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By Dr Zulfikar BuxAssistant Professor of Emergency MedicineConstipation in children is a common problem. It is often characterized by infrequent bowel movementsDr Zulfikar Buxor hard, dry stools and causes discomfort for both the child and parents. Various factors can lead to constipation in children. Common causes include early toilet training and changes in diet. Fortunately, most cases of constipation in children are temporary. Understanding how to manage your child constipation can prevent unnecessary visits to the doctor.HOW OFTEN SHOULD MY CHILD HAVE A BOWEL MOVEMENT?It depends on how old he or she is:·    In the first week of life, most babies have four or more bowel movements each day. They are soft or liquid.·    In the first three months, some babies have two or more bowel movements each day. Others have just one each week.·    By age two, most kids have at least one bowel movement each day. They are soft but solid.·    Every child is different. Some have bowel movements after each meal. Others have bowel movements every other day.HOW WILL I KNOW IF MY CHILD IS CONSTIPATED?Your child might:·    Have fewer bowel movements than normal·    Have bowel movements that are hard or bigger than normal·    Feel pain when having a bowel movement·    Arch his or her back and cry (if still a baby)·    Avoid going to the bathroom,Cheap Jerseys From China, do a “dance,” or hide when he or she feels a bowel movement coming. This often happens when potty training and when starting school.·    Leak small amounts of bowel movement into the underwear (if he or she is toilet trained)WHAT CAN CAUSE MY CHILD’S CONSTIPATION?Many factors can contribute to constipation in children, including:·    Withholding. Your child may ignore the urge to have a bowel movement because he or she is afraid of the toilet or doesn’t want to take a break from play. Some children withhold when they’re away from home because they’re uncomfortable using public toilets. Painful bowel movements caused by large, hard stools also may lead to withholding. If it hurts to poop, your child may try to avoid a repeat of the distressing experience.·    Early toilet training. If you begin toilet training too soon, your child may rebel and hold in stool. If toilet training becomes a battle of wills, a voluntary decision to ignore the urge to poop can quickly become an involuntary habit that’s tough to change.·    Changes in diet. Not enough fibre-rich fruits and vegetables or fluid in your child’s diet may cause constipation. One of the more common times for children to become constipated is when they’re switching from an all-liquid diet to one that includes solid foods.·    Medications. Certain antidepressants and various other drugs can contribute to constipation.·    Cow’s milk allergy. An allergy to cow’s milk or consuming too many dairy products (cheese and cow’s milk) sometimes leads to constipation.·    Family history. Children who have family members that have experienced constipation are more likely to develop constipation. This may be due to shared genetic or environmental factors.·    Medical conditions. Rarely, constipation in children indicates an anatomic malformation, a metabolic or digestive system problem, or another underlying conditionWHAT CAN I DO IF MY CHILD GETS CONSTIPATED?In most children with mild or brief constipation, the problem usually gets better with some simple changes. Have your child:·    Eat more fruit, vegetables, cereal, and other foods with fibre·    Drink some prune juice, apple juice, or pear juice·    Drink at least 32 ounces of water and drinks that aren’t milk each day (for children older than two years)·    Avoid milk, yogurt, cheese, and ice cream·    Sit on the toilet for five or 10 minutes after meals, if he or she is toilet trained. Offer rewards just for sitting there.·    Stop potty training for a while, if you are working on it·    Be supportive. Reward your child’s efforts, not results. Give children small rewards for trying to move their bowels·    Avoid giving newborns and babies water or any other substitutes in the first four months of their life. Breast feeding or formula feeding will provide them with their nutrients during this period.WHEN SHOULD I TAKE MY CHILD TO THE DOCTOR?You should have your child seen if:·    He or she is younger than four months old·    He or she gets constipated often·    You have been trying the steps listed above for 24 hours, but your child has still not had a bowel movement·    There is blood in the bowel movement or on the diaper or underwear·    Your child is in serious pain·    Your child develops a fever·    Starts to vomit·    Is having weight lossFollowing these simple steps and understanding your child will surely help the situation. Constipation should not be a regular dilemma for you or cause constant discomfort for your child.