Constipation
Constipation is common in childhood, particularly when children are being potty trained at around two to three years old.
These can be tricky to spot. Your child may be constipated if:
- They don't poo at least three times a week
- Their poo is often large, hard and difficult to push out
- Their poo looks like 'rabbit droppings' or little pellets
If your child is potty trained, soiled pants can be another sign of constipation, because runny poo (diarrhoea) may leak out around the hard, constipated poo. This is called overflow soiling.
If your child is constipated, they may find it painful to poo. This can create a cycle: the more it hurts, the more they hold on to poo. The more constipated they get, the more it hurts, and so on. Even if pooing isn't painful, once your child is really constipated, they may try to avoid going to the toilet altogether.
Why do children get constipated?
Your child may be constipated because they:
- aren't eating enough high-fibre foods like fruit and veg
- aren't drinking enough
- are having problems with potty (or toilet) training
- are worried or anxious about something, such as moving house, starting nursery or the arrival of a new baby
Find out about other causes of constipation in children.
Often there is no cause found for constipation in children and this is known as Idiopathic Constipation.
When should I worry?
If your child is experiencing significant pain or regularly soiling their pants, despite being on treatment, you should take them back to see your GP. Some children need more aggressive treatment of their constipation and your GP may decide that a paediatrician needs to be involved in their care. If your baby/child develops a new-onset severe tummy ache, please click here for advice about what to do.
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
What if your child's constipation continues despite changing their diet?
If your child remains constipated despite the treatments listed below, take them to their GP who can decide if they need medicines. The treatment for constipation depends on your child’s age. The longer your child is constipated, the longer it can take to get back to normal, so make sure you get help early.
Laxatives are often recommended for children, alongside diet and lifestyle changes.
It may take several months for the treatments to work, but keep trying until they do. Remember that laxative treatment may make your child's overflow soiling worse for a time before it gets better so consider the impact e.g. on school/planned trips.
Once your child's constipation has improved, it's important to stop it coming back. Your GP may advise that your child keeps taking laxatives for a while to make sure their poo stays soft enough to push out regularly: the medicines are safe and don’t cause a lazy bowel.
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
Firstly, try to stay calm. Getting constipated and soiling their clothes isn't something your child is doing on purpose, so there's no reason to get cross with them. You may both find the situation stressful, but staying positive and relaxed is the best attitude to help your child, and praising positive steps is important
Think about making changes to your child’s diet. Give your baby extra water between their normal feeds if they haven't started to eat solid food yet. If you're using formula milk, don't add more water to the mixture. For older children, make sure that they drink plenty of fluids and encourage them to eat fruit. Chop or purée it if it's easier for them to eat. The best fruits for constipation include apples, grapes, pears and strawberries.
If your child is potty training, they may be feeling anxious or stressed about using the toilet. This can cause them to hold in their poo and lead to constipation. Give your child plenty of time to use the toilet while they are still learning. Encourage them when they do use the toilet. Some parents find a reward chart works. If you think your child is having difficulty with toilet-training, you can also chat to your health visitor.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
How to prevent your child getting constipated?
- Make sure your child has plenty to drink – offer breastfed babies who aren’t eating solids yet plenty of breastfeeds. Formula-fed babies can have extra drinks of water between their formula feeds. See more advice on drinks for babies and toddlers.
- Give your child a variety of foods, including plenty of fruit and vegetables, which are a good source of fibre. See what to feed young children.
- Encourage your child to be physically active. For more information, read the physical activity guidelines for children aged under five years.
- Get your child into a routine of regularly sitting on the potty or toilet, after meals or before bed (for 5 minutes), and praise them whether or not they poo. This is particularly important for potty-trained boys, who may forget about pooing once they are weeing standing up. Reward schemes appropriate for age are important; as is consistency and patience.
- Make sure your child can rest their feet flat on the floor or a step when they're using the potty or toilet, to get them in a good position for pooing. Take a look at the Children's Bowel & Bladder Charity's leaflet, Children’s Bowel Problems for a picture of this.
- Ask if they feel worried about using the potty or toilet – some children don't want to poo in certain situations, such as at nursery or school.
- Stay positive and reassuring, so that your child doesn't see going to the toilet as a stressful situation – you want your child to see pooing as a normal part of life, not something to be ashamed of.
For more information and support:
- NHS Choices info on constipation in children
- Contact the ERIC helpline on 0845 370 8008, Monday to Thursday 10am to 2pm, or email a question to helpline@eric.org.uk
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
