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Constipation is common in childhood. Parents often become very worried about their child’s bowel habit. The main thing to realise is that every child is different. Normal can vary quite a bit. It is a change in what is normal for your child that suggests a problem. The frequency of bowel movements is not very important. What is important is that the stools are soft, well-formed and passed easily.

Babies will open their bowels anything from several times per day to once every few days. As your baby grows up, into a toddler and then a young child, you may see further changes in the stool frequency and consistency, often dependent on what they are eating. Anything from three times a day to once every other day is common and normal.

Constipation in children or babies can mean any, or all, of the following:

• Difficulty or straining when passing stools.
• Pain when passing stools, sometimes with a streak of blood on the toilet paper, due to a small tear in the skin of the anus.
• Passing stools less often than normal. Generally, this is less than three proper stools per week.
• Stools that are hard and perhaps very large, or pellet-like and small, like rabbit droppings.

Your child may be constipated because they are not eating enough high fibre foods or drinking enough water. When paired with good hydration, fibre keeps your digestive tract moving along as it should. This prevents and can even treat constipation.

Children between the ages of 1 and 18 should be getting between 14 and 31 grammes of fibre a day. Foods which are high in fibre are fruit, vegetables, cereals and wholemeal bread.

The list below can give you some ideas of what your child should eat to increase her fibre intake:

• Whole-wheat and whole-grain bread has an average of 2g of fibre per slice.
• High-fibre cereals like raisin bran-type cereals, contain about 5g of fibre per bowl.
• Each medium banana or orange contains 3.1g of fibre, which makes it a great afternoon snack.
• One small apple contains 3.6g of fibre.
• One medium baked sweet potato with peel contains 3.8g of fibre.
• Dried (or semi-dried) apricots or raisins for snacks.

Parent should encourage children to drink plenty of water.

However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst.

These may fill them up and make them less likely to eat proper meals with food that contains plenty of fibre. Try to limit these kinds of drinks and give them water as the main drink.

If you think your child may be constipated, take him to the doctor. The treatment for constipation depends on your child’s age. The longer your child is constipated, the more difficult it can be for them to get back to normal, so make sure you get help early.

Answers provided by Dr Lim Kok Chong, consultant paediatrician, Columbia Asia Hospital — Bukit Rimau.