I received a question from the mother of an 18 month old child asking if “The Ins and Outs of Poop” applies to children as young as hers. In fact, Chapter 3 of the second edition of the Ins and Outs of Poop is dedicated to infants and toddlers. Signs of functional constipation in toddlers include hard stools of any size, painful bowel movements, daily withholding and stool incontinence or leakage. For toddlers I recommend that parents initiate treatment right away if they see signs of functional constipation or encopresis. For otherwise healthy toddlers treatment usually starts with dietary changes including giving the child more water or juice such as 100% apple, prune or pear juice.
Because the treatment of encopresis in children is more successful the less time that hard stools and pain persist, I recommend that an oral laxative be strongly considered if a child's stool does not soften within 48 hours. Always consult with your pediatric healthcare provider if you any questions or concerns about the use of oral laxatives.