New Lifestyle and Constipation in Kids : Causes and Solutions

“Constipation is a common problem in Kids. Though it sounds like a less serious medical condition, it debilitates children in many aspects daily.”

What is Constipation?

Constipation is a condition in which the child passes hard stools or passes them infrequently.  In terms of frequency, the passage of fewer than three stools per week is categorized as constipation. However, this does not necessarily fit in all cases. Thus, in case a child passes hard stools every day, and stools are less frequent, then the child may be diagnosed with constipation on clinical examination.

Signs that a child may have constipation

• Each child has a different frequency of bowel movements. Reduction in frequency is a sign that the child may be constipated.
• Passage of hard stools that may look like separate small lumps
• The child complains of pain in the passage of stools
• The child intentionally avoids using the toilet
• Blood in stool
• Pain in tummy
• Loss of hunger
• Physical signs that a child is trying to hold their stool. These include clenching teeth, squeezing buttocks together, and a strained face.
• Passing stool in standing position

Types of Constipation

Constipation in children can be of the following two types:

Organic Constipation- This type of constipation occurs due to an underlying disease in the child. Examples include thyroid disorders, neurological disorders, celiac disease etc. This is a rarer form of constipation, and its treatment involves diagnosis and treatment of the underlying disease.

Functional Constipation- Constipation that occurs in absence of any clear cut disease is usually functional. There are many factors involved. This is when the child withholds their stools for several reasons.

Lifestyle and Diet are the major factors that determine the consistency and frequency of stools. Now with drastic changes in our lifestyles, constipation has become very common too.

Relation between New Lifestyle and Constipation

It is our habits that shape us, and it’s our habits that determine our health too. Below are some modern-day habits that are linked to the increased prevalence of constipation in children.

Diet Breastfeeding- A child starts feeding the moment they are born. It has been recommended to exclusively breastfeed babies till they are six months old. No other food or drink, including water, is recommended to be given to babies less than six months of age. However, in modern times top-feeds/ formula feeds are becoming increasingly common. Due to the unavailability of the mother, challenges in breastfeeding, and increased concerns regarding the adequacy of breastmilk or weight of the baby, most parents start top feeds for their babies before they turn six months. Top-feeds reduce the frequency of stools in babies, since the very start.

Complementary feeding – As soon as the baby turns six months old, complementary feeds are started. This is the time when solids are first introduced to the babies, which are given along with breast milk. It is recommended to give freshly cooked, home food to children. Fiber in diet, along with other nutrients is recommended at this time. Nuclear families in times today have raised the challenge of feeding the children well. Most children may reject what is offered to them first since they are still learning how to eat. However, this may lead to continued feeding of milk or offering only a certain type of food to babies that isn’t good for gut health and leads to constipation.

Food habits in older children – In times today, it is a fashion to feed outside food to children very frequently. We are also diverting from our traditional Indian food which contains more fiber, and proteins to a more Western diet. Consumption of high-fat and sugar-containing foods is very common today. Pizzas, pasta, cakes, and biscuits are consumed more frequently than ever. These foods not only increase the occurrence of constipation but also, increase the chances of developing other serious diseases like Crohn’s disease in children.

What you can do about it?

• Breastfeed your child exclusively for the first six months. There may be challenges, don’t be shy to consult a pediatrician or a lactation consultant to overcome them.
• Give proper complementary feeds to your child, and don’t get too comfortable with milk just because the child takes it easily.
• Add more fresh fruits and fibre to your child’s diet. When offering packaged food, check for the label of contents and prefer food with better nutritional value and high-fiber. Restrict on eating outside food, and prefer freshly cooked home food for your child.
• Limit drinks like soda and soft drinks, and encourage the consumption of more water.

1. Addiction to Screens

Unfortunately, the introduction of screens has done more harm than good to our health and minds. Along with many other problems, screen addiction can also increase constipation in children.

Children with hold their stools while they are sticking to the screens. Withholding the stools for a long time can lead to drying up of stools which makes them hard. Once hard, it becomes painful to pass the stool, and thus the child avoids it further. This then becomes a vicious cycle and the child gets constipated.

What you can do about it?

The usage of screens is becoming increasingly unavoidable in times today. However, parents should restrict screens whenever possible and regulate them with a limited screen time.

Reduction in physical activity

Screens not only lead to constipation due to the cycle explained above but also lead to a drastic reduction in physical activity in children. A sedentary lifestyle with less physical activity leads to constipation.

What you can do about it?

Make outdoor time fun. Have your child look forward to dedicated outdoor time by involvement in activities. Group play, enrolment in the training of a dedicated sport, and involvement of parents with the children outdoors are some examples where children can put the screen aside and head out for physical play. One can also have a dedicated time for exercise at home which can motivate the child for it.

Problems with Toilet training

Modern and busy families also face the challenge of toilet training. Parents are either over-enthusiastic and start toilet training very early in life, or continue to make their child wear diapers for a long period. Improper toilet training leads to the habit of with holding the stools by the child, which can further lead to the hardening of stools and difficulty in passage of it. The ideal time to start toilet training is when the child can sit comfortably on a pot. One and a half to two years is a good time to consider toilet training for your child. Also, when toilet training, parents should stay alert and guide their children to use the toilet as and when required, instead of waiting for them to give a cue.

What you can do about it?

Try to develop a regular toilet habit in your child. Make them sit on the toilet for at least ten minutes, preferably after a meal twice a day. Make this a fun time, and not a stressful time. Reward your child when they show any signs of trying to pass a stool or pass a stool. Don’t punish your child for not having a bowel movement, or for not being willing to sit on the toilet.

Emotional issues

Children are sensitive and react differently when dealing with their emotions. Stress, peer pressure, being mocked if they pass stools in public while being toilet trained, etc can lead them to withhold their stools. This could lead to the hardening of stools and the start of constipation for them. One should be empathetic when dealing with children, after all, they are just learning to regulate their emotions.

What you can do about it?

Get down to the level of your children and talk to them often. Understand their challenges instead of expecting from them. Don’t mock them or put them down, it may only worsen their habits, stay calm when dealing with their emotions. In case of increasing challenges talk to a pediatrician or a behavioral expert who can help the child deal with their emotions, and help parents understand them too.

Delayed Diagnosis

One may have so much to deal with on an everyday basis, that they may not pay attention to their child’s stool frequency and consistency. However, one should understand that though it may look like a minor issue to us, it’s a constant trouble for the child. The child puts all their mind and attention into controlling their stools the entire day. This may even make them less alert and more irritable. Delayed diagnosis and treatment of constipation makes it worse and complicates it further.

What you can do about it?

Stay aware about the health of your child. Look for signs of constipation in your child and seek help at the earliest in case you suspect it.

Diagnosis of Constipation in a Child

Diagnosis of constipation in a child involves taking a detailed history and physical examination of the child by a Pediatric gastroenterologist. At times supporting investigations like an abdominal radiograph may also be required. For organic causes or constipation that is not improving, blood tests, barium enema, rectal biopsy, or colonoscopy may also be needed in subsequent visits as decided by the specialist on case by case basis.

Conclusion

The modern world has made some things easier for us but has also introduced us to a new set of problems. Constipation, which has increased in children with newer lifestyles and habits can be dealt with ease if one stays mindful and alert about the health of their children.