What to do when your child is constipated? 6 quick and effective home remedies

Constipation in children is a common digestive issue that causes many parents anxiety. According to pediatric studies, about 3–5% of children who visit a doctor and up to 25% of cases seen by pediatric gastroenterologists are related to constipation. Many children withhold stool because they are busy playing, fear painful bowel movements, or are in the potty-training phase, causing their stool to become increasingly dry and hard, and making defecation more difficult.

If a child experiences prolonged constipation, they may suffer from abdominal pain, bloating, loss of appetite, fussiness, and disruption to daily activities. The good news is that most cases can be improved by adjusting diet, increasing water intake, establishing a regular toilet routine, and encouraging physical activity. In this article, Tiptory will guide parents on safe, easy-to-implement home care methods for constipated children, and help them recognize when to take their child to a doctor for timely treatment.

Part 1: Signs of Constipation in Children: How to Accurately Identify It

Symptom 1: Signs of constipation in children

Early recognition of constipation symptoms in children

• Children with constipation often try to hold in their stool because they fear pain during defecation. If not detected early, this condition can cause stool to become increasingly dry and hard, making the child even more reluctant to have a bowel movement and creating a difficult-to-break cycle.
• Parents should monitor the following symptoms to identify signs of constipation in children and provide appropriate care.

Difficulty passing stool

• The child has to strain hard or sit on the potty or toilet for a long time to pass stool.
• Each bowel movement requires a lot of effort and makes the child appear tired or uncomfortable.
• This is one of the most common symptoms of constipation in children.

Dry, hard, or bloody stool

• Large, dry, and hard stools, causing the child pain during defecation.
• In some cases, a few streaks of fresh red blood may appear on the surface of the stool or on toilet paper due to anal fissures from straining.
• If bleeding recurs or the amount of blood is significant, parents should take the child to a medical facility for examination.

Significant decrease in bowel movement frequency

• A child having fewer than 3 bowel movements per week may be a sign of constipation.
• However, parents also need to monitor stool characteristics and other symptoms, as bowel movement frequency can vary depending on age and diet.

Pain during defecation

• Children may cry, grimace, or refuse to go to the toilet due to fear of pain.
• Some children may also cross their legs, clench their buttocks, or try to hold in their stool to avoid discomfort.
• Prolonged stool retention can worsen constipation.

Nausea or loss of appetite

• When stool accumulates in the intestines for a long time, children may feel bloated, uncomfortable, nauseous, or eat less.
• These symptoms usually improve after the child has a bowel movement.

Abdominal pain or bloating

• Children may complain of intermittent abdominal pain or feel their abdomen is distended.
• The pain is often related to the amount of stool accumulated in the colon and tends to decrease after defecation.

Stool leakage into underwear

• Some children may pass only a small amount of soft or clay-like stool, which may even stain their underwear.
• This is not diarrhea but may be the phenomenon of liquid stool leaking around a hard stool mass stuck in the rectum.
• If this occurs frequently, parents should take the child to a doctor for assessment and appropriate treatment.

Symptom 2: Factors that make children prone to constipation

Lack of physical activity

• Children who jump and run less, sit more, or spend a lot of time watching TV, using phones, or tablets have a higher risk of constipation.
• Physical activity helps stimulate intestinal peristalsis, promoting the smooth movement of food and stool through the digestive tract.

Low-fiber diet

• Children who eat less green vegetables, fruits, whole grains, or other fiber-rich foods are often prone to constipation.
• Fiber helps soften stool, increase stool bulk, and make it easier for children to pass stool.

Insufficient water intake

• When the body is dehydrated, the intestines absorb more water from the stool, making the stool dry and hard.
• Encouraging children to drink enough water daily is one of the simplest ways to prevent constipation in children.

Use of certain medications

• Some medications can slow bowel movements or make stool drier, thereby increasing the risk of constipation.
• If a child starts experiencing constipation after taking medication, parents should consult a doctor before arbitrarily stopping or changing the medication.

Anal or rectal abnormalities

• Certain congenital issues or medical conditions of the anus or rectum can cause pain during defecation or hinder stool passage.
• These cases require examination by a doctor to determine the cause and appropriate treatment.

