Constipation in babies and children

Constipation is when a child has a hard poo (faeces or bowel movement) and/or does not go to the toilet regularly. 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 affects 1/3 of children and frequently occurs during the introduction of solid foods, toilet training and school.

There can be a huge range in the firmness and frequency of normal bowel movements in children.

Most children poo at least every 2–3 days however some breastfed babies may poo as infrequently as once per week.

Healthy infants (<6 months) can strain and cry before passing soft stools. Unless the stools are also hard, this is not constipation and will self-resolve.

Young children may ignore the urge to poo, causing a build-up of large hard bowel actions. This can lead to ‘poo holding’ often caused by fear after a painful poo or fear of doing a poo or the toilet. This leads to a cycle of withholding, constipation, and accidents.

So, what can you do?

Help your child with some behaviour changes to prevent poo holding.

Position – make sure when they go to the toilet that they have a stool so their knees are above their hips.  This makes pooing easier.  Make sure your child has the correct equipment for using an adult-sized toilet. This may include an inset for the toilet seat.

Toilet sits – get them to sit on the toilet for 2-3 minutes about 20 minutes after eating breakfast and dinner.

Try and keep this a positive experience and reward them for sitting not whether a poo is done or not.

Reinforce the good behaviours with encouragement and age-appropriate sticker or reward charts, or other creative options.

Why not use this training diary to keep track.

Have trouble getting them to stay?

The Wiggles have a toilet song which might help some or use a phone or iPad to keep them on there.

Sometimes these changes aren’t enough, and your child will continue to have constipation and pain.

See your GP for advice on what treatment to use for your child to help prevent further fear and negative associations from forming.