Normal stool consistency is soft, and it passes easily.

Normal stool frequency in Indian children

Age of Child	No.of Stool/day
0-1 month	5-6
1-3 months	3-4
4-6 months	2
7-24 months	1-2
1-18 years	1

Constipation Causes

1. Changes in routine

• o Timing of defecation


• o Nonavailability of toilets


• o During travel

2. Dietary factors

• o Predominant milk-based diet


• o Bottle-feeding


• o Diet poor in fiber


• o Change in infant formulas.

3. Acute stressor

• o Stressful events


• o Change of home


• o Change of school


• o Loss of near one


• o Major changes in family


• o Sibling rivalry


• o Intercurrent illness.

4. Changes in routine

• o Timing of defecation


• o Nonavailability of toilets


• o During travel

5. Forceful and too early toilet training

6. Sedentary lifestyle

7. Decreased outdoor playtime

Common complaints may be:

• • Nonspecific abdominal pain/discomfort


• • Painful defecation


• • Withholding of stools (typically child may go to the corner of the room or hide behind curtains and stand cross-legged or hold on a table and bend forward).


• • Soiling of pants with small amount of liquid stools


• • Urinary complaints (frequent urination).


• • Passing large size stools or pellet-like stools.


• • Bloating


• • Passing a lot of gas


• • Decreased appetite


• • Collapsing

When to see your paediatrician

Bleeding while passing hard stools is a sign you should see a doctor. It may be caused by fissure and can lead to withholding habit due to fear. Skipping days for long time at times denotes possible impaction.