In Sub-Saharan Africa, common causes include:

• Low-fiber diets (not enough fruits, vegetables, and whole grains)
• Not drinking enough clean water
• Delaying toilet use (e.g. due to fear of dirty or unsafe school toilets)
• Sudden changes in diet or routine
• Illness or fever
• Certain medicines (e.g. for coughs, pain, or epilepsy)
• Emotional stress (new school, family issues, etc.)
• Rarely, constipation may be caused by medical conditions like Hirschsprung disease or spinal cord issues.

Your child may be constipated if they:

• Pass stool less than 3 times per week
• Struggle or cry while passing stool
• Complain of belly pain
• Have hard, dry, or large stools
• Refuse to eat
• Soil their underwear (leakage from a blocked bowel)
• Suddenly start bedwetting after being dry
• Avoid using the toilet
• Swollen belly.
• Vomiting occasionally.

✅ Give more fluids
Encourage your child to drink clean, safe water throughout the day, especially in hot weather.

✅ Add fiber to meals
Include:

• Fruits (e.g., pineapple, cashews, tangerines, ripe pawpaw, oranges)
• Vegetables (e.g., pumpkin leaves, spinach, green leaves)
• Whole grains (e.g., millet, sorghum, guinea corn, maize meal with bran)
• Legumes (beans, lentils, groundnuts)

✅ Encourage toilet routine

• Encourage children to use the toilet at the same time every day, especially after meals.
• Teach them to relax and take time on the toilet.
• Make sure toilets are safe, private, and clean, especially at schools.

✅ Encourage movement
Active children have healthier digestion. Let them play and move daily.

✅ Respond to stool withholding
Some children avoid going to toilet due to previous painful experiences. Offer praise, support, and try to make toilet time relaxed.

Go to a clinic or hospital if your child:

• Has severe belly pain
• Has not passed stool in more than 5–7 days
• Passes blood-stained stool
• Has vomiting, fever, or swelling of the abdomen
• Is losing weight or refusing all food
• Soils their underwear often (after being toilet-trained)

Yes — in some cases, a health worker may prescribe stool softeners or mild laxatives. These should only be used under medical supervision. Overuse can be harmful.

Avoid giving herbal mixtures unless advised by a qualified health provider.

Cultural Beliefs and Misunderstandings

• Be patient and avoid punishment
• Create a calm, regular toilet routine
• Offer encouragement and rewards for effort (not just results)
• Talk openly about bowel habits — help reduce embarrassment

Constipation is common, treatable, and preventable. With good food, enough fluids, and a caring toilet routine, your child can stay healthy and happy.