Constipation
Constipation in Preschool-Aged Children – A Holistic Perspective
Constipation is a common issue in early childhood. It can first appear during the transition from an exclusively milk-based diet to a more varied solid diet. A more serious problem often arises between the ages of 2 and 3 – during potty training and the child's first experiences in group settings. The child consciously avoids defecation, withholding stool for several days, making it denser and harder. The resulting bowel movement is painful and triggers a new cycle of withholding – creating a vicious circle.
Lifestyle measures:
• Focus on a fiber-rich diet (dried fruits, oats, whole grains, flax and sunflower seeds, legumes).
• Ensure sufficient and regular fluid intake; avoid black tea and sugary drinks.
• Encourage daily physical activity – movement stimulates bowel function.
• Establish a regular toileting routine – ideally in a calm environment, 15–30 minutes after a meal, preferably in the morning.
• Ensure proper posture on the toilet – feet should be supported.
• At the beginning, temporary relief may be offered with glycerin suppositories (e.g., for 2–3 days), followed by lactulose-based syrups – but only with adequate fluid intake.
The Psychological Background of Constipation
When a pediatrician identifies constipation as a psychosomatic symptom, it often means that tension has developed in the child's experience or relational environment. Parents are often surprised by this interpretation – nothing obvious seems to be happening in the family. However, the cause may lie in unconscious adult behavior.
We frequently see parents, under pressure from others, introducing toilet expectations too early – "You were out of diapers by age one!", "When will they finally learn?" Sometimes, defecation becomes a family ritual that, during the toddler's defiant phase, is perceived as pressure – prompting the child to deliberately avoid pooping. Comparison with other children can also undermine the parent's confidence – and therefore, the child's trust.
How does constipation due to psychological causes manifest?
Parents usually notice the difficulty fairly quickly – the child refuses to push, contracts the anal muscles, cries, has abdominal pain, or resists being seated on the potty. Intense resistance and stool withholding are clear signals that something isn't right. Most parents seek help – from either a pediatrician or a psychologist.
When do these issues most often appear?
Most commonly between ages 2.5 and 4. However, it's not unusual to see cases in children under 2 or older than 4. Triggers often include the transition from diapers to a potty, or from potty to toilet – children may fear the toilet bowl, the sound of flushing, or feel insecure with their legs dangling.
It's also important how parents approach toilet training – excessive pressure, an authoritarian style, overprotection, or a chaotic home environment can all worsen the situation. Other triggers may include sibling jealousy, separation from the mother, starting preschool, parental divorce, moving house, or other stressful events.
How can a parent tell it's a psychological block?
An attuned parent can sense that emotional tension lies behind the constipation. Many instinctively turn to other parents, expert literature, a pediatrician, or psychologist. Intuition can help too. One mother, for example, created a safe space for her child, holding and comforting them during bowel movements, until the child gradually began asking for the potty themselves.
How can parents support their child?
• Don't force or punish – patience and empathy are key.
• Treat bowel movements as normal, not stressful.
• Acknowledge what's going on – e.g., "I see your tummy hurts. Can I help you?"
• Offer physical closeness – cuddles, presence, soothing words, or a soft "shhh" can reduce stress.
• Use storytelling – children's magical thinking responds well to healing tales of heroes and helpers.
• Create a pleasant environment – comfort, favorite books or songs, nice scents, fun toilet paper.
• Don't dramatize setbacks – avoid negative facial expressions, harsh comments, or oversharing in front of others.
• If needed, gently support the process with suppositories or flaxseed oil, always attuned to the child's needs.
• Praise successful bowel movements – build the child's confidence.
Homeopathic treatment:
When is it appropriate to seek professional help?
If medical causes have been ruled out and the issue persists, seeing a psychologist is a good idea. They can offer practical techniques – relaxation, massage, play-based exercises. The foundation, however, is working on the parent-child relationship. A psychosomatic approach invites reflection with questions like:
• What is my child emotionally attached to?
• What can't they "digest"?
• Where do they lack a sense of security?
• What are they afraid of?
• How do they express themselves, and where do they need more space?
The answers to these questions may hold the key to understanding and healing.
🧒 CONSTIPATION IN CHILDREN: WHEN TO SEE A DOCTOR?
📍 Warning signs ("red flags") you shouldn't overlook
Constipation is a common issue in children, often linked to psychological factors, diet, or habits. But sometimes, it can signal a more serious condition. Below is an overview of situations when it's important to consult a specialist.
🚩 Red Flags (Warning Signs)
🧭 What to do if you notice any of these signs?
• Don't wait, hoping "it will pass on its own."
• Talk to your pediatrician.
• If acute symptoms are present (pain, vomiting, no gas) → go to the ER.
• It's always possible to proceed gently: even specialist exams can be done with sensitivity and respect.
🧘♀️ Important:
Not all constipation is serious – most cases are functional. However, early diagnosis can prevent long-term complications and emotional distress for both child and parents.