Managing Constipation in Chicago Children

Constipation is one of the most common gastrointestinal challenges for our kids at Blue Bird Day in Chicago and one of the most frustrating for families.

When your child is uncomfortable, withholding stool, or struggling with painful bowel movements, it has a domino affect on mood, appetite, sleep and overall quality of life.

We have years of experience helping children and families control constipation through gentle massage and movement.

Constipation can happen for many reasons: low muscle tone, sensory processing differences, traumatic bathroom experiences, delayed gross motor milestones, or simply a nervous system that needs more support to coordinate bowel movements.

Chicago families need to know that whatever the cause, there are ways to help you nearby.

This guide walks you through the most effective, therapist approved strategies for supporting gastrointestinal (GI) mobility, improving pelvic floor function, and helping your child feel more comfortable.

If you’d like more personalized insight, please contact us today! We’re here to support you every step of the way.

Why Constipation Happens in Children

Constipation isn’t just about dieting, it’s deeply connected to motor development, sensory processing, and pelvic floor coordination. Children may struggle with constipation due to:

• Low muscle tone (common in children with Down syndrome, Autism, or developmental delays)
• Delayed gross motor milestones (core strength and posture affect bowel movements)
• Pelvic floor dysfunction
• Anxiety or fear around toileting
• Withholding behaviors
• Sensory sensitivities
• Changes in routine
• Limited fluid intake
• Low fiber intake

Constipation can also make potty training more difficult, as children may associate the toilet with discomfort or fear.

Supporting GI mobility through exercise, positioning, breathing, and manual techniques can make a meaningful difference.

Abdominal Massage for GI Mobility

Gentle, structured massage can help stimulate the colon and encourage bowel movements.

Before beginning any abdominal massage, it’s important to understand the basic landmarks: The colon runs from hip bone to hip bone and up to the rib cage. These boundaries help guide your hand placement.

Technique 1: The “Right Hip to Left Hip” Path

1. Start at the right hip bone.
2. Apply firm but gentle pressure upward toward the right rib cage.
3. Move across the belly (above the belly button) to the left rib cage.
4. Move downward toward the left hip bone.

You can use:

• Long strokes
• Small circular motions

Important: Too light = ticklish. Too hard = uncomfortable. Aim for “firm but friendly.”

Technique 2: The ILU Massage

This technique follows the shape of the letters I L U, which represent the path of the colon.

I:

• Start under the left rib cage
• Move downward to the left hip bone

L:

• Start at the right rib cage
• Move across to the left rib cage
• Move down to the left hip bone

U:

• Start at the right hip bone
• Move up to the right rib cage
• Move across to the left rib cage
• Move down to the left hip bone

This technique is widely used by pediatric therapists to support GI mobility.

Video Demonstration

A helpful demonstration of abdominal massage can be found here: Bowel Massage | Connect PT (Explanation begins around the 2 minute mark.)

Exercises That Support GI Mobility and Core Strength

Movement is one of the most powerful tools for improving digestion. When children move their bodies, they stimulate the muscles that support bowel movements — especially the core, spine, and pelvic floor.

Here are therapist recommended exercises:

1. Squats

Squats help lengthen and contract the pelvic floor, which supports healthy bowel movements.

2. Supine Bridges

Bridges strengthen the glutes and core, improving pelvic stability.

3. Single Leg and Tandem Balance

Balance activities activate deep core muscles and improve postural control.

4. Trunk Rotation

Twisting motions help stimulate the intestines and improve mobility.

These exercises can be incorporated into playtime — think obstacle courses, animal walks, or “bridge tunnels” where your child crawls under your bridge.

Diaphragmatic Breathing for GI Mobility

Breathing plays a surprisingly big role in digestion. When children breathe using their diaphragm (instead of their shoulders), it helps massage the internal organs and relax the pelvic floor — both essential for healthy bowel movements.

How to Teach Diaphragmatic Breathing

• Have your child lie down
• Place a hand or small toy on their belly
• Encourage them to “make the toy rise” as they inhale

Helpful Tools for Breathing Practice

These toys make breathing practice fun and engaging:

• Pinwheels
• Floating Blow Pipe Ball Game
• Siren Whistle

These tools help build breathing endurance and can be used both on and off the toilet to support bearing down and relaxation.

Signs Your Child Is Ready for Potty Training

Constipation and potty training are closely linked. A child who is constipated may resist the toilet, while a child who isn’t developmentally ready may become constipated from withholding.

