There are plenty of colorful ways to describe a bowel movement: Number two, log rolling, sinkers and floaters. For some kids, though, this normal bodily function can be anything but a smooth move.

Constipation has many different meanings, but is generally defined as infrequent or abnormally hard bowel movements. Some infants may have up to seven bowel movements per day or as little as one every seven days. In this case, the proof is in the pudding. If your child is having one soft, albeit explosive, poop every few days, there is not much to worry about. On the other end, if Junior is passing hard little balls then it is time to call the pediatrician.

‘Grunting Infant Syndrome’

Most infants, and anyone else who has tried lying down to have a bowel movement, will generally cry, scream, grunt, strain, pull their legs to their chest and turn red in the face. This behavior can be very disturbing to onlookers. If a soft stool is produced, one should feel reassured.

Constipation in early infancy should not be ignored. Delayed passage of meconium, a baby’s first bowel movement, beyond the first 24-48 hours of life may be due to an anatomic abnormality.

The potty training connection

In most children, the cause of constipation is due to active withholding of stool. The peak onset of constipation is during the potty-training process. This may be related to a fear of the toilet, being too busy to stop playing and answer the call of nature, parent-child struggles over potty training or fear of painful stools.

With the onset of constipation, painful bowel movements become more common. Kids become more fearful and learn to hold their poop.

The potty dance starts as kids learn to voluntarily clench their buttocks and bounce, stand or sit with stiff legs. As the rectum becomes more impacted with hard stool, overflow incontinence may occur leading to small diarrhea-like stools and soiling of underpants. Having intestines filled with hard stool may also interfere with complete emptying of the bladder, leading to frequent urination, urinary incontinence, bed-wetting or urinary tract infections.

If addressed early, correcting constipation may be as easy as drinking more water or fruit juices, eating more fiber, fresh fruits and vegetables or cutting down on milk consumption. In the case of chronic constipation and fecal retention, your pediatrician may prescribe a regimen that includes mineral oil or an osmotic agent such as polyethylene glycol to achieve a good cleanout. Use of enemas and rectal stimulation to relieve constipation is generally frowned upon in children. These procedures are uncomfortable and embarrassing and may increase fear, anxiety and future withholding of stool.

Sit-down therapy

Once a clean out has been achieved, establishing better eating habits and/or continuing mineral oil may be used to promote regularity. A child must then retrain himself to recognize the urge to go, rather than hold it in.

Increasing exercise and sitting down to have regular bowel movements can help establish regularity. In the morning, before school, is an ideal time to train your child to go, since many kids are embarrassed to poop at school because of hygiene issues or teasing from peers. Reading a comic book or a newspaper while sitting on the throne may work as a distraction and help nature do its thing.

We have all known people who are full of it … early intervention may help it pass more smoothly. And that’s the scoop on poop.

Dr. Brennan is a board-certified pediatrician in practice at the Sansum-Santa Barbara Medical Foundation Clinic, Hitchcock Branch (563-1995).