What is constipation?

Your child is constipated if they are doing hard poos or have trouble pushing poo out. If your child is constipated, they probably aren't pooing regularly either.

Many healthy children have problems with constipation from time to time. It's fairly common in babies, and can also happen around the time of toilet training.

Constipation usually gets better when your child gets older, and is usually stable by 4 years of age.

What is normal for children?

Constipation in kids is common and usually doesn't have a serious cause.

Normal bowel habits for children vary. Most children have a bowel movement (poo) at least once every 2 or 3 days. Some may go up to 3 times a day.

Some breastfed babies may only poo once a week, while others may have a poo after each feed.

What are the symptoms of constipation in children?

Signs that your child could be constipated include:

• looking uncomfortable or in pain when doing a poo
• becoming irritable or upset, or refusing to sit on the toilet
• getting tummy pain that comes and goes
• not having a good appetite
• rocking or fidgeting, crossing their legs and looking like they are trying not to poo
• pooing in their pants

Some children who are constipated may have an anal fissure. This is a small split in the anus (bottom) that causes pain and bleeding. This occurs because they have been straining (pushing hard) to pass poo.

In babies, constipation can cause dry and crumbly poos. It can also cause pain while pooing.

What causes constipation in children?

Constipation in babies can happen if they aren't having enough breastmilk or if their formula isn't made up properly. It can also develop when solid foods are started.

Children can become constipated if they:

• don't eat enough fibre
• drink too much milk and don't eat enough solid foods
• have an illness that makes them eat and drink less
• take certain medicines, such as some cough medicines

They may also hold back bowel movements (poo), instead of going when they need to go. This can happen if it's been painful for them to poo before.

Constipation often affects toddlers during toilet training. Older children sometimes become constipated when starting school.

Only a few children get constipated because of a medical condition.

How is the cause of constipation diagnosed in children?

Your doctor will ask about your child's symptoms. This includes asking:

• when the difficult pooing started
• what the poo looks like
• if pooing is painful
• if there are changes in diet (e.g. starting solid food, or there is not enough high fibre food)

Your doctor may feel your child's abdomen (tummy) and look at their bottom.

Tests

Most children won't need any tests for constipation.

If the constipation is severe and ongoing, your child's doctor may recommend tests.

When should my child see a doctor?

Your child should see your doctor if they:

• haven't done a poo in a week
• poo when they didn't mean to
• have a very sore anus (bottom)
• aren't eating or drinking enough

See your doctor or child health nurse if your child is under 12 months old and you think they are constipated.

When to seek urgent care

Your child should see a doctor urgently if they have constipation and any of these symptoms:

• fever
• vomiting
• blood in their poo
• pain

How is constipation treated?

It's important to act if your child is constipated since it can make them very uncomfortable.

Self-care at home

For toddlers and older children, try adding high fibre foods to your child's diet.

You could give them a natural laxative such as prune juice. To make it taste better, try mixing it with another juice, or freeze it to make icy poles.

You can help your child by teaching healthy bowel habits, such as not holding on. Get them to sit on the toilet after meals and make sure they are comfortable on the toilet. They may need a foot stool or a toilet ring to ensure they are in the right position.

Praise your child when they sit on the toilet, even if they don't do a poo.

Talk with your child if they are worried about going to the toilet. For older children, make sure they have easy access to toilets at pre-school or school.

Changing formula may be an option for formula-fed babies with constipation.

Medicines for constipation

Laxatives are medicines that can be used to help treat constipation. Talk to your doctor about laxatives, as they are not recommended for children without medical advice.

Can constipation be prevented?

A healthy diet with plenty of fibre can help with constipation.

Complications of constipation

Long-term constipation can cause problems such as faecal incontinence (soiling).

Resources and support

The Royal Children's Hospital Melbourne has a fact sheet on constipation in children. Royal Children's Hospital Melbourne also has factsheets in languages other than English.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.