Here are gross motor and physical signs that your child may be ready:

1. Regular Bowel Movements

Healthy, consistent stool patterns are essential. Refer to the Bristol Stool Chart for guidance on stool consistency.

2. Ability to Squat and Climb

Children who can climb onto surfaces or squat independently have the motor control needed for toileting.

3. Good Balance and Core Stability

Your child should be able to sit comfortably and relaxed on the toilet.

4. Adequate Hip Mobility

Good hip range of motion helps the pelvic floor relax, allowing stool to pass without pain or straining.

Balance, stability, and mobility all work together to support successful potty training.

Why Pelvic Floor Relaxation Matters

The pelvic floor is a group of muscles that must relax for stool to pass comfortably. If these muscles are tight, weak, or uncoordinated, constipation can worsen.

Signs of pelvic floor tension may include:

• Withholding behaviors
• Toe walking
• Difficulty relaxing on the toilet
• Straining or discomfort

Supporting pelvic floor relaxation through breathing, posture, and movement can make a meaningful difference.

When to Seek Professional Support

While these strategies can be incredibly helpful, constipation can sometimes be persistent or complex. If your child is experiencing ongoing discomfort, withholding, or difficulty with bowel movements, it’s important to consult a qualified healthcare professional for individualized guidance.

At Blue Bird Day in Chicago, our multidisciplinary team has extensive experience supporting children with:

• Chronic constipation
• Pelvic floor dysfunction
• Sensory based toileting challenges
• Low muscle tone
• Developmental delays
• Autism
• Down syndrome
• ADHD
• Anxiety around toileting

Our therapists use a combination of occupational therapy, physical therapy, developmental therapy, feeding therapy, and sensory integrated approaches to help children feel more comfortable and confident.

Small Steps Make a Big Difference

Constipation can be stressful for children and parents alike. It affects routines, comfort, and confidence — and it can make potty training feel like an uphill battle. But with patience, consistency, and the right strategies, children can make tremendous progress.

Remember:

• Celebrate small wins
• Keep routines predictable
• Use movement, breathing, and massage
• Support your child’s comfort and confidence
• Reach out for help when needed

Your child’s therapy team is here to support you every step of the way.

This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your child’s healthcare provider with questions or concerns about constipation or bowel health.

Frequently Asked Questions

How can movement and exercise help my child with constipation?

Movement is one of the most natural and effective ways to support healthy digestion in children. When your child moves their body — whether through play, structured exercise, or everyday activity — it helps stimulate the muscles involved in bowel movements, including the core, pelvic floor, and intestines. Simple activities like squats, bridges, and trunk rotations can make a real difference.

Even fun, playful movement like animal walks, obstacle courses, or crawling through “tunnels” counts. Diaphragmatic breathing — where your child breathes deeply into their belly rather than their chest — also helps relax the pelvic floor and supports the body’s natural urge to go.

If your child has low muscle tone or delayed gross motor skills, a physical or occupational therapist can recommend movement activities tailored specifically to their needs and abilities. At Blue Bird Day, we weave these strategies into therapy in ways that feel natural and enjoyable for your child.

Can sensory sensitivities make constipation worse in children with autism or developmental delays?

Yes — and this is something we see often at Blue Bird Day. Children with sensory processing differences may find the toilet loud, cold, or uncomfortable in ways that are hard to communicate. Some children are sensitive to the feeling of sitting on the seat, the sound of flushing, or the sensation of clothing removal.

These discomforts can trigger withholding behaviors, where your child holds in stool to avoid an experience that feels overwhelming. Over time, withholding leads to harder stools and more discomfort — creating a cycle that can be difficult to break.

The good news is that with the right sensory supports, gradual exposure, and a calm, predictable toileting routine, many children make real progress.

Our therapists work closely with families to understand your child’s unique sensory profile and create a toileting plan that feels safe and manageable for them.

How do I know if my child is constipated?

Constipation isn’t always easy to spot. Your child may be constipated if they have fewer than three bowel movements per week, experience pain or straining during a bowel movement, pass hard or pellet-like stools, or frequently hold in stool and resist going to the bathroom. You may also notice bloating, stomach discomfort, or changes in mood and appetite.

The Bristol Stool Chart can be a helpful visual guide for tracking stool consistency over time. If you’re unsure, your child’s healthcare provider or therapy team can help you assess what’s typical for your child and recommend next steps.

This post was originally published in January 2024 and was rewritten in July 2026 to include updated strategies.