Family history of constipation

• If parents or family members frequently suffer from constipation, the child may also be at higher risk.
• Genetic factors combined with dietary habits and lifestyle can affect a child's digestive function.

Neurological conditions

• Children with conditions affecting the nervous system, such as cerebral palsy, may have difficulty controlling bowel movements.
• This increases the risk of chronic constipation in children and requires long-term monitoring.

Stress or psychological changes

• Changes such as starting school, potty training, moving, or psychological stress can cause children to withhold stool.
• Prolonged stool retention is a common cause of constipation in children.

Hypothyroidism or metabolic disorders

• Certain medical conditions like hypothyroidism or metabolic disorders can reduce bowel activity, causing stool to move more slowly.
• If a child experiences prolonged, recurrent constipation, or if it's accompanied by weight loss, fatigue, and other abnormal signs, parents should take the child to a doctor to find the cause and receive timely treatment.

Symptom 3: When to take your child to the doctor?

Fever with constipation

• Constipation in children accompanied by fever may be a sign of infection or another medical condition that needs evaluation.
• Parents should not solely treat constipation at home if the child has prolonged or high fever.

Frequent vomiting

• If a child experiences continuous vomiting along with constipation, this could be a sign of bowel obstruction or a serious digestive disorder.
• Take the child to a medical facility for examination as soon as possible.

Blood in stool

• A small amount of blood may sometimes appear due to anal fissures when the stool is too hard.
• However, if there is a large amount of blood in the stool, it recurs, or the cause is unclear, the child needs to be examined by a doctor to rule out other digestive diseases.

Abnormal abdominal distension

• A hard, severely distended, or increasingly swollen abdomen may indicate severe stool impaction or an intestinal problem.
• This is a sign that medical examination should not be delayed.

Weight loss or slow weight gain

• Chronic constipation in children accompanied by weight loss, delayed development, or failure to gain weight for their age may be related to an underlying medical condition.
• The doctor may order necessary tests to find the cause.

Cracked skin around the anus

• Hard stool can tear the skin around the anus, causing pain, bleeding, and making the child even more afraid to have a bowel movement.
• If the fissures do not improve or recur frequently, the child needs to be examined and treated.

Rectal prolapse

• In some rare cases, the rectum may protrude from the anus after the child strains hard during defecation.
• This condition needs to be evaluated and treated early by a doctor to avoid complications.

Frequent urination or painful urination

• Constipation can put pressure on the bladder, increasing the risk of urinary tract infections in children.
• If a child experiences painful urination, frequent urination, or a weak stream, parents should take the child to a doctor for an accurate diagnosis.

Prolonged loss of appetite

• Children who are frequently bloated and uncomfortable due to constipation may eat less than usual.
• If the loss of appetite is prolonged or affects development, the cause needs to be found and treated appropriately.

Severe or prolonged abdominal pain

• Mild abdominal pain can occur when a child is constipated, but severe, continuous, or unresolving pain after defecation is an abnormal sign.
• Parents should take the child to the hospital immediately to rule out conditions requiring urgent treatment.

Part 2: How to treat constipation in children at home without medication

Method 1: Ensure the child drinks enough water

Increase water intake to soften stool

• When a child is constipated, drinking enough water helps soften stool, making it easier to move through the intestines and reducing pain during defecation.
• Encourage the child to drink water regularly throughout the day instead of only when thirsty.

Prioritize plain water and fruit juice

• Plain water is the best choice for staying hydrated.
• Some age-appropriate fruit juices can also help alleviate constipation by providing water and natural compounds that stimulate bowel movements.
• Avoid overusing juice as it can increase the child's sugar intake.

Monitor the child's reaction to milk

• Some children may experience constipation after drinking milk or consuming too many dairy products.
• If milk is suspected to be the cause, parents should consult a doctor or nutritionist before changing the child's diet.

Limit caffeinated beverages

• Children should not consume caffeinated beverages such as strong tea, energy drinks, or cola soft drinks.
• Caffeine can lead to greater dehydration, thereby worsening constipation in children.

