SEMBELIT!

Why is my toddler getting constipated?
The most likely reasons for your toddler's constipation are:

Eating too many low-fiber foods. If your child eats lots of milk, cheese, yogurt, or peanut butter, for instance, and not enough fruits, vegetables, and whole grains, she could wind up constipated.

Toilet anxiety. If your toddler is feeling pressured about toilet training, she might start deliberately withholding her stools. If she shows all the signs of straining to have a bowel movement — stiffening her body, arching her back, and getting red in the face — but nothing comes out, she may actually be trying to hold it in.

Even if your child is potty-trained, she may not be taking enough time on the toilet to completely empty her bowels. That can lead to a buildup of feces that causes the colon to stretch and cramp. An enlarged colon can lead to larger-than-normal, difficult-to-pass stools, making your child even more reluctant to use the potty.

Dehydration. If your toddler isn't getting enough liquids, her system will respond by absorbing more fluid from whatever she eats or drinks — and from the waste in her bowels, as well. This can result in hard, dry bowel movements that are difficult to pass.

Lack of activity. Movement helps blood flow to your toddler's digestive system, so if she's not active, she may experience trouble in the BM department.

How can I treat my toddler's constipation?
Here are some things to try:

• Avoid giving your child too many foods that have a binding effect. These include bananas, cooked carrots or squash, and large quantities of dairy products such as milk, cheese, yogurt, and ice cream. Two to three servings of dairy per day are adequate for a toddler. (One serving equals 1/2 cup milk, for example.) For more guidelines, see our age-by-age guide to feeding your baby and toddler.

• Boost your child's fiber intake. Give her plenty of whole wheat crackers, cereal, or bread, and fruits and vegetables such as prunes, apricots, plums, peas, beans, and broccoli.

• To help keep your toddler's stools soft, increase the amount of fluid she drinks. Water is your best choice, but a little prune or apple juice might also help. However, you'll want to limit your toddler's juice consumption to about 4 ounces per day, to prevent tooth decay and a ruined appetite. She should wet four or five diapers a day or, if she's toilet-trained, pee at least once every five to six hours.

• Encourage her to crawl, cruise, or walk every day, to get the blood flowing to all of her organs.

• Massage your toddler's belly. Measure three finger-widths below her navel and apply gentle but firm pressure there with your fingertips. Press until you feel a firmness or mass. Maintain gentle but constant pressure for about three minutes.

• Don't pressure your toddler to toilet train before she's ready. Pushing her to use the potty can make her afraid or resentful, and she could wind up withholding bowel movements. If you notice your toddler doing this, increase the amount of fiber she eats (see above), back off on the training, and wait to try again until you've spotted the signs she's really ready.

• Encourage your child to use the potty as soon as she feels ready to poop. If she says she never feels ready, try having her spend five to 10 minutes on the toilet after breakfast and dinner. (Children who've been constipated for a long time may have lost the ability to perceive that their rectum is full.) Try to make this a pleasant experience by reading a book with her while she's sitting there. But don't force her to stay there if she doesn't want to, or she'll come to think of using the toilet as a punishment.

• Talk to your toddler's doctor about treatment options. She may suggest an over-the-counter stool softener, a lubricant such as mineral oil, a suppository, or laxatives if your toddler is very constipated. A glycerin suppository will stimulate the rectum and help your toddler pass a stool. While using a suppository occasionally is fine, don't do it on a regular basis, or your toddler could wind up relying on them to have a bowel movement.

Note: If your child is deliberately holding back her stools, treating her with suppositories or an enema could be extremely upsetting to her. Always check with your doctor before resorting to this type of treatment.

• If your toddler is passing such hard, dry stools that she tears the delicate skin near the opening of her anus (you may be able to see these tears, known as anal fissures, or a little blood), you can apply some aloe vera lotion to the area to help it heal. Be sure to mention the tears to your doctor.