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Ask Dr. K: Modify toddler’s diet and habits to treat constipation

DEAR DOCTOR K: My toddler has frequent constipation, and I have been giving him milk of magnesia about once a week. Is there any risk with this over-the-counter medicine?

DEAR READER: I’d suggest speaking to your pediatrician or family physician before continuing to give your son milk of magnesia.

Normally, children pass stool at regular intervals without much effort or pain. Infants and toddlers typically have several bowel movements a day. Most children age 2 or older have one every day. My pediatrician colleagues here at Harvard tell me they consider a child to be constipated when bowel movements happen less often than expected, or when the stools are hard and difficult or painful to pass.

Still, even though most children do not have constipation, it is a common problem. That’s particularly true for children between the ages of 2 to 5. This is the period when toilet training and developmental changes are happening. Many toddlers eat little fiber and lots of foods that contribute to constipation, such as dairy products, rice and bananas. Children also may not drink enough fluids. All these factors can cause constipation.

Before turning to medication, try modifying your child’s diet and toilet habits:

• Give your son more fiber-rich foods, such as beans, broccoli, carrots, bran, whole grains and fresh fruits.

• Minimize the dairy foods you feed him, such as yogurt, cheese and milk.

• Have your son drink prune juice. It works for kids as well as for adults.

• Encourage your toddler to drink four to six glasses of water each day.

• Make sure he gets regular exercise.

• If your son is toilet-trained, help him establish regular bowel movements by sitting him on the toilet for 10 minutes at the same time each day, preferably after meals.

• If you think your son is acting out because he resents potty training, try stopping it for a few weeks.

These changes usually help. But if they don’t, ask your pediatrician or family physician if you should try stool softeners and laxatives. These types of medications are available without a prescription and have minimal side effects.

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