Causes of constipation in children
Constipation happens for several reasons.
It can happen when children hold poos in. They might hold poo in because they:
- are too busy playing
- have pain when they do a poo (or has hurt before) and they’re afraid to go to the toilet
- don’t want to use the toilets at preschool or school.
Constipation might also happen because children:
- aren’t eating enough fibre
- have been sick and have been eating and drinking less.
These situations can all lead to a build-up of poo in the bowel. When this happens, the poo gets too big or hard to push out easily.
There are some underlying medical conditions that might cause constipation in children, but these aren’t common.
Symptoms of constipation in children
A normal poo should be easy to push out and look like a sausage.
But if your child is constipated, poo becomes hard to push out. Your child might feel pain and discomfort when doing a poo or trying to do one. This might make your child avoid pooing, which can make the problem worse.
Hard poo might overstretch your child’s anus and cause small tears on the surface, which might lead to pain and bleeding.
Your child might also have tummy pains that come and go. Some children might show ‘holding on’ behaviour like rocking or fidgeting, crossing legs or refusing to sit on the toilet. They might also seem generally cranky.
If your child has been constipated for a long time, they might poo in their pants without meaning to. It might be a small or large amount of poo, and it might happen at any time of the day. This is called soiling or faecal incontinence.
Some children poo 2-3 times a day, and other children poo twice a week. This range is normal.
Should you see a doctor about constipation in children?
You should take your child to the GP if your child:
- needs a laxative more than a few times a year
- has constipation that doesn’t get better after you give them a laxative
- hasn’t done a poo for seven days
- poos in their pants without meaning to
- has constipation and also fever, vomiting, blood in their poo or weight loss
- has painful cracks in the skin around their anus
- has constipation and you’re worried they aren’t eating or drinking enough.
Treatment for constipation
Your child needs healthy bowel habits to avoid constipation.
The first step towards healthy bowel habits is diet. A healthy diet with enough fibre helps to prevent constipation. Foods that are high in fibre include wholegrain breads and cereals, fruit and vegetables.
Sitting on the toilet regularly and pushing can help with constipation. For example, try encouraging your child to sit on the toilet for five minutes about 20-30 minutes after eating breakfast, lunch and dinner.
Regular toileting can help your child learn to be aware of and respond to their body’s urge to poo. One way to do this is by starting a sticker or reward chart to praise your child for going to the toilet.
Some children might need a laxative to pass 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:
- osmotic laxatives like lactulose, Movicol® or OsmoLax®, which increase the water in your child’s poo and soften it
- liquid paraffin oil, which softens and lubricates the poo
- stimulants like Senekot® or Dulcolax SP® drops, which stimulate the bowel to get rid of 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 best way to treat your child’s constipation.
It can be easier for your child to do a poo if they sit on the toilet with feet flat on the ground and knees apart, while leaning slightly forward. If your child’s feet don’t reach the floor, you can put a footstool or box in front of the toilet.
Constipation in babies
Babies might be constipated if their poo is dry and crumbly or like pellets, or doing a poo seems to cause them pain and discomfort.
If you think your baby is constipated, see your GP or child and family health nurse.
It’s rare for breastfed babies to be constipated. They might go up to five days without doing a poo.
Constipated breastfed babies might need more breastmilk. If your breastfed baby seems constipated, try feeding more often.
Formula-fed babies might be constipated if infant formula isn’t made up correctly and doesn’t have enough water in it.
Getting the formula mix right and giving your baby extra fluids might help.
Babies who’ve started eating solids
Babies who’ve started on solids might have firmer and less frequent poos at first. This usually sorts itself out in a few weeks.
Adding more water to your baby’s solids might help.
Other causes of constipation in babies
If a hard poo has caused a tear in the rectum or anus, it might hurt to poo. In this situation, babies might instinctively hold poos in. The remaining poo gets hard and more difficult to push out.