Constipation in babies is defined as having hard stools that are painful or difficult to pass. If the stools are staying soft but are infrequent, it is not considered constipation. It is common for babies to skip a few days or a week, and they might cry and grunt and turn red in the face trying to poop. If the stools are staying soft, it is not constipation. It is just a matter of getting more coordinated and learning to poop.
When babies have hard stools, the treatment is to get the stools to be softer. A simple treatment is to use 1 tsp of Karo Syrup mixed in a 4 ounce bottle of either formula or water, once a day. After a week or two, the stools will get softer and you can stop the Karo.
In older children, constipation is defined as infrequent stools that are large and hard. Constipation can lead to bloating of the abdomen, stomach ache, and urinary symptoms like pain on urination or incontinence. Sometimes children will hold back the stool because they are afraid that it will hurt. In that case, hard stool builds up in the rectum, and liquid stool can seep around it and cause leakage that the child may not even be aware of. This is called encopresis. Treating the constipation will often stop the encopresis. If not, consult your doctor.
The goal of treating constipation in older children is also to make the stool softer. This is best done with natural fiber that holds more moisture inside the intestines and keeps the stools from drying out and getting hard. Increasing high fiber foods, like fruits and vegetables is a very good way to do this. If that’s not enough, or if you can’t get the child to eat those foods, then it’s OK to try medication that contains fiber, such as Miralax or Metamucil. Start with a low dose and gradually increase if needed. Check with the doctor if not improving.