Constipation in babies & kids: signs, treatment & prevention

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.

What are the symptoms of constipation in children?

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.

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

What causes constipation in children?

Holding in poos

Constipation can happen when children hold in their poos. Children might do this 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.

Illness or diet

Constipation might also happen because children have been sick and have been eating and drinking less than usual.

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.

Medical conditions

There are some underlying medical conditions that might cause constipation in children, but these aren’t common.

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.

Does your child need to see a doctor about constipation?

Yes, your child might need to see a doctor about constipation.

Take your child to the GP if you think your child is constipated and they:

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

Also take your child to the GP if the simple changes suggested below aren’t helping with the constipation or if you’re worried that your child isn’t eating or drinking enough.

What to do if your child holds in their poo

Talk positively about poo – for example, ‘Doing a poo will help your tummy feel better’.
Reassure your child that they’ll be OK – for example, ‘It’s OK to let the poo come out. I’m right here with you’.
Encourage your child to relax – for example, you could try slow, deep breathing with your child.
Distract your child – for example, you could talk to them about their favourite story or sing a song together.
Pick up your child and hold them on your hip with their legs around you. Gently reassure them and rub their back. This can help your child relax enough to poo.

How to use diet and toileting to prevent constipation in your child

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

Diet

A healthy diet helps to prevent constipation. A healthy diet includes wholegrain breads and cereals, fruit and vegetables. Our guides can help you meet your child’s healthy food needs:

Toileting tips

Sit your child on the toilet with their feet supported and their knees apart, while leaning slightly forward. This can make it easier for your child to poo.
Try using a potty. Young children often find it easier to poo while sitting 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.
Encourage your child to go to the toilet regularly – for example, 3-5 minutes about 20-30 minutes after eating breakfast, lunch and dinner.
Praise your child for sitting on the toilet, even if they don’t do a poo. A reward chart might also help.

How to relieve your child’s constipation with 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.

Types of laxatives and how they work

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 so it slides out more easily
Stimulants like Senekot or Dulcolax SP drops – these stimulate the bowel to squeeze and push the poo along.

Some children with chronic constipation will need to keep taking laxative medicine 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.

Constipation in 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. This is OK if their poo is soft, they’re not in pain and they’re still growing well.

Constipation in 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.

Constipation in 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.

Young babies can scrunch up their faces and seem to strain when passing a poo, but this is a normal part of development. If their poo is soft and they don’t look distressed at other times, they’re probably not constipated.