Expert Advices on Constipation in Kids: How to Deal with Stubborn Tummies - January 2025

Spending hours on the toilet seat isn’t fun. And it’s not healthy for you either. That’s what sufferers of constipation experience often. When it’s your kids who are in that position, it can be easy to worry as a parent. We sat down with pharmacist Nazatul Amira Hamzah at Primabumi Sdn Bhd to learn more about childhood constipation and what parents need to know about this common but inconvenient condition. Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Nazatul is a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. She currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur. Hopefully some much-needed advice from our pharmacist, Nazatul will shed some light on how parents can help things flow smoothly for their kids again. Question 1: How do I know that my child is having constipation? Constipation in children is characterised by a delay or trouble passing stools for a minimum of two weeks. You would notice that your child is having fewer than 3 bowel movements per week. Question 2: How do I know that my child is having constipation? Your child may suffer from constipation if they exhibit certain obvious symptoms. And even some uncommon ones, too. The usual is, of course, having fewer bowel movements than usual, passing very large, hard and/or dry stools, pain or discomfort when defecating and gassy or bloated stomach. Other red flags to watch out for can also include stomach aches, decreased appetite, and encopresis (soiling of the underpants). But other symptoms can also point towards constipation such as lack of energy and being irritable or angry all the time. Question 3: What causes constipation in children? Several contributing factors include insufficient water intake and a lack of high-fibre foods in the diet, both of which can impede proper bowel movements. Additionally, a sedentary lifestyle and the practice of ignoring the natural urge to pass stools, known as 'withholding', can exacerbate the issue. Transitioning from breast milk to cow's milk or an infant formula, along with introducing processed foods to a child's diet, may also contribute to constipation. Dehydration, especially when worsened by fever, diarrhoea, and vomiting, is another significant factor. Some medications can also have constipation as a side effect so be sure to be on the lookout for that. Emotional stress, such as the challenges associated with moving to a new place or starting school, can impact the digestive system as well. Question 4: Is constipation dangerous? Constipation is a common problem for kids who have learned to use the toilet, usually around ages 2 to 3. Parents need to pay attention to this issue. If constipation happens a lot or lasts a long time, it can cause some serious problems: Rectal bleeding: This means there might be blood in the poop, and it could look bright red or dark and sticky. Haemorrhoids (also called piles): Swollen veins can form inside the bottom or outside near the opening. This often happens when kids push too hard to poop. Rectal prolapse: The lining of the rectum comes out through the bottom and sticks out of the body. Poop buildup: Faeces can get stuck and hard in the bottom and rectum, causing a problem. Question 5: What can I do to help ease and prevent my child from having constipation again? To help your child with constipation and prevent it from happening again, start by making some lifestyle changes. Here's what you can do: Make sure your child drinks enough water. For kids under four, aim for two to three glasses a day, and for those over four, eight glasses a day is recommended. Include a variety of foods in their diet, especially fruits and vegetables. For children aged three to six, try to give them two servings of fruits and two servings of vegetables every day. Encourage your child to stay active and move around. Physical activity can help with regular bowel movements. Have your child use the toilet twice a day for 5 to 10 minutes, preferably after breakfast and dinner. This routine can help them establish a regular bathroom habit. Question 6: I’ve tried all the recommended lifestyle changes but my child’s is still constipated. What should I do? If your child is constipated, here's what you can do: The first treatment option recommended by NICE (the National Institute for Health and Care Excellence, United Kingdom) is macrogol oral powder. This helps soften the stool by keeping fluid in the colon, which gets absorbed by the stools. This makes bowel movements more natural as the volume of stools increases. You can expect bowel movements within 24 to 48 hours after taking macrogol. However, it's important not to use macrogol for more than 3 months. Another treatment for constipation is lactulose, which comes as a sweet-tasting, colorless liquid. It may take up to 48 hours for your child to respond to treatment with lactulose. Both macrogol and lactulose are available over-the-counter in Malaysia. Question 7: Some friends of mine recommended using enemas to treat my child’s constipation. Is this a good idea? Using an enema involves injecting fluids into the rectum to clean the colon, encourage bowel movements, or deliver medication. While enemas can be effective for clearing hard stools, they are generally not recommended for children. Using enemas in children can cause discomfort or pain during insertion. Prolonged use may lead to dehydration and an imbalance in electrolyte levels and gut flora – a diverse community of microbes in the digestive system that includes bacteria, fungi, and viruses, contributing to human metabolism. It's crucial not to give enemas to children under 6 years old or use them for an extended period without consulting a doctor. Always seek medical advice before considering enema use for children. Question 8: Do probiotics help with my child's constipation? Which probiotics work well in this case? Certainly, probiotics can be helpful in aiding your child's recovery from constipation. They work by increasing the frequency and volume of bowel movements through the promotion of intestinal peristalsis. Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract. Additionally, probiotics can reduce the transit time of faeces in the intestine. Specifically, probiotic strains from the Bifidobacterium and Lactobacillus families have been shown to provide these beneficial effects in clinical studies. Incorporating probiotics into your child's diet may support their digestive health and help alleviate constipation. Question 9: When should I bring my child to a doctor? You are strongly advised to seek urgent medical attention when any of the following occurs: your child complains of strong pain despite treatment there is blood in your child’s stools your child also has a fever your child is not eating Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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