Making sure your child has plenty of water to drink, and enough fibre in their diet, can help prevent constipation.
Sitting on the toilet regularly is important.
There is a wide range of normal pooing for breastfed babies. They may poo as often as after every feed or as infrequently as once in 10 days. Breastfed babies' poo is mustard yellow, soft and can look like it has seeds in it.
Most bottlefed babies and older children will have a poo every day or every second day. Some have more than one poo a day. The poo should be like a soft sausage - like types 3 and 4 in the diagram below.
If your child of any age has firm, hard or painful poo, they are likely to be constipated. If children are not breastfeeding and are pooing less than every 3 days, they are likely to be constipated.
Your child may be constipated if they have some of the following:
Constipation in children is common.
There are many possible reasons for your child's constipation. Often, it is several things:
Toileting habits are important. Your child can become constipated if they:
Take a look at this video by the Pediatric Gastroenterology Clinic, Primary Children's Hospital, US, for more information.
Constipation often starts after 1 hard poo has caused pain. The natural response to a painful experience is to try and avoid or escape it in the future. So, the next time your child feels the urge to poo, they 'hold on' in an attempt to avoid passing another painful poo. This results in the poo becoming firmer, larger and even more painful to poo out and your child becomes even more reluctant to poo in the future.
This leads to a vicious cycle:
The key to stopping this cycle is making the poo soft again.
Find out what you can do about your child's constipation [1]
If constipation continues for a long time and all the poo doesn't come out, the bowel can become overloaded and stretched. The overloaded and stretched bowel means the feeling of needing to do a poo is lost and can cause soiling accidents.
Constipation is hardly ever due to an abnormal bowel. Most bowel problems show up in early life and are diagnosed within the first few months. Occasionally, constipation in children can be due to coeliac disease.
If your child passed meconium (the green/black poo newborn babies pass) within 24 hours of birth, it is unlikely your child has a bowel problem causing constipation.
Your doctor may suggest your child sees a specialist nurse or doctor if:
ESPGHAN and NASPGHAN. 2014. Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN [3].
Royal Children's Hospital, Melbourne. Clinical Practice Guideline: Constipation [4].
National Institute for Health and Clinical Excellence, U.K. May 2010. (Updated 2017). Constipation in children and young people [5].
Bristol stool chart image reproduced and adapted from Wikimedia Commons
License https://creativecommons.org/licenses/by-sa/3.0/ [6]
Cabot Health, Bristol Stool Chart
CC BY-SA 3.0
File:BristolStoolChart.png
Created: 1 January 2014
https://commons.wikimedia.org/wiki/Category:Bristol_Stool_Chart#/media/File:BristolStoolChart.png [7]
Illustration of child showing constipation and worse constipation - by Dr Greta File. Property of KidsHealth.
This page last reviewed 07 March 2022.
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Links
[1] https://kidshealth.org.nz/constipation-treatment
[2] https://kidshealth.org.nz/soiling
[3] https://www.naspghan.org/files/documents/pdfs/position-papers/Constipation_Feb_2014.pdf
[4] https://www.rch.org.au/clinicalguide/guideline_index/Constipation/
[5] https://www.nice.org.uk/guidance/CG99
[6] https://creativecommons.org/licenses/by-sa/3.0/
[7] https://commons.wikimedia.org/wiki/Category:Bristol_Stool_Chart#/media/File:BristolStoolChart.png
[8] https://kidshealth.org.nz/node/1860?language=mi
[9] https://kidshealth.org.nz/node/1691?language=mi
[10] https://kidshealth.org.nz/node/1861?language=mi
[11] https://kidshealth.org.nz/node/1921?language=mi
[12] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F190%3Flanguage%3Dmi