Constipation in Children (Bachon mein Qabz): Causes, Diet and Safe Treatment

A child who hides in the bathroom, cries at the thought of the toilet, or goes days without a stool is a worry for any parent. Constipation in children (bachon mein qabz) is very common, and it is rarely serious. But a hard, painful stool can start a cycle where the child holds it in, which makes the problem worse.

This guide explains how to recognise constipation in children, what causes it, the diet and habits that help, when a laxative may be appropriate, and the warning signs that need a doctor.

How do you know a child is constipated?

It is not only about how often your child goes. Look for:

• Fewer than three stools a week.
• Hard, dry, pellet-like or very large stools.
• Pain, crying or straining when passing stool.
• Blood-streaked stool or a small tear (fissure) at the anus.
• Tummy ache, bloating or poor appetite.
• Soiling of underwear. This can happen when liquid stool leaks around a blocked mass of hard stool.
• Avoiding the toilet, squatting, crossing legs or hiding when the urge comes.

Breastfed babies may go several days between stools and still be fine if the stool is soft and they feed well. Concern is about hard, painful stools, not the number of days.

Common causes

• Low fibre and low fluids: too much white bread, biscuits, chips, cheese and milk, and too little fruit, vegetables and water.
• Withholding: a child avoids the toilet because of a painful past stool, a busy play schedule, school toilets, or a fear of using them.
• Changes in routine: starting solids, switching from breast milk to formula or cow’s milk, toilet training, starting school or travelling.
• Illness and fever, which reduce food and fluids.
• Medicines, such as some cough and iron medicines.
• Medical conditions, which are less common, including an underactive thyroid, coeliac disease and some nerve or bowel problems.

Diet and habits that help

• Add fibre: fruit such as papaya, pears, apples (with the skin), guava and prunes (aloo bukhara), vegetables, daal, oats, whole-wheat roti and dalia.
• Offer plenty of water, and smaller amounts of milk. More than about two to three cups of milk a day can reduce appetite for fibre-rich foods and contribute to constipation.
• Go easy on constipating foods: white rice, bananas that are not fully ripe, chips, biscuits, cheese and processed snacks.
• Set a toilet routine: sit on the toilet for five to ten minutes after meals, when the gut is most active. A footstool under the feet helps a child to relax and push.
• Do not pressure or punish. Make the toilet a calm place. Praise effort, not only results.
• Encourage active play every day.

For a baby under six months, see a paediatrician before giving anything other than breast milk or formula. Do not give home mixtures to infants.

Laxatives and fibre products

When diet and habits are not enough, a doctor or pharmacist may advise a laxative for a short time, so that stools stay soft and passing them is not painful. This breaks the cycle. Never give a laxative to a child without checking the age limit and getting medical advice, and do not use them for long periods without supervision.

• Bulk-forming fibre such as ispaghula husk (isabgol) adds bulk to the stool. It must be taken with plenty of fluid.
• Osmotic laxatives such as lactulose draw water into the bowel and soften stool.
• Stimulant laxatives such as sodium picosulfate drive the bowel to contract. They are often used short term and under advice. Products at Khasmart include Laxoberon Drops and Laxoberon Syrup.

Explore the constipation and digestive health categories. Always follow the pack and your doctor’s instructions on how much to give and for how long.

What not to do

• Do not use enemas, suppositories or oils unless a doctor advises.
• Do not give adult laxatives or herbal mixtures with unknown ingredients to a child.
• Do not stop a prescribed treatment as soon as the stool is soft. Many children need weeks to months of treatment to retrain the bowel.
• Do not ignore blood, vomiting or severe pain.

When to see a doctor

• Constipation that lasts more than two weeks, or keeps coming back.
• Blood in the stool, or a painful split at the anus.
• Vomiting, especially green vomit, or a swollen, hard belly.
• Fever, weight loss or poor growth.
• A newborn who does not pass the first stool in the first day or two, or constipation from the first weeks of life.
• Constant soiling, bedwetting that is new, or a child who refuses to use the toilet.
• Your child seems to be in a lot of pain.

If your child has diarrhoea and vomiting instead, see our guide to waterborne diseases. For a baby with tummy troubles, read about baby colic.

Frequently asked questions

How often should a child pass stool?

Anywhere from three times a day to three times a week can be normal for older children, as long as stools are soft and comfortable.

Does milk cause constipation?

In some children, too much cow’s milk can. Balance it with fibre-rich foods, and ask your doctor if you suspect an allergy.

Is it safe to give a laxative?

Many are safe for short-term use when advised by a doctor, with the right type and the right amount for the child’s age and weight.

Will my child grow out of constipation?

Most children improve with diet, routine and treatment. Early treatment prevents a long-term cycle.

Order digestive care and children’s essentials from Khasmart, with delivery across Pakistan.

This article is for general information and is not a substitute for advice from your paediatrician or pharmacist. It does not include dosage; always follow the directions on the pack or from your doctor.