If your little one is suffering pain or discomfort when doing a poo, complaining of a sore or swollen tummy and having bowel movements less than three times a week, it’s very likely that they are constipated.  Constipation is quite common in babies and young children and is often noticed when babies change from breastmilk to formula milk or when they begin weaning onto solid foods.

How will I know if my child is constipated?

The first step in identifying constipation is to look out for the signs:

  • suffering pain or discomfort when passing a stool (poo)
  • complaining of a sore tummy or having a swollen stomach
  • Going to the toilet   less than three times per week and passing either a very large stool or several small hard stools like pellets
  • straining to pass a stool which might in fact be holding on to stools to prevent the pain when they are passed
  • avoiding passing a stool by activities such as dancing about or hiding
  • soiling – this looks like diarrhoea but it happens when the bowel is full with a large hard stool and very loose stools leak around it and into pants, pyjamas and bedclothes.
  • foul smelling wind and stools
  • excessive farting
  • poor appetite
  • lack of energy
  • an unhappy, angry or irritable moods
  • generally feeling unwell

If your child is showing these symptoms, it’s a good idea to visit your GP as soon as possible as if not treated, behavioural problems can arise making it more difficult to overcome.

What are normal bowel habits?

  • Babies pass a stool an average a few times a day in the first week of life to two per day at the age of one
  • Breast fed babies tend to pass softer and more frequent poo compared to formula-fed babies
  • By the age of four, the average frequency has reached the same as adults(range of three stools per day to three per week)

What causes constipation?

The exact cause of constipation is not fully understood but certain factors can make it worse, such as:

  • Fever and dehydration
  • Not drinking enough or not having enough fibre in their food
  • Potty training difficulties
  • Problems with nursery/school toilets
  • Changes in lifestyle and/or routines
  • Lack of exercise
  • Being forced to sit on the potty/ toilet for a long period of time
  • Family history of constipation

Constipation is more common in Down’s syndrome children, autistic children and children with physical disabilities such as cerebral palsy.

Toilet training

Toilet training is an important milestone in your child’s development.  The right environment with the right motivation and positive encouragement are all very important, including making sure your child sits correctly on the potty or toilet; knees should be higher than hips, spine should be straight, tummy pushed out and elbows placed on knees. The toilet should be comfortable, clean, warm, private and inviting.

Preventing constipation

  • Make sure your toddler is drinking enough fluid – six to eight drinks a day. Always give a drink with each meal and at least one in between meals or with a snack.
  • Your toddler may need more fluid in hot weather or after a lot of physical activity.
  • Water is the best choice of drink.  Fruit juices aren’t recommended for toddlers but if you use them make sure they are well diluted.
  • Eat together as a family as often as possible and encourage your toddler to eat fruit at breakfast and vegetables and fruit at the other main meals. Give wholegrain breakfast cereals and wholemeal bread.
  • Encourage your toddler to be physically active, to play outside, and walk rather than always travelling in a push chair or car seat.
  • A consistent routine will help your toddler develop regular toilet habits. For example, sitting on the potty or toilet for a few minutes after meals. Hand washing afterwards can be fun!
  • Listen and watch for signs that your toddler is ready to begin potty/toilet training. Take your time, don’t rush it. Give praise and positive encouragement. Minimise fuss over ‘accidents’. Make sure your toddler can sit on the toilet, supported (using a child seat or foot stool for example) so that he or she feels safe.
  • If these measures do not work your healthcare professional may suggest seeking further medical advice.