"mommy, my butt hurts."

Dr. Melissa King: I have heard this line a few times when my children are referring to having a difficult time having a bowel movement. As a parent I realize that I often do not know EVERY time my child has a bowel movement once they become potty trained. I have to pay close attention to realize how often they are going #2. It seems that I talk about constipation at least once a day in my practice. I realize for my school age kids and above this is a VERY embarrassing conversation. I however attempt to normalize this conversation and have the discussion with each of my patients because there are so many problems associated with constipation from chronic abdominal pain, frequent urinary tract infections, bed wetting or accidents, to soiling oneself.

The large intestine is mostly responsible for absorbing water back into the body and moving the stool toward elimination outside of the body. Constipation occurs when there is irregular or not enough stooling, causing stools to become too hard, too large or too painful to pass, lasting for more than two weeks. Constipation can still occur even when your child goes to the bathroom every single day. They may just be passing a small amount of the stool that they are making and eventually this backs up.

Constipation seems to affect a large number of patients that I see and AAP reports this as a common condition for both general pediatricians and subspecialists. If you bring your child in for a complaint of belly pain, problems peeing or stooling, back pain or vomiting, I am likely going to ask you about their bathroom habits. Here are some quick tips to keep in mind to help minimize constipation:

1. Make sure that your child eats plenty of fiber. Healthy fiber options include whole grains, oats, fruits and veggies. There are age appropriate goals ranging from about 20 grams/day for toddlers to about 40 grams/day for adolescent boys.
2. Drink plenty of water. I tell most kids to try to drink 5 glasses of water each day. Notice that I said water, not just anything.
3. Get plenty of exercise. In order to keep things moving down below, be sure to keep moving your lower extremities by walking, running, or swimming.
4. Sit on the potty every day. The best time of day to sit on the potty is about 15 minutes after a meal for 5-15 minutes. I recommend making sure your child is comfortable on the potty with their feet on the floor or a step stool. They can use this time to have a book read to them or to read themselves.

You are in charge of what you offer your child to eat and drink at home. It is not mean, or unfair of you to offer them only healthy options. Teach them from an early age healthy eating habits that will last them a lifetime. Remember too that kids learn by example and the above recommendations are not just for children.

Melissa King, DO “Dr. Mom Sqaud” Dr. King is a general pediatrician in the Children’s Health Clinic at Dayton Children’s and the mother of two kids. As part of the “Dr. Mom Sqaud,” Dr. King blogs about her experiences as both as doctor and a mom and hopes to share insight to other parents on issues related to both parenting and kids health.