and intake of other foods that promote soft stools, such as water, fruits and vegetables.
• Establish a bathroom routine: Have your child sit on the toilet at the same times each day — especially after meals — to encourage regular bowel habits.
• Use positive reinforcement: Reward systems or encouragement can reduce stress around bathroom use, especially for younger children.
• Physical activity: Regular movement helps stimulate digestion and can support healthy bowel movements.
• Over-the-counter remedies: In some cases, pediatricians may recommend a short course of a stool softener or laxative. These medications should only be used under medical supervision.

If your child’s constipation is persistent, painful or accompanied by other symptoms like vomiting or weight loss, it’s important to seek medical advice. With the right support, most children recover and return to comfortable, regular bathroom routines.

If dietary modification doesn’t help treat constipation, your pediatrician might recommend a stool softener and, in rare cases, a laxative. In a small number of cases, constipation might require blood work or imaging.

Foods that help relieve constipation

When it comes to easing constipation in children, certain foods can naturally promote softer, more regular bowel movements. Here are some specific, kid-friendly foods that can help:

• Pears are high in natural sorbitol, which can help draw water into the intestines and soften stools.
• Prunes (dried plums) are a well-known remedy; prunes are rich in fiber and sorbitol. Serve them chopped, pureed or as prune juice.
• Apples (with skin) contain insoluble fiber, which adds bulk to stool. Try sliced apples as a snack or baked apples for dessert.
• Raspberries are one of the highest fiber fruits, just a small serving can help support digestion.
• Oatmeal is a warm, comforting breakfast that contains soluble fiber to help keep digestion moving.
• Sweet potatoes are rich in fiber and gentle on the stomach. Serve baked, mashed or roasted.
• Green peas are packed with fiber and easy to add to pastas or soups.
• Chia seeds absorb water and form a gel-like texture, helping to soften stool. Stir into yogurt, smoothies or oatmeal.
• Popcorn (air-popped) is a fun, high-fiber snack for older children — just avoid too much butter or salt.
• Watermelon, while low in fiber, has high water content, which helps hydrate the digestive system.

Incorporating these foods into your child’s meals and snacks can make a noticeable difference in relieving constipation.

Chronic or severe constipation

Most constipation is short-term, but in some cases, it becomes chronic or more severe and needs extra attention.

Chronic constipation may require a longer-term treatment plan, including dietary changes, scheduled toilet times and sometimes the use of stool softeners or laxatives under the guidance of a pediatrician. In rare cases, a referral to a pediatric gastroenterologist may be necessary for further evaluation.

Constipation danger signs

While most constipation is manageable at home, certain danger signs signal your child may need medical help right away. Seek immediate care if your child shows any of the following:

• Severe or worsening abdominal pain
• Vomiting, especially if accompanied by a swollen belly
• Bloody stools or black, tarry stools
• Unexplained weight loss
• Fever along with constipation
• No bowel movements for more than 7 days
• Signs of dehydration, such as dry mouth, sunken eyes or decreased urination

These symptoms could indicate a blockage, infection or another serious condition. Don’t hesitate to contact your pediatrician or go to the emergency center if your child appears very uncomfortable or unwell. See Texas Children’s emergency locations.