When is Constipation an Emergency in Babies and Children?

Everybody poops, but not everybody poops with the same regularity. Kids will likely experience constipation at least once, which can often be treated at home, but sometimes it requires medical care.

When is constipation an emergency in babies and children? Here's what parents need to know about constipation in children.

When is constipation an emergency in babies and children?

Pay attention to additional symptoms a constipated child is experiencing. For example, if they aren't eating or their belly is distended and hard, that's something experts say should be evaluated.

Call the pediatrician first to describe symptoms. The doctor can recommend the next steps for treating constipation and advise if a trip to their office or the ER is needed.

"The thing that we look out for is discomfort," says Samantha Butzke, M.D., a pediatric gastroenterologist at Gastro Health in Annapolis, Maryland.

Most constipation falls into the category of functional constipation, "which is probably in about 95% of kids that we see," says Brent Keith, M.D., a pediatric gastroenterologist at GI Alliance in Plano, Texas.

Functional constipation is when kids hold in their poop on purpose because they're afraid it will hurt to go. But holding it in makes the stool get larger and harder—which means it probably will hurt when they use the potty. Functional constipation is most common among toddlers, and it can make toilet training a challenge.

But, Keith says, the other 5% of constipation is from a disease-related cause or other medical condition. If a kid is constipated, err on the side of caution and call the pediatrician to rule out something serious.

When should I take baby to the ER for constipation?

One of the first things newborns do is poop. A newborn's first poop is what's called meconium—a thick, sticky black-green substance that comes from the consumption of amniotic fluid in the womb. Babies should pass meconium within the first day of life. And it's a red flag parents shouldn't ignore if it doesn't happen, Keith says.

"If there's delayed passage of meconium—beyond 24 to 48 hours—that should be brought to your doctor's attention right away," Keith says.

Butzke adds, "If a baby is not comfortable if the baby is trying to get a stool out and is unable to, or if the baby is refusing to eat, those are signs that it might be an emergency and might need intervention."

When is constipation severe in babies?

Again, be aware of other symptoms accompanying a lack of bowel movement.

"Any child or baby with constipation associated with rectal bleeding, fever, vomiting, a large distended belly or tender abdomen should seek medical care right away to ensure there is not a more ominous cause for their constipation," Keith says.

How long can a constipated baby go without pooping?

Because the body so easily absorbs breastmilk, they don't poop as much. It's normal for some breastfed babies to go up to a week without having a bowel movement, Butzke says.

Formula-fed babies generally poop every day. "With formula-fed babies, I'm not concerned unless we're on day three of no stool," she says.

If babies aren't pooping after these normal windows of time, they should be evaluated by a physician.

FAQs

What does blood in the stool mean?

Most of the time, blood in the stool is the result of an anal fissure, says Keith—usually caused by a big, hard piece of poop being pushed out. Again, pay attention to other symptoms along with the blood.

"When you couple blood in the stool with a lethargic kid who's throwing up green stuff, that's not good," Keith says. "When you have blood in the stool and you have a big belly and a kiddo that's hard to arouse, that's not good. That's the emergency room."

What are the common causes of constipation in kids?

Too much dairy in the diet can lead to constipation. Limit dairy products to no more than 16 to 24 ounces per day.

Too much iron can also cause constipation. Some babies may take iron supplements, which they need for their growth and development. If they have trouble pooping, their pediatrician can prescribe medication that can help.

Kids who are picky eaters and don't get enough fiber can also become constipated. Kids who either don't get enough physical activity or have low muscle tone can also become constipated, which makes it difficult for the colon to contract properly.

How can you prevent constipation in kids?

Proper hydration is key. Drinking plenty of water keeps the poop soft and easier to pass.

Adding more fiber to the diet is another way to ensure kids have regular bowel movements. High-fiber foods include fruits and vegetables, whole grains, nuts, and legumes.

Ensuring children get plenty of exercise will also help keep things moving when kids sit on the toilet.

Finally, a toileting routine can help avoid constipation. Getting your kid to sit on the toilet at the same time every day comfortably can help things move along.

Experts

• Samantha Butzke, M.D., a pediatric gastroenterologist at Gastro Health in Annapolis, Maryland
• Brent Keith, M.D., a pediatric gastroenterologist at GI Alliance in Plano, Texas