Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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Am Fam Physician. 2006;73(3):481-482

See related article on constipation.

Keep a positive attitude

If your child has constipation or stool leakage, it is important for you to maintain a positive attitude. Getting angry or making your child feel ashamed can make matters worse.

When it is time for your child to try to have a bowel movement, use simple positive words, such as “Now it is time to sit on the toilet.” Praise your child for each toilet-sitting and for other cooperation.

Remember the way your child’s body works

After a person eats, the intestines squeeze to move food along. You can use this natural urge to help your child.

Place your child on the toilet after each meal. If your child’s feet do not touch the floor, provide a footstool for support.

Have your child stay on the toilet for 5 to 10 minutes. During this time, you can read to your child, or your child can listen to a tape or CD.

Keep a list of your child’s bowel movements

Here are some things you should write down:

  • When your child sat on the toilet

  • How long your child sat on the toilet

  • What your child’s stools looked like

  • If your child had any soiling of his or her underwear

Start a reward program

Begin rewarding your child for just sitting on the toilet. For example, if your child sits on the toilet at the planned time, reward the child with a favorite activity. If your child refuses to sit on the toilet, the activity does not happen until after the next planned toilet-sitting.

If your child has a bowel movement, give your child praise and a reward. Try not to use food as a reward. Some children like to be awarded with stickers or stars on a chart. Older children like to add up points for a larger reward, such as a trip to a movie theater.

Add more fiber to your child’s diet

Whole grains, fruits, and vegetables contain fiber. Most food labels list fiber content. The table in this handout shows the fiber content of some foods.

Each day, the grams of fiber in your child’s diet should equal his or her age in years plus 5. For example, a five-year-old should consume 10 grams of fiber a day.

Encourage your child to drink more water

Increase your child’s fluid intake by 1 or 2 cups of water a day. A 35-pound child should drink about 7 cups (8 ounces in a cup) of fluid a day, and a 60-pound child should drink about 9 cups (8-ounce size) of fluid a day. If your child is already drinking this much fluid, substitute water for one or two glasses of the milk or juice your child already is drinking.

FoodGrams of fiber
1 apple with skin3.7
2/3 cup of raisins4
1 cup of strawberries3.4
1 orange3
1 medium carrot2
1 ear of corn2
1 package of instant oatmeal3
1 large biscuit of shredded wheat cereal2.5
1 cup of raisin bran cereal8
1 slice of whole wheat bread2
1 baked potato with skin5
1 cup of baked beans14
1 cup of lima beans13

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