It doesn't matter how often your child has bowel movements. Some only defecate every other day, or even less. Some children have a natural tendency to be constipated. Eating a lot of highly processed (a.k.a. “junk”) foods causes constipation, too, because they are absorbed into the system so completely, all that remains is a hard, heavy mass. The best cure is a diet rich in fruits, vegetables, and whole grains (especially bran, brown rice, whole wheat, and oats) to add lightweight bulk, and lots of water to soften it. Also, avoid foods that bind, such as bananas, chocolate, peanut butter, and cheese.

Fluid Intake

Toddlers need four to six cups of fluid daily under normal circumstances — more in hot weather or if they are ill with fever, vomiting, or diarrhea. Besides water (from the tap or bottled; plain or carbonated), good sources include soup, juice, and milk. However, milk provides only ⅔ cup of fluid per cup; the rest is solids.

Pain and Pressure of Constipation

Serious problems with constipation or worse, with impaction, can complicate potty training. Small hard “marbles” don't usually cause a problem, but wide stool can be painful to pass and cause tears that take time to heal. Small drops of blood on underwear or toilet paper may signal that this has happened, as well as rectal itchiness, which occurs as the tears start to heal. Gently wash the anus with soap and water after each bowel movement, and have your youngster soak in a warm bath to ease the pain. Put a dab of petroleum jelly on your finger and insert it into your child's rectum to help protect the sore area.

The added pressure on the bladder from a lot of hard stool can give children less time to get to the potty, so they have more wetting accidents. Since a full bowel leaves less room for the bladder, it can't hold as much urine, so urination is more frequent. The pain of constipation can also blur the sensation of needing to urinate, so children have difficulty realizing when they need to go to the potty. It can hurt to urinate, too. It can cause encopresis, too (see Chapter 10).

Psychological Constipation

Emotional factors can undermine children's ability to relax the anal sphincter at will so it will release stool, resulting in psychological constipation. Sitting on a cold toilet seat, potentially being splashed by cold water (if a potty seat is used), watching part of oneself being discarded and sucked down a noisy drain, and losing the special time one-on-one time while a beloved parent wipes and cleans and rubs them with sweet-smelling creams and lotions — is this what being a big boy is all about? Stress during potty training can cause constipation. Add to that a diet rich in junk food and low in fiber, and it's no wonder toddlers become constipated.

Shaping up your child's diet might help. Otherwise, doses of mineral oil will make it impossible for your youngster to hold back a bowel movement while softening the stool enough so passing it doesn't hurt. But is dosing a youngster with mineral oil to pry out feces an invasion of bodily integrity? Consult your conscience as well as your pediatrician to decide. Inquire about the possible need for vitamin supplements.

Remember that it's one thing to administer laxatives, stool softeners, and enemas to youngsters who are suffering from constipation or impaction because a pediatrician prescribed them. It's quite another to dose children with laxatives instead of straightening out their diet. And using laxatives to ensure your child has bowel movements at particular times so you can get her on the potty during potty training should be considered some sort of abuse. Don't do it!