Constipation

What is constipation?

Constipation is when poo is too big or too hard to push out.

There’s a big range of normal when it comes to poo and pooing. The number of times that children poo can range from 3 times a day to only twice a week.

Symptoms of constipation in children

Normally, poo is easy to push out. It looks like a sausage.

But if your child is constipated, they might:

feel pain and discomfort when trying to poo
avoid pooing
have small tears around their anus, which cause pain and bleeding
have tummy pains that come and go
show ‘holding on’ behaviour like rocking or fidgeting, crossing legs or refusing to sit on the toilet
seem irritable.

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. This is called soiling or faecal incontinence.

Causes of constipation in children

Constipation 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 it has hurt before)
don’t want to use the toilets at preschool or school.

Constipation might also happen because children:

aren’t eating enough fibre as part of a healthy diet
have been sick and have been eating and drinking less.

These situations can 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.

Medical help: when to get it for constipation in children

If you think your child is constipated, you should take your child to the GP if they:

are under 12 months
have fever, vomiting, blood in their poo or weight loss
are in significant pain.

You should also take your child to the GP if simple changes to their diet and toilet routines aren’t helping with the constipation or if you’re worried that your child isn’t eating or drinking enough.

Preventing constipation in children: diet and toileting

Healthy bowel habits can help your child avoid constipation. These habits start with diet and toileting.

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. Our guides can help you meet your child’s healthy food needs:

Toilet tips
It can be easier for your child to do a poo if they sit on the toilet with their feet supported and their knees apart, while leaning slightly forward.

Young children often find this easier on a potty than an adult toilet. If your child is using an adult toilet and their feet don’t reach the floor, make sure they have a foot stool that positions their knees higher than their bottom. A child toilet seat can also help.

Sitting on the toilet regularly can help with constipation. Try encouraging your child to sit on the toilet for 3-5 minutes about 20-30 minutes after eating breakfast, lunch and dinner. Praise children for sitting, even if they don’t do a poo. A reward chart might also help.

Treating constipation in children: laxatives

Laxatives are a type of medicine that help with emptying the bowels. Some children might need a laxative to pass hard poo without pain. It’s best to speak to your GP before giving laxatives to your child.

Laxatives include the following:

Osmotic laxatives like lactulose, Movicol or OsmoLax – these increase the water in your child’s poo and soften it.
Liquid paraffin oil – this softens and lubricates the poo.
Stimulants like Senekot or Dulcolax SP drops – these 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 GP will let you know about the best way to treat your child’s constipation.

Constipation in babies

Babies might be constipated if their poo is dry and crumbly or like pellets, or if 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.

Breastfed babies
It’s rare for breastfed babies to be constipated. In the early weeks, most babies will poo at least once a day. If they poo less often than this, it might be a sign they need more breastmilk.

At about 6 weeks of age, some babies will start to go longer between poos, and some might poo only once a week. If their poo remains soft and they’re not in pain and they continue to grow well, this is normal.

Formula-fed babies
The number of times that formula-fed babies poo can range from 3 times a day to only twice a week. If babies poo less often than this, it might be because 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, pooing might hurt your baby. In this situation, your baby might instinctively hold poos in. This can mean that the remaining poo gets hard and more difficult to push out.