Our 22-month-old, olivia, hasn’t had a bowel movement for a full week, which isn’t uncommon for her as she often goes days between poops. However, this time she seems uncomfortable: • Her face appears inflamed. • She says her tummy hurts and grabs her back. • She barfed earlier today. • We gave her a suppository several hours ago, but it hasn’t worked yet. • She’s teething, which may be contributing to her discomfort. We’re concerned about how to help her get more regular bowel movements and relieve her current discomfort. Are there any steps we can take now, and what should we monitor for signs that this may need urgent medical attention? Thank you for your guidance.

Managing constipation in children involves several strategies that can be effective for improving regularity and addressing current discomfort. Here are some expert-recommended steps:

1. Dietary Changes: A move towards a high-fiber diet can greatly benefit children experiencing constipation. Include more whole foods in Olivia's meals and consider specific foods like kiwi, prunes, and flax seeds, which are known for their bowel-regulating properties. Prunes and prune juice are particularly recommended because they contain sorbitol, which helps draw water into the intestines and aids in stool movement 1.

2. Hydration and Activity: Ensure Olivia is well-hydrated, as dehydration can worsen constipation. Encourage simple physical activities like playing or walking, which can stimulate bowel movements 1 2.

3. Home Remedies: For immediate relief, consider using a castor oil abdominal massage in a clockwise motion, which can be soothing and promote bowel movement. Mild laxatives like magnesium supplements (ensure kid-appropriate dosages) or certain herbal tinctures might also help, but consult a healthcare provider before use 3 4.

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4. Comfort and Reassurance: Since teething might be contributing to her discomfort, ensure Olivia has ample time to rest and feel comforted, which can ease stress and promote digestive health.

5. Seeking Medical Attention: If Olivia continues to vomit or appears severely uncomfortable, it is crucial to seek medical advice. Additionally, if conventional methods like fiber, fluids, and physical activities do not result in improvement, consulting a pediatric gastroenterologist might be necessary to rule out more serious conditions 2 5.

Pay attention to Olivia's overall behavior and symptoms, such as changes in pain or signs of dehydration, and contact a healthcare provider if her condition does not improve soon or if new symptoms arise.