Toddler Constipation Remedies: The Ultimate Toddler Stool Softener

Summary

If you’re looking for safe toddler constipation remedies that go beyond prune juice, you’ve come to the right place.   Although there is no strict definition, constipation in toddlers generally refers to fewer than three bowel movements per week or the presence of hard stool or painful bowel movements.

In a diaper, hard stool may look like stool made of many small lumps or formed stool that’s lumpy.

Constipation in children is somewhat common, with an estimated 30% of kids developing constipation at some point in their early life [1], [2].

The most significant changes in your child's life that can lead to constipation include:

  • When a baby changes diet from breastmilk (or formula) to solid food
  • When toddlers begin toilet training, this can lead to withholding
  • When kids start school [1]

Signs of constipation in toddlers

Signs of constipation in toddlers are pretty straightforward and in many ways, similar to adults. Hard, painful, and infrequent stool can point to toddler constipation.

  • Fewer than three poops per week
  • Mild to severe abdominal pain
  • Hard, lumpy stool that may not pass easily
  • Withholding, which may look like your little one  crossing legs or making scrunchy faces
  • Eating less or feeling less hungry than usual
  • Short temperament for no apparent reason

What causes constipation in toddlers?

Withholding is a common cause of constipation in little ones. Many toddlers tend to ignore the urge to poop because they are busy playing. Over time, this makes stool harder and more challenging to pass.

Sometimes withholding is accompanied by a fear of going poop that can come from the sensation of pooping or from an episode of constipation that was painful. Regardless of the cause, withholding means more time in the gut. And drier, harder stool.

Ouch!

Other causes of constipation in toddlers include:

  • The need for more fluids each day, which is essential for softening everything in the gut
  • The need for more dietary fiber
  • A change in environment, such as a new school
  • Some medications, such as NSAIDs (non-steroidal anti-inflammatory drugs) and antihistamines , can cause constipation
  • Iron supplements (instead, try directing your little one towards meat; heme iron is more bioavailable anyways!)
  • Slow gut movement, also referred to as motility

Does the gut microbiome play a role in constipation?

The TLDR? While it makes sense that the gut microbiome would have a direct relationship to constipation - and stool transit time - the reality is that it’s too soon to say what that relationship is.

The link between the gut microbiome and constipation is not well studied, especially in toddlers and children [3]. What’s more, the science here is somewhat unclear and contradictory.

For example, one study reported that children with constipation are more likely to be delivered via C-section and have a short breastfeeding period, which can be associated with changes in the gut microbiome [4].

A baby’s first 1,000 days are crucial during the development of the gut microbiome. Multiple factors - such as type of delivery (vaginal or  C-section birth), type of feeding (breastfeeding,  formula, or a combo), and antibiotic use - can influence the baby gut microbiome [5]. It’s also worth noting that  kids who were born prematurely, suffered from necrotizing enterocolitis, and were treated with antibiotics are more likely to see  constipation during childhood [6].

Kids with constipation who aren’t flexing those fiber-loving taste buds tend to have lower levels of Prevotella but increased levels of the genera Blautia, Coprococcus, Ruminococcus, and Faecalibacterium. Whereas levels of friendly Bifidobacterium and Lactobacillus are unchanged [7].

So, there’s that.

But here too, we have some conflicting conclusions: Other studies have found that kids with constipation appear to have lower levels of beneficial Lactobacillus species [4], [8].

Ultimately, we need a little more research to understand what's happening with the gut microbiome of constipated littles.

Toddler constipation remedies

Fortunately, there are a few remedies and healthy habits that you can try at home to move things along and get your toddler poop when constipated.

While these tips include healthy potty habits, diet is critical.

Healthy potty habits include:

  • Sitting on the toilet regularly after breakfast, lunch, and dinner for around three to five minutes. Even if they don't poop, a habit is built.
  • Encouraging your little one to listen to their body and not withhold poop. Show them that they can continue playing after toilet time.
  • Getting rid of frightening or painful associations, when possible. Ensure your toilet is equipped with special toddler toilet seats and rails since many kids worry they will fall in the toilet. You may also want to bring your toddler their favorite books so they can look at them.

In addition to healthy potty habits, diet is essential to address when tackling constipation. A  fiber-filled diet will also nourish good gut bacteria and protect against  the invasion of unfriendly bacteria.

Some practical constipation remedies for your toddler that you can start using today:

  • Make sure your toddler drinks enough water. Water and other liquids are essential to soften everything in our gut, which will make the poop pass quickly [12]. Remember that fluids don't mean only water. You can include herbal tea, sugar-free drinks, infused water, and plenty of soup. Avoid giving your toddler soda, caffeinated beverages, and drinks with high amounts of sugar.
  • Speaking of liquid, watch milk consumption. Too much dairy can cause constipation or make ongoing constipation worse. Instead, try replacing it with dairy alternatives such as almond or oat milk, as long as your little one is not allergic to them [1].
  • Did we say fiber? We did. Be sure to include more fiber in your toddler’s diet [12], [13].

