A parent's guide to childhood constipation: what to look for and how to treat it
Childhood constipation is one of the most common issues I treat in my practice.
But this doesn’t make it normal or healthy.
Not only can constipation be uncomfortable for your child, but it can also lead to serious health problems, especially when it’s a chronic issue.
Having regular bowel movements allows your child to detox harmful chemicals they’re exposed to every day, which is necessary to avoid chronic illness. And regular, healthy bowel movements are a sign of optimal health for your child.
Now, I know potty problems aren’t easy for you or your little one. But the good news is there are a number of things you can do as a parent to help your child overcome it!
None of which involve harmful laxatives like Miralax… which we’ll dive into later on in this article.
What Defines “Constipation” For Your Child?
It’s defined differently depending on your kiddo’s age.
I’ll start by mentioning that all poops, no matter what age, should be soft and well-formed. If your infant or toddler is pooping hard pellets, this is constipation and it needs to be addressed.
Another key marker for infants – newborns to 12 months – is consistency. [1]
Your little one’s schedule should be consistent, whether that’s going after every meal or once a day at relatively the same time.
Please note: While consistency is the primary marker of constipation, we would still like to see your infant pooping daily.
For toddlers and older kids, constipation is defined as infrequent, hard stools that are difficult to pass. [2]
Ideally, kids at this stage should be having 1-2 soft, well-formed bowel movements per day. If they’re going less, this could be a sign of constipation.
What Are Signs & Symptoms of Constipation in Kids?
You can use the telltale signs above – hard or dry poops – to determine whether your child is constipated.
But sometimes, it’s not so obvious.
Here are some less-apparent signs your child may be constipated:
bloating
soiling their underwear
very large stools
stomach aches
alternating soft and very hard stools
underlying irritability
decrease in appetite
cramping or nausea
discomfort while pooping
traces of blood in the stool
changing positions to delay pooping, like rocking back and forth on their toes or clenching their buttocks [3]
If you notice your child displaying any of the symptoms above, it’s a good idea to reach out to your trusted healthcare practitioner.
In some cases, your child could be going to the bathroom regularly but still be dealing with some level of constipation we want to get on top of.
What Causes Childhood Constipation?
As a naturopathic doctor, my mission with every issue I see is to get to the root cause.
In my practice, childhood constipation often occurs because your child is:
not getting enough fiber in their diet.
not eating enough food – this is especially common for extremely picky eaters.
not getting enough movement throughout the day.
not drinking enough water throughout the day.
holding stool out of fear, embarrassment, or because they don’t want to stop whatever activity they’re doing!
going through recent changes in their day-to-day schedule or environment, like going on vacation or just starting school.
recovering from an illness, like the flu, where they weren’t drinking a ton of water or moving their body.
problems related to gut health, like gut dysbiosis and leaky gut.
This isn’t an exhaustive list, but these are common causes for kids. Addressing the cause is essential to facilitate true healing and prevent future dysfunction.
This is just one of the many reasons I’m not a fan of band-aid fixes like Miralax.
What You Need to Know About Laxatives.
Most constipated children who come to me have previously been prescribed a laxative. Most often, Miralax.
Here are my problems with this.
First, Miralax has never been tested on young kids. It says it’s meant for ages 17+ directly on the bottle.
Second, its recommended use is no longer than 7 days. Again, this is stated directly on the bottle!
And yet, patients who come to me are usually well under the age of 17 and have been on Miralax for much longer than one week to treat chronic constipation.
This can have unwanted side effects.
Did you know there’s a significant amount of evidence suggesting that Miralax is a neurotoxin?
Thousands of parents have reported their child developing neuropsychological problems – including depression, tantrums, and anxiety – after using Miralax. [4]
For these reasons, I don’t use Miralax in my practice. Instead, I opt for alternative natural medicines that are safe and still effective.
Let’s get into more methods like THIS, shall we?
A Naturopathic Approach to Treating Childhood Constipation.
Before diving into natural remedies, I first look at the foundations of health. When I say optimizing these areas is key to your child’s overall well-being, I mean it!
Let’s start with nutrition. Fiber (found in fruits, vegetables, legumes, and whole grains) helps food move through the digestive system and supports a healthy microbiome. [5]
Diet
Is your child eating enough fiber?
Most aren’t! That’s why it’s important to focus on serving your child fibrous-rich foods.
Fibrous, constipation relieving foods include:
Apples & pears with the skin
Prunes
Chickpeas/hummus
Black beans
Ground flax seeds
Soaked oats
Sprouted, whole grain bread
We also want to limit processed & packaged foods, like white bread, granola bars, and crackers.
Water
Is your child drinking enough water?
Fluids keep everything “moving” through your intestines to have healthy, soft poops. [7]
The problem is, most kids don’t drink enough!
As a general rule, children should be drinking about half their body weight in water (in ounces) each day OR drinking 8oz per age year of water daily.
