Constipation in toilet-trained children can be a result of holding poos in. Your child might be put off going to the toilet because he’s too busy playing, because it hurts to go to the toilet, or because he doesn’t want to use the toilets at his preschool or school.
Constipation might also happen if your child isn’t drinking enough fluids or eating enough fibre, or as a result of an illness where your child eats and drinks less.
These situations can all lead to a build-up of poo in the bowel. When this happens, the poo gets too hard for your child to push out easily.
There are some underlying medical conditions that might cause constipation in children, but these are uncommon.
There’s a big range of normal when it comes to how often children do a poo. Some kids go 2-3 times a day, and other children go twice a week.
The main symptom of constipation is hard poo. If your child’s constipated, she might feel pain and discomfort when she’s doing a poo, which might make her avoid going to the toilet. The hard poo might overstretch the skin around the anus and cause small, superficial tears, which might lead to pain and bleeding.
Your child might also have tummy pains that come and go. He might show ‘holding-on’ behaviour such as squatting, crossing his legs or refusing to sit on the toilet. He might also seem generally cranky.
If your child has been constipated for a long time, she might poo in her pants without meaning to. This happens because the hard poo is stuck and stretches the rectum. Your child might then lose the urge to go the toilet because her rectum always feels stretched. Liquid poo might then overflow around the old hard poo, without your child feeling it. This is called encopresis.
When to see your doctor
You should take your child to the doctor if:
- you need to give your child a laxative more than a few times a year
- your child’s constipation doesn’t get better after you give her a laxative, or the constipation lasts longer than two weeks
- your child poos in her pants without meaning to
- your baby (less than 12 months) is constipated
- your child’s constipation is accompanied by fever, vomiting, blood in the poo or weight loss
- your child has painful cracks in the skin around his anus.
Your child needs healthy bowel habits.
You can first build these habits through diet. A healthy diet that contains adequate fibre and lots of fluids (especially water) helps to both treat and prevent constipation. Foods that are high in fibre include wholegrain breads and cereals, fruit and vegetables.
If your child is constipated, encourage her to develop the habit of sitting on the toilet regularly and pushing, three times a day for 3-5 minutes each time (usually after meals). Also teach your child to respond to her body’s urge to poo by going to the toilet.
You might need to give your child a laxative if he’s constipated, so he can pass the hard poo without pain.
Prune juice is a mild natural laxative that works in some children. If this doesn’t work, you should see your doctor.
Possible laxative medications include liquid paraffin oil (which softens the poo), an osmotic laxative such as Movicol (which increases the water in the poo and softens it), and a stimulant such as Senekot (which stimulates the bowel to remove the poo). Some children with chronic constipation will need to keep taking laxative medications for several months. Your doctor will let you know about the appropriate course of treatment.
Constipation in babies
Your baby is constipated if her poo is dry and crumbly or like pellets, and seems to cause her pain and discomfort. Lots of babies go red in the face and strain when doing a normal poo. This is only a sign of constipation if the poo is also hard.
It’s rare for breastfed babies to be constipated. If your breastfed baby’s constipated, it’s possible he isn’t getting enough breastmilk. You might need to feed him more often.
Bottle-fed babies might be constipated because the milk formula isn’t made up correctly and doesn’t contain enough water. Getting the formula mix right and giving your baby extra fluids might help with her constipation.
Some babies can get constipated if a hard poo has caused a tear in the rectum or anus, which hurts them. They instinctively hold on, so the remaining poo gets hard and more difficult to push out.
If you think your baby’s constipated, talk about it with your doctor or maternal and child health nurse.