Deborah Cloney, MD, is a pediatric gastroenterologist with Helen DeVos Children's Hospital. She is this week's guest blogger.

Constipation is one of those topics that parents generally don't choose to talk about. But it is such a common issue, that if they did talk more about it, particularly ways to avoid it, fewer children would have to suffer through it.

So, let's talk about kids and constipation. First, it helps to know that it is extremely common-as a pediatric gastroenterologist, at least once a day I treat a child who is dealing with constipation, and I've been doing so for the past 19 years. At Helen DeVos Children's Hospital, there are about 1,000 patient visits per year due to constipation.

Kids become constipated for many reasons. However, many times these reasons are related to behavior, based on their attempts to avoid large, painful bowel movements-if they've had one, they will likely try to avoid the next one.

As a parent, you often have an opportunity to help your child avoid constipation. In fact, a healthy diet and a calm, patient manner are often what help most in preventing constipation or preventing a more severe case of constipation from developing. Here are other ways you can help:

• Make sure your child is drinking lots of water and getting plenty of high fiber foods.
• Be aware of early warning signs. If your child complains of frequent stomachaches or has blood when he or she wipes, these may be signs that he or she is becoming constipated. If this is happening, you may also want to try a pediatric fiber supplement, but make sure your child drinks enough fluid with it, or else it won't work.
• Don't put pressure on a toddler who is potty training. They may hold back out of fear or anger. Also, don't allow your child to play video games or read books while they are on the toilet waiting for a bowel movement-it is important for a child to learn the signals their bodies send them, and concentrate on the task at hand. That said, I recommend spending no more than 5 minutes waiting on the toilet for a bowel movement. If it doesn't happen by then, let your child do another activity.
• Talk to your early school age child about using the bathroom at school. A child this age may be afraid or embarrassed to have a bowel movement away from home. Address their specific concerns, then talk to them about constipation and the importance of going when you have to go.
• Don't stop communicating with your older child about constipation. Older children can become used to constipation and no longer want to talk to you about it. However, they need to be reassured that you are there to help them and that communication is important. At the same time, they should be made aware that there are consequences to chronic constipation. For instance, over time, they can lose their ability to sense when they need a bowel movement and can accidentally leak fecal matter. Severe constipation can also cause urinary problems, as an impacted stool can press on the bladder.

If your child is already constipated, you may want to contact your pediatrician for advice-it's likely you will not even need to go in for a visit at first, but your doctor should be able to offer recommendations, such as a non-stimulant stool softener. If you follow your pediatrician's advice, and the constipation remains (or if it returns), you may want to schedule an office visit. If it continues, your pediatrician may refer you to a pediatric gastroenterologist.

One final note-in my practice, I often see children who have had chronic constipation, so they now leak fecal matter. Many parents think a child is doing this on purpose, but they are not. Their rectums have become full, and they really are not aware that it is happening. So if this has happened to your child at some point, please be gentle and patient with them. It isn't their fault.

Once, quite a few years ago, I treated a teen who was constipated. At the last visit, the mother and daughter told me that no longer having to deal with constipation literally changed their lives. I'll always remember this-even though it seems so simple, constipation is something that has a major impact on a person's life. Once it is treated, though, a child can focus on new things and rewarding activities.

- Dr. Cloney

Jennifer Hoekstra is the Safe Kids Program Coordinator at Helen DeVos Children's Hospital and an injury prevention specialist. She is our guest blogger this week.

As an injury prevention specialist, one of the reasons why I like Halloween is I see it as a chance for parents to enjoy anticipating the holiday with their children, but also to use it as an opportunity to reinforce good safety habits that should be followed throughout the year.

To have a safe and enjoyable Halloween, first, I suggest you start brainstorming with your child in advance about his or her costume instead of trying to pull something together on Halloween Day-chances are greater that if you try to make a costume at the last minute, it won't be as safe.

Once you've decided on a character and are ready to make or buy a costume, keep the following safety guidelines in mind. Remember, most of these tips can also be used when choosing any type of clothing your child wears throughout the year.

• Make sure the costume is flame-resistant. If you're purchasing a costume-including masks, beards and wigs that go with them-check that they are labeled "flame resistant."
  
• Avoid costumes with big or long sleeves, flowing skirts or scarves. Many times people light jack-o-lanterns or have bonfires on Halloween, so having a close-fitting costume helps minimize the chance it will catch on fire.
  
• Check that your child's costume is short enough. This will help prevent your child from tripping and injuring him- or herself.
  
• Buy or make costumes that can be seen in the dark. If your costume is not reflective, add reflective tape that will glow when headlights shine on it.
  
• Make sure your child carries and uses a flashlight. Also, if you haven't used the flashlight in a while, test it before Halloween Eve.
  
• Wear good walking shoes. Walking in the dark is challenging and it is easy for children to trip and fall. Do not let your child wear high heels or other footwear that is not sturdy.
  
• Make sure your child can see. If your child is wearing a mask, make sure it is secured properly so it will not cover his or her eyes. Also, headwear should also be secured so it does not slip down over your child's eyes.
  
• Consider non-toxic face paints or cosmetics instead of a mask. Masks pose a safety risk because they can slip and restrict breathing or obscure vision. If a mask is used, make sure it has large eyeholes and fits securely.
  
• Check all costume accessories. Make sure all materials used are soft or flexible, including any type of weapon, such as a sword.

Now, here are a few important safety precautions to go over with your child before he or she goes trick or treating:

• Young children should stay with an adult.
  
• For older children, plan and review a trick or treating route that is acceptable for them to navigate alone. Agree on a specific time when they should return home.
  
• No running. Also, do not walk between parked cars, in the street or in other people's yards.
  
• When going to the door to trick or treat, watch for jack-o-lanterns, Halloween décor or any furniture that might present a danger.
  
• Do not to eat any candy or treats before an adult has carefully examined them at home.
  
• Only trick or treat at homes where you know the residents and make sure their outside lights are on, so you know trick-or-treating is welcome.
  
• Teach your children how to call 9-1-1 if they have an emergency or become lost.

Unfortunately, almost every year we see at least one Halloween related injury at Helen DeVos Children's Hospital. This year, let's follow these safety tips and enjoy the planning, preparations, and parties.