Ensure the child drinks enough water daily

• A child's water needs vary and depend on their age, weight, activity level, weather, and health condition.
• On hot days or when the child is very active, the amount of water needed will increase.

Recognize signs of dehydration in children

• Parents should pay attention to signs such as:
  • The child is tired, sluggish, or less active than usual.
  • Urine is dark yellow or cloudy.
  • Urinating less frequently than usual.
  • Dry lips or dry mouth.
• If the child shows signs of dehydration, water should be supplemented early because dehydration is one of the common causes of prolonged constipation in children.

Method 2: Increase fiber for children

Supplement fiber-rich foods daily

• Fiber helps retain water in stool, making it softer and supporting efficient bowel movements.
• When a child is constipated, increasing fiber intake is one of the simplest and most effective ways to improve difficult bowel movements.

Prioritize fiber-rich foods

• Parents should add a variety of the following food groups to their child's meals:
  • Legumes and nuts.
  • Whole wheat bread, oats, brown rice, and whole grains.
  • Fresh fruits like pears, apples, oranges, kiwis, or plums.
  • Green vegetables like broccoli, spinach, amaranth, pumpkin, and seasonal vegetables.
• Varying foods regularly helps children get enough nutrients and prevents boredom.

Increase fiber gradually

• Do not increase too much fiber in a short period as it can cause bloating or discomfort.
• Add it little by little and combine with adequate water intake for fiber to work best.

Meet fiber needs by age

• Recommended daily fiber intake includes:
  • Young children: about 20g of fiber/day.
  • Teenage girls: about 29g of fiber/day.
  • Teenage boys: about 38g of fiber/day.
• These are reference levels; actual needs may vary depending on the child's age, physical condition, and diet.

Combine fiber with a healthy lifestyle

• Only supplementing with fiber-rich foods may not be enough to improve constipation in children.
• For better results, parents should ensure their children drink enough water, exercise daily, and establish a regular toileting habit. These are important factors in preventing recurrent constipation.

Method 3: Foods that help children have easier bowel movements

Supplement foods that support bowel motility

• Some foods rich in fiber and containing natural compounds can support bowel motility, help soften stool, and improve constipation in children.
• Parents should prioritize adding these foods regularly to their child's diet rather than only using them when the child is already constipated.

Fruits good for constipated children

• Many fruits are rich in fiber and contain abundant water, helping children have easier bowel movements, including:
  • Prunes.
  • Peaches.
  • Pears.
  • Fresh plums.
  • Apples.
  • Apricots.
  • Raspberries.
  • Strawberries.
• Parents can let children eat them directly, make smoothies, or cut them into small pieces to combine with yogurt, depending on the child's age and eating ability.

Increase legumes

• Legumes are a rich source of fiber and nutrients, contributing to improved digestive function.
• They can be prepared into soups, porridges, or stews to make them easier for children to eat.

Supplement peas

• Peas contain a lot of fiber, vitamins, and minerals, which help increase stool bulk and support bowel motility.
• This is a suitable food to include in the diet of constipated children.

Add spinach to meals

• Spinach provides a significant amount of fiber along with many vitamins and minerals beneficial for the digestive system.
• Parents can prepare it as soup, porridge, or puree to suit different ages.

Notes on supplementing natural laxative foods

• Increase fruit and vegetable intake gradually to allow the child's digestive system to adapt.
• Combine with ensuring the child drinks enough water and exercises daily to enhance effectiveness.
• If the child has prolonged constipation, pain during bowel movements, or does not improve after dietary changes, parents should take the child to a doctor for appropriate advice and treatment.

Method 4: Limit constipation-causing foods

Reduce foods that can worsen constipation

• When a child is constipated, in addition to increasing fiber and ensuring adequate water intake, parents should also adjust foods that can lead to dry, hard stools or slow down the digestive process.
• Not all children experience constipation due to the same foods, so monitor your child's reactions to establish an appropriate diet.

