Constipation in children

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

Symptoms of constipation in children

Your child may be constipated if:

• they have done less than 3 poos in the last week
• their poo is large and hard
• their poo looks like "rabbit droppings" or little pellets
• they are straining or in pain when they poo
• they have some bleeding during or after having a poo, because their poo is large and hard
• they have a poor appetite or stomach pain that improves after they poo

If your child is over 1 year 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.

Causes of constipation in children

Constipation in children has many possible causes. Sometimes there's no obvious reason.

Some of the possible causes include:

• not eating enough high-fibre foods like fruit and veg
• not drinking enough fluids
• feeling pressured or being regularly interrupted while potty (or toilet) training
• feeling worried or anxious about something – such as moving house, the arrival of a new baby, or starting nursery or school

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

How to treat your child's constipation

If you think your child may be constipated, take them to a GP. The treatment for constipation depends on your child's age.

The longer your child is constipated, the more difficult it can be for them to get back to normal, so make sure you get help early.

Laxatives are often recommended for children who are eating solid foods, alongside diet and lifestyle changes.

It may take several months for the treatments to work, but keep trying until they do. Remember that laxative treatment may make your child's overflow soiling worse before it gets better.

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 regularly.

Treating constipation with soiling (children pooing their pants)

Getting constipated and soiling their clothes is not something your child is doing on purpose, so there's no reason to get cross with them.

You may both find the situation stressful, but staying calm and relaxed is the best attitude to help your child deal with the problem.

A health visitor or GP can offer helpful tips.

Read about soiling (children pooing their pants).

How to prevent constipation

• Make sure your child has plenty to drink – offer breastfed babies who are not eating solids yet plenty of breastfeeds. Formula-fed babies can have extra drinks of water between their formula feeds. This must be cooled boiled water for babies under 6 months. See more advice on drinks for babies and young children.
• Give your child a variety of foods, including plenty of fruit and vegetables, which are a good source of fibre. See what to feed young children.
• Encourage your child to be physically active. For more information, read the physical activity guidelines for children aged under 5 years.
• 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 are 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.
• Ask if they feel worried about using the potty or toilet – some children do not want to poo in certain situations, such as at nursery or school.
• Stay calm and reassuring, so that your child does not see going to the toilet as a stressful situation – you want your child to see pooing as a normal part of life, not something to be ashamed of.

If you'd like advice about taking the stress out of going to the toilet for your child, speak to a health visitor.

Find out more advice for children with constipation on ERIC, The Children's Bowel and Bladder Charity website

More information and support

• ERIC, The Children's Bowel & Bladder Charity, is a UK charity for families affected by bedwetting, daytime wetting, constipation and soiling. ERIC has a freephone helpline on 0808 801 0343 (Monday to Thursday, 10am to 2pm), or you can email the service via a webform at www.eric.org.uk/helpline.
• Bladder and Bowel UK: child information library has a range of booklets and leaflets covering bladder and bowel problems in children.