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My five-year-old is often constipated. Should I be worried?

The question: I have two girls, ages 5 and 7. Ever since she was a baby, my youngest has seemed prone to constipation, at least compared with her older sister. They have roughly the same diet and aren't picky eaters. Should I be concerned that this may be a sign of an underlying health condition?

The answer: Constipation is one of the most common conditions that we see at our pediatric clinic and it affects children of all ages. I define constipation as stools that are large, hard and may be painful to pass. Some constipated children will only pass a stool once or twice a week. Stools that are painful to pass often cause the child to withhold them in the future, which only makes the problem worse.

Fortunately, it is extremely uncommon for constipation to be a sign of an underlying health problem. As long as your child seems otherwise healthy (eating well, growing normally) then there is probably no need for panic or concern. Some children's bowels are sensitive to dairy products, which can result in constipation. This doesn't mean that dairy products need to be eliminated, but if your child has a generous intake of cheese, milk or yogurt, then decreasing the amount ingested can sometimes be helpful. Reducing the fat content of dairy products, for example by switching from homogenized to 2 per cent or 1 per cent milk, can also loosen up a child's bowels.

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Some children with more severe constipation may require medication or stool softener but this is best discussed with your child's physician. Make sure you encourage good bathroom habits in your child, such as having him or her sit on the toilet after each meal. Sitting properly on the toilet (with your child's feet flat on the floor or on a step stool) also promotes easier passage.

Encourage your child to drink lots of water and include fruits, vegetables and whole-grain products in your family's meal plan. This can help prevent constipation and will promote good eating habits for the entire family.

Send pediatrician Michael Dickinson your questions at He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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