Monitor milk and dairy product intake

• Some children may experience constipation after drinking milk or consuming a lot of dairy products such as cheese, butter, or yogurt.
• If this is suspected to be the cause, parents should consult a doctor or nutritionist before adjusting the diet to ensure the child still receives adequate calcium and necessary nutrients.

Do not overconsume starchy foods

• Some starch-rich foods include:
  • Carrots.
  • Pumpkins.
  • Potatoes.
  • Unripe bananas.
• These foods still have nutritional value, but if children eat too much of them without enough green vegetables, fruits, and water, the risk of constipation in children can increase.

Limit processed foods

• Fast food and processed foods often contain:
  • Lots of fat.
  • Lots of sugar.
  • Lots of salt.
  • Little fiber.
• These foods not only increase the risk of constipation in children but also make them feel full quickly, leading to less consumption of green vegetables, fruits, and other fiber-rich foods.

Prioritize a balanced diet

• Instead of completely avoiding a certain food, parents should create a diverse menu with plenty of:
  • Green vegetables.
  • Fresh fruits.
  • Whole grains.
  • Age-appropriate protein-rich foods.
• A balanced diet combined with adequate water intake and regular exercise will help improve constipation in children more effectively, while also supporting long-term healthy digestive function.

Method 5: Encourage children to exercise

Increase daily physical activity

• Physical activity helps stimulate bowel movements, aiding the easier movement of food and stool through the digestive tract.
• For constipated children, maintaining a daily exercise routine can help improve bowel movements and reduce the risk of recurrent constipation.

Let children play outdoors

• Create opportunities for children to run, climb, or participate in active games at parks, playgrounds, or amusement centers.
• These activities are not only good for the digestive system but also help children develop physically and release energy.

Encourage children to cycle

• Cycling is a suitable activity for many ages, helping to strengthen abdominal muscles and the digestive system.
• Parents should let children cycle regularly according to their ability and always ensure safety measures are taken.

Let children swim

• Swimming is a full-body exercise that improves health, strengthens muscles, and promotes effective bowel movements.
• If possible, parents can let their children swim 1–3 times per week, adjusted to the child's age and physical condition.

Establishing a long-term exercise habit

• There's no need to over-exercise; the key is to maintain regular physical activity every day.
• Combining exercise, a fiber-rich diet, adequate water intake, and timely bowel movements will help children with constipation improve effectively, while supporting a healthy digestive system and reducing the risk of recurrence in the future.

Method 6: Establish a toilet routine

Establish a fixed toilet schedule daily

• For children with constipation, establishing a regular bowel movement schedule helps form a natural defecation reflex.
• Parents should encourage children to sit on the toilet or potty for about 10 minutes, 30–60 minutes after each meal. This is when bowel movements are most active, making it easier for children to pass stool.
• Do not force or pressure the child if they are unable to go.

Guide children to relax during bowel movements

• Many children withhold stool because they fear pain, which prolongs constipation in children.
• Guide children to:
  • Breathe in and out slowly and deeply to relax the body.
  • Relax the abdominal and anal muscles.
  • Maintain a relaxed state of mind instead of straining too hard.

Help children reduce their fear of defecation

• Parents can encourage children to imagine fun things or visualize bowel movements occurring gently and painlessly.
• This helps reduce stress and creates a positive feeling each time the child uses the toilet.

Gentle abdominal massage

• Before the child sits on the toilet, parents can massage the abdomen in a circular, clockwise motion for a few minutes.
• Gentle massage can help stimulate bowel movements and make the child feel more comfortable.

Encourage instead of reprimand

• Praise children when they proactively sit on the toilet or try to have a bowel movement, even if unsuccessful.
• Parents can offer small rewards such as:
  • Giving stickers.
  • Allowing extra time for their favorite games.
  • Verbal praise to encourage them to maintain the habit.
• Avoid scolding or putting pressure on them, as this can make children even more afraid of using the toilet.

Adjusting to the correct sitting posture

• When sitting on the toilet, place a small stool under the feet so that the knees are higher than the hips.
• This posture helps the rectum be in a more favorable position, reduces straining, and helps children with constipation pass stool more easily.

