A Blog from Your Kaiser Permanente Pediatricians in Northern California

Child sitting on toilet

Constipation in Kids

What goes up must come down. You clean your house, but it will never stay clean for long. And what goes in makes what comes out. These are laws of nature – and I’ll get back to that last one in a moment.

Constipation is a problem for many kids! They have infrequent, (or fewer than 3) hard poops in a week, that are either small, ball shaped, or large enough to plug a toilet. These hard poops can cause abdominal pain and hurt coming out. Sometimes a child can be so backed up they actually have a small amount of liquid stool that overflows and causes soiling or incontinence in their underwear.

There are 2 main causes of constipation.

First, your child may be holding their stool – or choosing to not go. This can happen because they don’t want to stop doing what they’re enjoying – like playing. They may also feel embarrassed to use the bathroom in a public place. Or they’ve learned that having a bowel movement can hurt. But how did they get hard painful stools in the first place?

For the most part, diet causes constipation or – “what goes in makes what comes out.” Eating a high-fiber diet and drinking lots of water can help prevent constipation. Children should have a daily intake of fiber that at least equals their age plus 5 grams of fiber. For example, if your child is 4 they should get at least 9 grams of fiber a day.

Fiber is found in fruit, veggies, and grains. Lots of low-fiber foods are sweet – like cookies, and ice cream – and if given the choice, kids will choose those less healthy options. So it can take some work to increase their fiber intake!

Try going to the store alone and looking at what you usually buy to see if there’s a higher fiber alternative: brown rice instead of white, whole-wheat or corn tortillas instead of white-flour ones, whole wheat pasta, or double-fiber bread instead of white. Then, at every meal offer a fruit, and at each lunch and dinner offer veggies. Ifyou have a picky eater, keep offering them healthy choices.

Here’s a daily menu that includes plenty of fiber:

Fiber Source
½ cup Fiber One cereal, Banana 
Turkey sandwich on 2 slices whole-wheat bread
Lean meat, 1 cup brown rice, 1 cup broccoli

Daily Total: 33.3 grams of fiber

Choose fruits and vegetables based on your child’s favorites and age. Here’s the fiber content in some common foods:

Fiber Content
Fiber One cereal 
14 grams of fiber in ½ cup 
5.3 grams/cup cooked 
Apple, medium-sized 
3.5 grams 
2.5 grams 
2.6 grams
3.0 grams/cup 
11.9 grams in 11 prunes 
3.0 grams/cup 
5.0 grams/stalk 
4.6 grams/cup 
2.1 grams/cup 
Green beans 
3.4 grams/cup 
7.2 grams/cup 
Potato with skin 
2.3 grams/medium potato 
4.1 grams raw; 8.0 grams chopped
1.0 gram / ½ cup 
Kidney beans, cooked 
7.4 grams / ½ cup 
Baked beans 
18.6 grams/cup 
Bran muffin 
6.3 grams/muffin 
Whole-wheat bread 
1.66 grams/slice 
White bread 
0.55 gram/slice 
Brown rice 
2.4 grams/cup cooked 
White rice 
0.6 gram/cup cooked 
Oat bran 
8.3 grams/oz 
Wheat bran 
12.4 grams/oz 

Other things that can help prevent constipation:

  • Limit low-fiber, processed high sugar foods – these will worsen constipation.
  • Encourage your child to sit on the toilet after meals. We have a natural “gastro colic” reflex that makes it more likely we’ll have a stool right after eating.
  • Encourage lots of physical activity.
  • Talk with them about not withholding – when they feel the urge they should try to poop – even if they’re busy playing or at school.

If your child is already constipated, they may need some medicine to help hydrate and soften stools while you’re making these diet changes. Miralax is a safe, effective over-the-counter choice. You can also make a phone or video visit appointment with your pediatrician to discuss options for treating constipation.

Find more resources for parents:
My Doctor Online
Constipation in Children.

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.