What we see in clinic

At The Children's Naturopath, constipation is one of the most common digestive concerns we see in children, from babies through to teenagers.

Drawing on over 28 years of clinical experience, we pay particular attention to how frequently children empty their bowels, how long food takes to move through the digestive tract, and whether diet or withholding behaviours are contributing.

One of the first questions we ask parents is: "Does your child pass a bowel movement every day, and what does it look like?"

Many parents assume that a bowel movement every two or three days is normal, particularly if their child is not complaining of pain. However, infrequent bowel movements can allow stools to accumulate and become harder to pass.

Why passing a stool doesn't always mean the bowel is empty

An important observation in clinic is that some children pass stools regularly but are not completely emptying their bowels.

For example, a child may pass small amounts of stool each day while larger amounts remain in the bowel. This can contribute to bloating, reduced appetite, tummy aches and sometimes loose stools that leak around retained stool.

We therefore look beyond bowel movement frequency and ask parents to observe stool size, shape, consistency and whether their child appears comfortable afterwards.

Ideally, stools should be soft, formed, sausage-shaped and easy to pass without straining.

The corn test: understanding bowel transit time

One simple observation we sometimes recommend is the corn test, which can help parents estimate how long food takes to travel through their child's digestive system.

A child eats a small serving of sweetcorn with their evening meal, and parents record when they first notice corn kernels in their stool.

If corn is eaten at dinner and appears in a bowel movement the following day, that suggests a relatively quick transit time. If several days pass before the corn appears, it may indicate slower movement through the digestive tract.

The corn test is a rough home observation, not a precise measurement — but it can be useful alongside a bowel diary.

When pain leads to withholding

A pattern we frequently explore is constipation that begins after a child experiences one particularly painful bowel movement.

The child may then avoid using the toilet because they associate passing stools with pain. As stool remains in the bowel, more water is absorbed, making it harder and more uncomfortable to pass.

This can create a cycle of pain, fear and withholding.

In these situations, we pay attention to both stool consistency and the child's confidence around using the toilet. Making bowel movements comfortable and predictable is an important part of breaking this cycle — and where a child is badly impacted or withholding, their doctor should be involved, as stool softeners are often part of the answer.

Could diet be contributing?

Another area we investigate is whether a child's diet contains enough fluid, fibre and a suitable balance of foods to support regular bowel movements.

In clinic, we often see children whose diets are dominated by bread, crackers, pasta and other refined carbohydrates, with relatively small amounts of vegetables, fruit and other fibre-containing foods.

We also consider whether dairy or wheat may be contributing to digestive symptoms in individual children. Rather than making numerous dietary changes at once, we encourage parents to observe whether changes in particular foods are associated with improvements in bowel movements, bloating and abdominal comfort.

What we encourage parents to observe

A simple bowel and food diary can provide valuable information. We encourage parents to record:

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  How many days pass between bowel movements.

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  Whether stools are hard, pellet-like, sausage-shaped or loose.

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  Whether their child strains, experiences pain or avoids the toilet.

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  Whether their child appears to empty their bowel completely.

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  Any bloating, tummy aches or changes in appetite.

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  Daily fluid intake and the types of foods being consumed.

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  Results of the corn test, when used.

Our clinical focus is on establishing comfortable, regular bowel movements and understanding the dietary, digestive and behavioural factors that may be preventing this, alongside your child's existing care.

References

Clinical insights by Fiona Stock — Paediatric Naturopath & Children's Nutritionist, founder of The Children's Naturopath, with 28 years of clinical experience.