CONSTIPATION:

CHILD OVER 1 YEAR OF AGE
Constipation (con-sti-PA-shun) in children can cause concern for parents. Sometimes children have poor bowel habits because they are not encouraged to be on a regular schedule. Sometimes they are just "too busy" to spend enough time on the toilet to empty their bowels.

SIGNS OF CONSTIPATION
Constipation is a change in the child's bowel habits. The child may have constipation if his or her stools are too hard, too infrequent, too painful, too large, too wide, or if he cannot push it all out. Other signs include:

o Abdominal pain (cramping)                                                             o Very infrequent, though soft, stools (less than 1 in 3 days)                   o Soiling (the child has an "accident" in his pants)                                o Painful bowel movements

WHAT TO DO FOR CONSTIPATION
If your child is toilet trained, have him or her sit on the toilet for 10 minutes after breakfast or until he empties the lower bowel completely. Place a footstool under his feet. Do not let his feet dangle. - Check your child's bowel movement every so often so you will know what is normal and abnormal for your child. - Make sure your child eats fruits, vegetables, and whole grain cereals every day
* Adding a daily serving of bran cereal to your child's diet can be helpful.
* Encourage your child to drink extra water and fruit juice between meals.
* A serving of prunes or prune juice once a day may help.

Encourage your child to come in from play every time he has the urge to have a bowel movement:
o Use a reward system
o Try to stay calm and not be too concerned if your child cannot have a bowel movement. Let your child leave the bathroom and try again later in the day.

WHAT NOT TO DO

Do not give enemas, suppositories, or laxatives unless you are told to do so by your doctor.

REWARDS
Every child likes to see how well he is doing on a project. Everyone likes to be rewarded for success. Every time your child sits on the toilet long enough to have a bowel movement, give him a reward whether he has a bowel movement or not. You can select a simple reward (such as favorite TV show or a sticker). Use a calendar or daily record to keep track of the extra fluids he drinks and when he sits on the toilet. After a few weeks, agree on a greater reward for sitting on the toilet. If you use the reward system every day, in time your child will develop his own schedule for good bowel habits. Remember: Never punish your child when he cannot have a bowel movement or if he soils his pants. Children do not have problems with bowel movements on purpose, and punishment only keeps them from developing good bowel habits.

WHEN TO CALL THE DOCTOR
Call your doctor if any of the following occurs:                                   o If your child has bright red streaks of blood in the stool.                     o If constipation continues for days.                                                   o If there is abdominal or rectal pain along with the constipation.            o If your child continues to have accidents.