What is constipation?

Constipation is when your child is having difficulty pooing.

Constipation is common in childhood, particularly when children are being potty trained at around 2 to 3 years old.
 

The NHS recognise the following as symptoms of constipation:

  • They've not done a poo at least 3 times in the last week
  • Their poo is large and hard
  • Their poo looks like "rabbit droppings" or little pellets
  • They're straining or in pain when they poo
  • They've some bleeding during or after having a poo, because their poo is large and hard
  • They've a poor appetite or stomach pain that improves after they poo
  • They're avoiding emptying their bowels
  • They cry when pooing
  • They poo in their pants
  • There’s a bad smell when passing wind
  • Your child is unhappy, angry or irritable
  • Unexpected day time or night-time wetting
  • Urinary tract infection

If your child is over 1 years old, soiled pants can be another sign of constipation, as runny poo (diarrhoea) may leak out around the hard, constipated poo. This is called overflow soiling.
 

  • Feeling worried or anxious about something – such as moving to a new house, the arrival of a new baby, or starting nursery or school
  • Not eating enough high-fibre foods like fruit and vegetables
  • Not drinking enough fluids can be a common cause, it's recommended that children have a minimum of 6-8 cups of water a day
  • Feeling pressured or being regularly interrupted while pooing, the bathroom is a good place to start those regular toilet habits and show them where the poo goes
  • Feeling rushed, instead provide a relaxing calm place for your child to use the potty. Blowing bubbles or singing songs whilst on the toilet or potty can help to relax your child
  • Sitting in the wrong position on the toilet; a step or box to prop their feet up helps your child’s body when releasing a bowel movement

If your child is constipated, they may find it painful to poo, which may mean they don't want to try to poo. This can create a vicious circle. The more they hold back, the more constipated they get. 
 

Don't leave a child that's constipated, the longer it is left the worse it can become, leading to the child developing a fear of going to the toilet or pooing.

Contact your health visitor for advice, they may feel that your child needs to see the GP or refer to the children’s continence team. 

Treatment for constipation

The treatment for constipation varies on your child’s age and the decision will need to be made by a GP. 
It may take several months for the treatments to work, but keep trying until they do. 

The laxative treatment that the GP may prescribe may make your child's overflow soiling worse before it gets better. Please be mindful that ‘overflow’ is not felt by a child; try and remain calm and reassuring when your child has an accident, they're not doing it purposefully and will feel unsure about what's happening to their body.  Remain neutral, get them nice and clean and comfy, staying calm will help them feel relaxed.

Tips to help your child with constipation

  • Talk to your toddler, ask them what they're worried about and reassure them that you understand that they have tummy ache and feel uncomfortable and that you're going to help it get better.
  • Try using baby massage techniques to settle discomfort and to assist bowel movements.
  • Once your child's constipation has been dealt with, it's important to stop it coming back. A GP may advise that your child keeps taking laxatives for a while to make sure their poo stays soft enough to push out it regularly.
     

  • Physical activity is great to get their bowels moving
  • Drinking lots of fluids and eating a good variety of fruit, vegetables and fibre
  • Get your child into a routine of regularly sitting on the potty or toilet, after meals or before bed, and praise them whether or not they poo. This is particularly important for potty-trained boys, who may forget about pooing once they're weeing standing up
  • Make sure your child can rest their feet flat on the floor or a step when they're using the potty or toilet, to get them in a good position for pooing. ERIC The Children's Bowel & Bladder Charity's leaflet, Children's Bowel Problems shows this position.
     

Useful resources can be downloaded to help a toddler understand their bowel movements and make them less daunting. 

'Poo Go Home' written by Tamsin Black and 'Sneaky Poo' written by Ian Williams and Yvonne Wright.

Please see this friendly video from the children's continence team advising you about their service.