Many parents discover that just as their child is becoming toilet trained, constipation may become a problem.

The most common cause of constipation in infants and toddlers is painful defecation. A difficult or painful bowel movement can begin a cycle of avoidance and worsening symptoms that can take weeks or even months to correct.

But other events also can be triggers of pediatric constipation:

Common Causes of Pediatric Constipation in Children Under Two
Family move
High fever
New medication
Starting daycare
Switch from breast to bottle
Toilet training
Traveling

Common Causes of Pediatric Constipation in Children Aged Two to Four
Birth of sibling
Family move
New medication
Parents' divorce or separation
Starting daycare
Toilet training
Traveling

The beginning of toilet training commonly results in at least a brief period of pediatric constipation. According to the medical literature, about 1 in 5 toddlers becomes constipated for at least four months when learning to use the toilet.

Many parents find that children are more willing to use the toilet to urinate than to defecate.  A great deal of wasted effort can be avoided simply by waiting until the child expresses an interest in using the potty for both toilet functions before taking him or her out of underpants.

Years of problems can also be avoided simply by not scolding your toddler for failure to use the toilet, and by never calling bowel movements as "stinky," "nasty," or "dirty."

Lack of fiber is the most common cause of pediatric constipation in children over the age of 3. Surprisingly, the medical literature reports that children who don't get enough fiber usually don't get enough calories, either, even if they get most of their calories from sugary foods. The constant feeling of fullness caused by pediatric constipation in the child-sized digestive tract takes appetite away.

Once you've made sure your child is comfortable with the potty, and getting enough fiber and enough calories, here are some additional simple steps for pediatric constipation relief.

1. Consider minimal doses of fiber supplements such as Metamucil, Fiberall and Citrucel - but never give fiber and laxatives at the same time. Fiber helps stool absorb water, making it easier to pass.
2. Consider reducing the amount of milk in your child's diet. Sometimes toddler constipation is due to milk sensitivity. On occasion, a child can become constipated due to a cow's milk allergy or sensitivity.
3. Encourage your toddler to sit on the potty after meals, especially after breakfast. The longer a child avoids going to the bathroom, the harder the stool will become. Intestinal reflexes occurring as food enters the stomach make evacuating the bowels easier.
4. If you provide enough fluids (water, juice, and milk) for your toddler, constipation will be less of a problem.  If your child is dehydrated, stools will be hard to pass. A good way to tell your child is getting enough fluid is frequency of urination. Children who urinate every three to four hours when they are awake are getting enough water.
Other important guidelines for treating pediatric constipation include:
Do consult a doctor if constipation develops suddenly, is accompanied by fever, or is associated with pain on the right side of the abdomen.
Don't give your child laxatives. They are too strong for treating toddler constipation.
Don't worry if there is a small amount of bright red blood on the toilet tissue. This is probably due to an anal fissure, which will heal when toddler constipation is treated.

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