Constipation in Children

Constipation is a very common presentation, both in primary and secondary care. Considerable variation in ‘normal’ bowel habit in children is accepted. A normal pattern of stool evacuation is thought to be a sign of health in children of all ages. Especially during the first months of life, parents pay close attention to the frequency and the characteristics of their children’s defecation. Any deviation from what is thought by any family member to be normal for children may trigger a call to the nurse or a visit to the pediatrician. Stool frequency is also agedependent. Infants have a mean of 4 stools per day during the first week of life. It reduces progressively in early childhood, from more than four stools a day to a mean average of 1.7 stools per day at 2 years of age and 1.2 a day at age 4 years, 2,3 by which age 98% of children are toilet trained. Some normal breast-fed babies do not have stools for several days or longer. After 4 years, the frequency of bowel movements remains unchanged. The normal frequency of bowel movements at different ages has been defined (Table 1).