Parents can often become concerned about their child’s bowel habits. Constipation is one of the most common complaints doctors hear from parents. Knowing what is “normal” can help ease parents' concerns. These are guidelines, not hard and fast rules. You know your child better than anyone, and if you are concerned to call your doctor.

What is Normal and When Should I Intervene?

Babies over 1 month of age who are breastfed can often skip bowel movements for 4 or more days. If the subsequent bowel movement is large and soft you can consider this normal. Breastfed babies under 1 month who are not having regular bowel movements should see the doctor. It could indicate that they are not getting enough food.

Babies can grunt and turn red while eliminating. This is normal because they are usually lying flat and don’t have gravity to aid them in passing stool. Also, the size of the stool is related to the size of the appetite of the child. A big eater is going to have a big stool, and this is normal.

Table food added to a diet will change a baby’s stool. Toddlers and children who do not eliminate regularly can experience pain while trying to pass the stool. Passing a stool should be pain-free. Pain often triggers a “holding” response in a child. They become fearful of the pain and refuse to go. Adding extra fiber (fruit and fruit juices, vegetables) and water can help decrease the hardness of the stool, decrease the pain, and increase the urge the child will find harder to resist. If this does not immediately help the problem, you should see your doctor. Do not administer laxatives to children except under the supervision of a doctor

Normal constipation and slow elimination can escalate over time if this is a struggle for your child it may be helpful to keep a diary to help you be aware of bowel movement frequency.

Some Helpful Guidelines

Go to the Emergency Room if your child is vomiting green bile. Yellow vomit is normally just stomach juices. Bile is green.

Call your doctor immediately, regardless of the time of day if:

Infants under 12 months who suddenly have a weak sucking reflex or muscle weakness, children who look and act very sick should be seen immediately
Your child is weak, vomits more than twice and has bloating or swelling of the stomach your child has abdominal pain that goes on for over an hour
Infants under 1-month-old who are not having bowel movements

Make an appointment the next day if:

Your child has some blood in their stool or visible in the diaper
Your child refuses to go to the bathroom even though the need is obvious
Your child is under 2 months of age and is showing more than a normal strain

Make a “next available” appointment if:

Constipation is becoming a frequent issue
There is leaking stool
Changes in diet (adding more fiber and liquid) are not helping
You are in the midst of potty training and your child is holding their stool
You are concerned as a parent that something is wrong

Trust your instincts!

GI Associates is a certified endoscopy facility with a staff of board-certified physicians highly trained in gastroenterology for adult and pediatric patients. Contact GI Associates at 601-355-1234 to request a pediatric gastroenterologist to care for your child.