Now, I know this can be tough to reach.
My best advice is to serve your child hydrating foods that help them reach their water intake. This can include fruits, veggies, and smoothies with water in it.
You can also create a nourishing herbal infusion to encourage fluids and bowel movements. Check out this Instagram post to learn how to make your own at home.
Movement
Is your child moving?
Physical activity helps food move through the large intestine. [8] Again, we want to do everything we can to keep things moving through the body towards elimination!
Younger kids typically have no problem getting enough movement throughout the day! But once kids are in school, this can become more challenging.
Here are a few things I recommend to encourage movement:
Take morning or evening walks around the neighborhood.
Build movement into their after-school routine (riding bikes, going to the playground, playing in the backyard).
Have dance parties in the kitchen!
Jump on a trampoline, or get a rebounder for indoors.
Physical activity plays an important role in many aspects of your child’s health. Try to figure out the best way to make activity/movement fun and part of their daily lives!
Establishing a potty routine
If you take one thing away from this blog, let it be this! Have your child sit on the toilet morning and evening for at least 10 minutes even if they don’t feel like they have to go!
Consider purchasing a kids squatty potty (or using another in-house stool) to elevate the knees and get the body in the optimal position for stooling
My Top Natural Remedies and Supplements for Childhood Constipation.
Let’s move on to the good stuff!
There are a number of natural remedies and supplements you can use to help stimulate bowel movements that are both safe and effective.
Top Remedies:
Castor Oil Abdominal Massage
Castor oil contains high levels of ricinoleic acid, an omega-3 fatty acid, that acts as a natural laxative by encouraging blood flow and stimulating digestion. [9]
Gently massaging your child’s stomach helps with this entire process, as well.
If you’ve never given your child a castor oil abdominal massage, here’s how it’s done!
Instructions:
Step 1: Place a few drops of castor oil in your hands and rub them together to warm it up.
Honeybee Hippie’s Digestion Ease (code: drmichelle), herbal infused castor oil, is one of my favorites!
Step 2: Starting at the right lower quadrant of their stomach, massage the castor oil into their belly in a clockwise circular motion using firm but gentle pressure.
Step 3: Massage up to the right upper quadrant, then to the left upper quadrant, down to the left lower quadrant, and back to the right lower quadrant.
Do this for about 5-10 minutes, or until the castor oil is completely absorbed. Then, have your child throw on an old t-shirt or pajamas, as castor oil can stain.
Squatty Potty
If you don’t already have one, I highly recommend getting a squatty potty for your child!
You can keep this small stool beneath the toilet for your child to use every time they go to the bathroom.
It works by putting your kiddo’s body in a natural squatting position that allows poop to pass more easily.
Epsom Salt Baths
Not only do Epsom salt baths support detoxification, but they may also help relax your child’s gut and soften their stool, making it easier to pass.
The recipe:
“Fragrance-free” Epsom salts
½ cup for 15-60lb kids
1 cup for 60-100lb kids
1.5 cups for 100-150lb kids
Optional: 2-5 drops high-quality essential oils (I recommend lavender or chamomile to promote relaxation!)
Add these ingredients to a warm bath and let your child soak for a minimum of 20 minutes. Be sure they’re drinking plenty of water during and afterward to stay hydrated!
Top Supplements
If addressing the foundations of health and trying natural remedies isn’t enough to help your child overcome constipation, it may be time to turn to supplements in the short term.
Here’s a list of my favorites for childhood constipation:
Probiotics
Probiotics can be a helpful tool for children struggling with constipation because they support a healthy balance of gut bacteria—key players in digestion and regular bowel movements. Certain probiotic strains, like Bifidobacterium lactis and Lactobacillus rhamnosus, have been shown to improve stool frequency and consistency by enhancing gut motility and softening stools naturally. They also help reduce inflammation in the gut and support the intestinal barrier, creating a more balanced environment for smooth, comfortable digestion.
Infants 4- 24 months: Klaire Labs Ther-Biotic Baby: 1 scoop daily with food
2 years+: Klaire Labs Ther-Biotic Kids: 1 chewable daily with food
Teens+: Klaire Labs Complete: 1 capsule daily with food
Remember: The quality of products & dosage is important. I recommend speaking with your trusted provider before administering any new supplement to your child.
Tummy glycerite (now called “Tranquil Tummy”)
Made of several carminative herbs that help soothe the digestive tract and support optimal digestion of food.
Many times children will need a “bowel cleanup” to completely get rid of the fecal impaction. The stretched out muscles and nerves take weeks to months to recover depending on how long the child has been constipated. This can be done safely and effectively using natural medicine.
Let’s Not Settle for “Watch and Wait”.
Childhood constipation might be common, but it isn’t normal or healthy.
To learn more about how you can optimize your child’s digestion and avoid constipation, check out our “gut health” module on our membership community, Healthy Families Collective. We also have a pediatric constipation protocol inside our membership.
