Does my child have to poop every day?

There is a common misconception that a healthy person, including a child, must have a bowel movement every single day. In reality, the normal frequency of bowel movements can vary widely from person to person.

What is a "Normal" Frequency?

For children, there is no single "normal" frequency. What is normal for one child may not be normal for another. A child's age, diet, and activity level all play a role. While many children do have a bowel movement once a day, it is also perfectly normal for a child to go every other day, or even every three days, as long as they are comfortable and the stool is soft.

The definition of constipation is based on symptoms, not just frequency. According to the Rome IV diagnostic criteria, functional constipation in children is defined by having two or more of the following for at least one month [1]:

• Two or fewer defecations in the toilet per week
• At least one episode of fecal incontinence per week
• History of retentive posturing or excessive volitional stool retention
• History of painful or hard bowel movements
• Presence of a large fecal mass in the rectum
• History of large-diameter stools that can obstruct the toilet

As you can see, frequency is only one part of the picture. A child who poops every three days but has soft, painless stools is not constipated. A child who poops every day but strains and passes hard, painful stools is constipated.

Focus on Consistency, Not Frequency

Instead of focusing on the number of days between bowel movements, it is more important to pay attention to the consistency of the stool and whether the child is having any pain or difficulty. The Bristol Stool Chart is a helpful tool for this. The goal is a Type 3 or Type 4 stool, which is soft and easy to pass.

If your child is not pooping every day but is otherwise happy, healthy, and passing soft stools without pain, there is no need to worry. If, however, they are showing any of the other signs of constipation, such as straining, pain, or hard stools, it is important to seek advice from a healthcare provider, regardless of the frequency.