Consistent habit maintenance

• Improving constipation in children often takes time, especially for children who have developed a habit of withholding stool.
• Maintaining a regular daily toilet schedule, combined with a fiber-rich diet, adequate water intake, and regular exercise, will help the digestive system function more effectively and reduce the risk of constipation recurrence.

Part 3: When should children with constipation see a doctor?

Note 1: Use medication as directed by the doctor

Consult a doctor before using medication

• If constipated children do not improve after dietary and lifestyle changes, parents should take them to a doctor for advice on appropriate treatment methods.
• Although some stool softeners or fiber supplements are sold over-the-counter, parents should not self-administer them to children without a doctor's opinion.

Stool softeners and fiber supplements

• Doctors may consider using stool softeners or fiber supplements to:
  • Soften stool.
  • Reduce pain during defecation.
  • Help children pass stool more easily.
• These products are only effective when children drink enough water daily.

Dosage must be appropriate for each child

• The medication dosage is not the same for all children but is calculated by the doctor based on:
  • Age.
  • Weight.
  • Severity of constipation.
  • Overall health condition.
• Parents should not arbitrarily increase, decrease, or prolong the duration of medication use.

Adequate water intake when using fiber

• If the child is prescribed fiber supplements, ensure they drink enough water throughout the day.
• Lack of water can make fiber less effective, and even worsen constipation in children.

Glycerin suppositories should only be used when necessary

• In some cases, doctors may recommend using glycerin suppositories to help children pass stool when it is too dry and hard.
• This is a short-term supportive measure and should not be overused or used regularly without guidance from healthcare professionals.

Do not self-administer laxatives long-term

• Overuse of laxatives can lead to bowel dependence on the medication and affect natural defecation function.
• Parents should prioritize adjusting the diet, increasing water intake, encouraging children to exercise, and establishing a regular toilet routine. Medication should only be used when prescribed by a doctor or when home care measures are ineffective.

Note 2: Do not self-administer laxatives

Only use laxatives when prescribed by a doctor

• Parents should not self-administer laxatives to children with constipation, even if the medication is sold over-the-counter.
• Choosing the wrong medication can increase the risk of abdominal pain, diarrhea, electrolyte imbalance, or mask other serious underlying conditions.

Cases requiring medical treatment

• If a significant amount of stool is impacted in the intestines or the child experiences chronic constipation, the doctor may prescribe stronger treatment methods to help the child pass stool.
• These methods require monitoring by healthcare professionals to ensure safety and effectiveness.

Bulk-forming laxatives

• This group of medications helps increase water in the stool, making it softer and increasing its volume for easier elimination.
• These medications are often used in conjunction with adequate water intake for best results.

Osmotic laxatives

• These medications work by drawing more water into the intestines, making stool softer and easier to move.
• This group of medications is often considered by doctors in treating constipation in children, depending on the child's age and condition.

Stimulant laxatives

• This group of medications stimulates the muscles of the intestines to contract and push stool out.
• These medications are usually only used when the stool is already soft but the child still cannot pass it normally.
• Due to their strong effect, stimulant laxatives are usually prescribed only for a short period and when other treatment methods have not been effective.

Mineral oil and other supportive measures

• In some cases, doctors may consider using mineral oil or other supportive methods to soften stool.
• Their use must strictly adhere to the doctor's instructions to minimize the risk of aspiration or other undesirable side effects.

Do not overuse laxatives

• Laxatives are not a long-term solution for constipated children.
• Parents should prioritize building a fiber-rich diet, ensuring children drink enough water, exercising regularly, and establishing a regular toilet routine. If a child's constipation persists or recurs frequently, take them to a doctor to identify the cause and choose an appropriate treatment method.

Note 3: Treating fecal impaction in children

Recognizing fecal impaction

• Fecal impaction occurs when dry, hard stool accumulates in the rectum for a long time, preventing constipated children from having normal bowel movements.
• This condition can cause abdominal pain, bloating, painful defecation, or leakage of some liquid stool into the underwear due to soft stool flowing around the hard mass.
• If fecal impaction is suspected, parents should take their child to a medical facility for examination.

