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If your child is passing hard, painful stools, going to the toilet less often, or crying and holding back when they need to go, you are not alone. Constipation is one of the most common reasons parents bring children to Kids Care International Hospital in Rawalpindi and Islamabad. The reassuring news: in the vast majority of children, constipation is not caused by any serious disease and improves fully with the right treatment and habits.
A child is considered constipated when they have fewer than three bowel movements per week, or when stools are hard, dry, large, or painful to pass — even if they go every day. Constipation happens when stool moves too slowly through the intestine, allowing too much water to be absorbed, which makes the stool hard and difficult to push out.
What counts as “normal” changes with age:
| Age | Typical bowel movements |
|---|---|
| Newborn (breastfed) | After every feed, or once in several days — both can be normal |
| Newborn (formula-fed) | 1–3 per day |
| 6 months – 3 years | 1–2 per day |
| Over 3 years | Once daily, or at least every other day |
Children may avoid going to the toilet due to fear of pain, dislike of public toilets, or reluctance to stop playing.
Passing a large, hard stool can cause pain, leading the child to hold stool to avoid discomfort.
Starting toilet training too early or turning it into a stressful experience can lead to stool withholding.
Low intake of fiber-rich foods (fruits, vegetables, whole grains) or inadequate fluid intake is a major cause.
Travel, school stress, hot weather, or starting school can disrupt normal bowel habits.
Some children may develop constipation due to cow’s milk allergy or excessive consumption of milk and cheese.
A child with constipation may show one or more of the following symptoms:
Constipation is usually not serious, but medical advice is important if it lasts longer than two weeks or is accompanied by:
Early evaluation helps prevent complications and reassures parents.
Pediatric anorectal malformations are birth defects that affect the anus and rectum in babies. These problems can make it difficult for a child to pass stool normally.
Doctors usually notice anorectal malformation when a baby is born and examined. They might see that the anus is very small, missing, or in the wrong place.
Children may have trouble controlling stool, experience accidental leakage, diarrhea, pain or burning during bowel movements, and sometimes bleeding or inflammation.
Doctors perform simple and gentle tests to understand your child’s condition. They carefully examine the baby and may use X-rays or ultrasound to see inside the body. These painless tests help doctors identify the problem and choose the best treatment for your child.
Most babies need surgery to fix the anus and rectum. The exact type and timing depend on how serious the problem is. Treating early usually gives the best results.
These are types of anorectal malformations where the rectum connects to the wrong place. In boys, stool may pass with urine (recto-urethral). In girls, stool may come out through the abnormal opening just behind the vaginal area (recto-vestibular). Both need surgery to restore normal bowel function. If stool comes out of vagina then it is recto-vaginal fistula.
Yes! After surgery and proper care, most children grow up healthy and active, able to do everything other kids do. The doctors and hospital team support both you and your child throughout recovery.
Yes, the hospital offers full care—diagnosis, surgery, and follow-up—supporting both the child and parents through every step of recovery.
Most children stay a few days to a week. Doctors keep them until they are healing well, feeding properly, and able to pass stool comfortably.
If constipation becomes chronic, it can lead to:
Rarely. Surgery is only considered when constipation is caused by a structural condition such as Hirschsprung’s disease or an anorectal malformation, or in exceptional chronic cases that fail all medical treatment. KCIH’s pediatric surgery team evaluates these children thoroughly before any decision.
If chronic constipation is ignored, it can lead to:
♦ Offer a fiber-rich diet from an early age, increasing gradually
♦ Encourage regular water intake — especially in summer
♦ Keep toilet training relaxed and pressure-free
♦ Teach children never to ignore the urge to pass stool, at home or school
♦ Keep a consistent daily routine for meals and toilet time
Constipation in children is common, treatable, and — in almost all cases — not a sign of anything serious. With soft stools, a calm toilet routine, and a little patience, the fear fades and normal habits return. If your child’s constipation is persistent, painful, or worrying you, our pediatric specialists at KCIH are here to help — from simple guidance to full evaluation under one roof.
It varies by age. Breastfed newborns may pass stool after every feed or only once in several days — both can be normal. Toddlers and older children typically go once or twice a day. A child is considered constipated when they have fewer than three bowel movements per week, or when stools are hard, dry, and painful to pass.
In most cases, no. Constipation in children is very common and usually improves with diet changes, more fluids, and healthy toilet habits. However, if it lasts more than two weeks, or comes with fever, vomiting, weight loss, a swollen abdomen, or blood mixed in the stool, your child should be examined by a pediatric specialist without delay.
It is safer not to. Laxatives such as lactulose are commonly used for children in Pakistan, but the correct medicine and dose depend on your child’s age, weight, and the severity of constipation. Giving the wrong laxative — or stopping it too early — can make the problem return. Always have a doctor guide the treatment.
This is called stool withholding, and it usually starts after one painful bowel movement. The child becomes afraid of the pain, holds the stool in, and the stool becomes even harder — creating a cycle. Breaking this cycle needs softened stools (through diet or doctor-prescribed medicine), patience, and never punishing or pressuring the child.
Occasional constipation often settles within a few days of diet changes. Chronic constipation takes longer — treatment usually continues for several weeks to months, because the bowel needs time to regain its normal size and rhythm after being stretched. Stopping treatment too early is the most common reason constipation comes back.
At Kids Care International Hospital (KCIH) Rawalpindi, constipation is managed by our pediatric medicine and pediatric surgery teams, including Dr. Muhammad Umar Nisar, Consultant Pediatric & Neonatal Surgeon with over 15 years of experience. Children with chronic or complicated constipation are fully evaluated to rule out underlying conditions before a treatment plan is made.
KCIH is the twin cities’ dedicated children’s hospital, with pediatric specialists, an in-house diagnostic facility, and pediatric surgeons available under one roof. This means everything from simple constipation to complex conditions like Hirschsprung’s disease can be diagnosed and treated at the same place, without referrals elsewhere.
