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Constipation is when a child has a hard poo (faeces or bowel movement) or does not go to the toilet regularly. There is a lot of difference in the firmness and frequency of normal bowel movements in children.
Constipation is a common problem in children, particularly around the time of toilet training or starting solids. It can also become a problem after a child has had a painful or frightening bowel movement.
Constipation can cause:
If your child is constipated, they might look more bloated than usual, and you may even be able to feel hard lumps of poo if you press gently on their stomach.
Long-term constipation can cause your child to soil themselves (do a poo in their pants). This happens if your child's rectum (bottom) is full of poo for a long time and it becomes stretched. Your child may not get the urge to go to the toilet because the rectum always feels stretched. The poo can then pass into your child's pants, without them feeling it. Medically, soiling is called ‘encopresis’ or ‘faecal incontinence’.
In most cases of constipation in children, no serious cause is found. Some possible reasons include:
You only need to worry about the firmness or frequency of your child's poo if it seems to be causing a problem. In most cases, you can treat your child at home to help their constipation.
If your toilet-trained child is constipated, it is important for them to develop the habit of sitting on the toilet regularly.
Diet is less important in the treatment of constipation for children than it is for adults, but increasing fibre intake might help some children who have a natural tendency to be constipated. To add more fibre to your child's diet, you can try the following:
If your child is over the age of 18 months, reduce cow's milk intake to a maximum of 500 ml per day and avoid sweet drinks before meals. This will help to improve your child's appetite at meal times. Drinking plenty of water will help soften your child’s poo.
For babies on solids, increased fruit and vegetables in their diet might help. You can give your baby up to three tablespoons of strained, stewed prunes or apricots, three times a week, or give them prune juice diluted with water.
Babies with constipation who drink formula might need their formula changed.
If your baby is under 12 months old and you think they are constipated, you should consult your GP or Maternal and Child Health Nurse.
For older children, if simple diet changes aren’t helping, your child is in significant pain or if they are bleeding from their bottom, you should take them to the GP.
Your GP may recommend a laxative treatment. Children who have been constipated for many months are likely to need laxative medications for several months, in addition to being encouraged to have healthy bowel habits.
Laxatives are available over the counter at pharmacies, but it is not recommended children take laxatives without medical advice.
When should I be worried about the colour of my child’s poo?
Generally, it is OK if children have poo that is coloured anywhere from yellowy-brown through to dark green. If your child’s poo is white, red or black, take them to see their doctor.
My baby strains to poo, does that mean they are constipated?
It is common for children under six months of age to strain before passing a soft bowel action. This is not constipation, but rather reflects a slowly developing skill/ability to co-ordinate a bowel action.
Developed by The Royal Children's Hospital General Medicine and Emergency departments. We acknowledge the input of RCH consumers and carers.
Reviewed February 2018.
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