Treat only under a doctor's guidance

• The treatment of fecal impaction in children must be performed by a doctor or strictly according to the instructions of healthcare professionals.
• Parents should not arbitrarily administer enemas or suppositories to children, as this can cause anal or rectal damage or worsen the condition.

Rectal suppositories

• In some cases, doctors may prescribe rectal suppositories to help soften stool and stimulate bowel movements in children.
• The medication is inserted into the rectum as a suppository, which then dissolves and takes effect locally.
• Its use must be in the correct dosage, with the correct technique, and as prescribed by the doctor.

Rectal enemas

• If the fecal mass is too large or too hard, the doctor may prescribe an enema to introduce a solution into the rectum, helping to soften and expel the stool.
• This method often provides quick relief in treating fecal impaction, but should only be performed in a medical facility or under the specific guidance of a doctor.

Post-treatment monitoring

• After the fecal mass is removed, parents need to continue implementing preventive measures for constipation in children, including:
  • Ensure the child drinks enough water.
  • Increase fiber-rich foods.
  • Encourage daily physical activity.
  • Establish a regular toilet schedule.
• Maintaining these habits helps reduce the risk of recurrent constipation and limits future fecal retention.

Do not self-medicate with laxatives

Always consult a doctor before treatment

• Parents should not self-administer laxatives, enemas, or rectal irrigation to children with constipation without a doctor's guidance.
• Each type of medication has different indications, contraindications, and dosages. Incorrect use can increase the risk of abdominal pain, diarrhea, dehydration, or electrolyte imbalance.

Dosage must be appropriate for each child

• The medication dosage is determined by the doctor based on various factors such as:
  • Age.
  • Weight.
  • Severity of constipation.
  • Overall health and co-existing medical conditions.
• Do not use another child's dose or self-adjust the dose without prior instructions.

Avoid self-enema at home

• Enemas should only be performed when prescribed by a doctor and with proper technique.
• Improper technique can cause anal and rectal damage or make the child more fearful of using the toilet in the future.

Prioritize treating the cause

• In most cases, constipation in children can be improved by adjusting diet, increasing fiber intake, drinking enough water, regular physical activity, and establishing a regular toilet schedule.
• If these measures are ineffective or the child shows unusual signs, the doctor will choose the most appropriate and safest treatment method.

Take the child to the doctor if constipation is prolonged

• If constipation in children is prolonged, recurs frequently, or is accompanied by signs such as severe abdominal pain, vomiting, fever, abdominal distension, or blood in the stool, parents should take the child to a medical facility for timely evaluation and treatment, instead of self-medicating at home.

References

1. Baker SS, Liptak GS, Colletti RB, Croffie JM, Di Lorenzo C, Ector W, Nurko S. Constipation in Infants and Children: Evaluation and Treatment. Journal of Pediatric Gastroenterology and Nutrition. 1999;29(5):612–626.
2. Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, Staiano A, Vandenplas Y, Benninga MA. Evaluation and Treatment of Functional Constipation in Infants and Children: Evidence-Based Recommendations From ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition. 2014;58(2):258–274.
3. National Institute for Health and Care Excellence (NICE). Constipation in Children and Young People: Diagnosis and Management. London: National Institute for Health and Care Excellence; 2023.
4. American Academy of Pediatrics. Toilet Training Guidelines: Parents—The Role of the Parents in Toilet Training. Elk Grove Village, IL: American Academy of Pediatrics.
5. National Institute of Diabetes and Digestive and Kidney Diseases. Definition and Facts for Constipation in Children. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases.
6. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Constipation in Children. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases.
7. American Academy of Pediatrics. Caring for Your Child's Constipation. Elk Grove Village, IL: American Academy of Pediatrics.
8. Merck Manual Professional Edition. Constipation in Children. Merck & Co., Inc.
9. MSD Manual Consumer Version. Constipation in Children. Merck & Co., Inc.
10. World Gastroenterology Organisation. WGO Practice Guideline: Constipation. World Gastroenterology Organisation.
    

Content edited by: Sidney Bailey Hoang.

Information reviewed and verified by expert: William Harris.