Fiber: The ultimate toddler stool softener

Most toddler constipation remedies include some sort of fiber recommendation. This is because fiber - in its many forms - is the ultimate toddler stool softener. Parents wondering about how to make a toddler poop when constipated can use carb and fiber-rich food as therapy. The trick to doing this effectively though is to know what kind of fiber you’re looking for.

But what is fiber - exactly?

Fiber encompasses a group of non-digestible carbohydrates (or  complex sugars) found in vegetables, fruits, various grains, and sea vegetables. Working these into your little one’s diet on a daily basis can help clear up constipation in toddlers and kids [13].

Because we cannot digest fiber, it can act as a prebiotic in the gut - essentially feeding the good bacteria that live there [14], [15]. Healthy, well-fed good gut bacteria means they’ll grow in numbers. This growth and shift in the toddler microbiome can help fight constipation [16].

There are two types of fiber: Insoluble fiber and soluble fiber.  

1. Insoluble fiber doesn’t dissolve in water and falls into the category of “roughage.”

An excellent example of insoluble fiber is cellulose, which is found in many plants and not digestible by humans. It’s also not well fermented by our gut bugs. But with plenty of water, insoluble fiber is crucial for constipation since it bulks up stool and promotes bowel movements [17].

You can find plenty of insoluble fibers in seaweeds or sea vegetables, nuts, beans, cauliflower, potatoes, and green beans.

2. Soluble fiber dissolves in water.

This type of fiber includes many commonly used  prebiotics, such as:

  • Inulin
  • GOS
  • FOS
  • Chicory root fiber

While we cannot digest soluble fiber, our gut bacteria can [17]. You can find plenty of soluble fibers in oats and fruits such as apples, citrus fruits, and many vegetables such as onions, carrots, and peas.

A toddler constipation remedy for picky eaters

One type of prebiotic that isn’t technically a “fiber” but is a non-digestible carb are the HMOs (human milk oligosaccharides) found in breastmilk and some prebiotic supplements.

HMOs have the special ability to feed a type of good gut bug known as Bifidobacterium. And it’s one reason why breastmilk can support baby gut health.

Toddlers, older kids, and adults with constipation can also benefit from HMOs. Some of our favorite HMO supplements include:

If you're wondering whether or not your toddler has the bacteria they need to break down HMOs and you want to get to the root of constipation, we recommend the baby gut health test for littles, ages 0 - 3 years old.

References

[1] Vriesman, M.H. et al. (2020) Management of functional constipation in children and adults. Nat Rev Gastroenterol Hepatol 17, 21–39.

[2] Camilleri, M. et al. (2017) Chronic constipation. Nat Rev Dis Primers 3, 17095.

[3] Avelar Rodriguez, D. et al. (2021) Functional Constipation and the Gut Microbiome in Children: Preclinical and Clinical Evidence. Front. Pediatr. 8, 595531.

[4] Moraes, J.G. de et al. (2016) Fecal Microbiota and Diet of Children with Chronic Constipation. International Journal of Pediatrics 2016, 1–8.

[5] Tamburini, S. et al. (2016) The microbiome in early life: implications for health outcomes. Nat Med 22, 713–722.

[6] Chen, S.-M. et al. (2020) The Risk of Developing Constipation After Neonatal Necrotizing Enterocolitis. Front. Pediatr. 8, 120.

[7] Zhu, L. et al. (2014) Structural changes in the gut microbiome of constipated patients. Physiological Genomics 46, 679–686.

[8] Jomehzadeh, N. et al. (2020) Quantification of Intestinal Lactobacillus Species in Children with Functional Constipation by Quantitative Real-Time PCR. CEG Volume 13, 141–150.

[9] de Meij, T.G.J. et al. (2016) Characterization of Microbiota in Children with Chronic Functional Constipation. PLoS ONE 11, e0164731.

[10] Khalif, I. et al. (2005) Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Digestive and Liver Disease 37, 838–849.

[11] Vandeputte, D. et al. (2016) Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut 65, 57–62.

[12] Roma, E. et al. (1999) Diet and Chronic Constipation in Children: The Role of Fiber: Journal of Pediatric Gastroenterology & Nutrition 28, 169–174.

[13] Katsirma, Z. et al. (2021) Fruits and their impact on the gut microbiota, gut motility and constipation. Food Funct. 12, 8850–8866.

[14] Slavin, J. (2013) Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients 5, 1417–1435.

[15] Gibson, G.R. et al. (2017) Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 14, 491–502.

[16] Vandeputte, D. et al. (2017) Prebiotic inulin-type fructans induce specific changes in the human gut microbiota. Gut 66, 1968–1974.

[17] Gill, S.K. et al. (2021) Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol 18, 101–116.

[18] Hegar, B. et al. (2019) The Role of Two Human Milk Oligosaccharides, 2′-Fucosyllactose and Lacto-N-Neotetraose, in Infant Nutrition. Pediatr Gastroenterol Hepatol Nutr 22, 330.