Cure for a Common Childhood Problem?

My three-year-old daughter suffers from constipation. Prunes and pear juice aren’t working, and she can be a picky eater. What do you recommend?

– June 26, 2003

Updated on 6/30/2005

Constipation is a common problem for children and is usually temporary. Strictly speaking, a child is constipated if he or she has fewer than three bowel movements per week or if the stools are hard, dry, and unusually large or difficult to pass. Because constipation can make bowel movements painful, youngsters may try to avoid having them. (In addition, about 60 percent of constipated children experience recurrent abdominal pain, a common stress-related condition in youngsters.)

The causes of constipation in kids are usually simple and relatively easy to correct: not enough fiber in their diets, not drinking enough liquids or not getting enough exercise. Then, too, constipation can occur when youngsters ignore the urge to have a bowel movement. They can do this for reasons ranging from not wanting to take a break from playing to embarrassment at using a public bathroom or because a parent isn’t around to help when the urge occurs. Medication can also be a factor. So if your daughter is taking any type of a drug, make sure that it isn’t to blame. Those that can cause constipation include aspirin and codeine, vitamins with high doses of iron, the bismuth in Pepto-Bismol, as well as some chemotherapy agents (vincristine) and some psychiatric drugs (imipramine).

I consulted my colleague, Sandy Newmark, M.D., a pediatrician here at the University of Arizona Arizona Center for Integrative Medicine, about the best way to deal with constipation in young children. Here are his recommendations:

  • Decrease dairy products: These foods can be constipating. You’ll need to provide your daughter with an alternative source of calcium such as calcium-fortified soy milk or a calcium-fortified breakfast cereal.
  • Increase fluids: Encourage your daughter to drink lots of water.
  • Increase fiber: Give her lots of high-fiber fruits and vegetables as well as high-fiber cereals, whole grain breads and beans.

Although these measures will probably do the trick, if her episodes of constipation last longer than three weeks and prevent her from participating in her normal activities, you might want to consult her pediatrician. Don’t be tempted by the laxatives designed for children on the market. They can be dangerous to youngsters and should be given only under the direction of a pediatrician.

Andrew Weil, M.D.

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