three-day Fear of such pain makes the child even more determined to postpone bowel movements. Constipation enlarges the colon, causing a loss of muscle tone, and the physical impulse to empty the bowel becomes weaker. This cycle can lead to chronic constipation. SIGNS AND SYMPTOMS The major sign of constipation is stools that are too hard, too dry, and larger in diameter than usual. Constipation can cause pain in the anus during bowel movements. Red blood may appear on and around the stools. Other symptoms are cramps in the abdomen and an eventual loss of appetite. If constipation continues for days or weeks, paradoxical diarrhea may develop. In this condition, loose, watery stools seep around the hard stool in the colon and are passed as diarrhea. When this happens, it can be difficult to tell whether the child has constipation or diarrhea. HOME CARE For immediate temporary relief, use a glycerine suppository or disposable commercial enema. For a longterm cure, increase the amount of roughage and decrease the amount of constipating food in your child's diet. (Check with your physician to ensure that your child's diet is nutritionally adequate.) If constipation occurs during toilet training, stop training efforts. PRECAUTIONS • Check with your doctor before giving laxatives to a child. Laxatives may force passage of a hard stool and cause pain that leads to further holding back by the child. • Enemas, suppositories, and laxatives are habitforming. They should never be used on a regular basis. • Do not assume that a child is constipated simply because bowel movements do not occur every day. MEDICAL TREATMENT Your doctor will perform a rectal examination and a careful examination of the child's abdomen. Xray studies of the bowel may be performed to look for possible physical abnormalities. RELATED TOPICS: Diarrhea in older children; Diarrhea in young children; Stomachache, acute; Stomachache, chronic Quick Reference Convulsions with fever SYMPTOMS • Fever • Unconsciousness • Uncontrollable jerking movements • Muscle spasms • Brief cessation of breathing • Bluish skin • Loss of control of bladder or bowels HOME CARE • Protect the child from injury during the thrashing or jerking movements. • Call your doctor immediately. • Do not put your fingers into the child's mouth. PRECAUTIONS • Do not give aspirin or any other medication by mouth to an unconscious child. • Do not give mouthtomouth resuscitation to a child having convulsions. • Do not place a convulsing child in a tub of water to reduce the child's temperature. • If the child cannot bend the neck forward after convulsions have ended, or if the child has collapsed or is exhausted, report this to your doctor. • If a child tends to have convulsions with a fever, sponge the child's body with a damp (lukewarm) sponge at the first sign of fever.? Convulsions are uncontrolled contractions or spasms of the muscles. If a child who has a fever goes into convulsions, there are two possible causes. whooping