Constipation

Your child may be constipated if:

• they have not done a poo at least 3 times in the last week
• their poo is large and hard
• their poo looks like "rabbit droppings" or little pellets
• they are straining or in pain when they poo
• they have some bleeding during or after having a poo, because their poo is large and hard
• they have a poor appetite or stomach pain that improves after they poo

If your child is over 1 year old, soiled pants can be another sign of constipation, as runny poo (diarrhoea) may leak out around the hard, constipated poo. This is called overflow soiling.

As well as less frequent, hard stools can cause tummy pains, poor appetite, feeling off colour, behavioural changes such as being more irritable or unhappy, and feeling sick etc.

Your child may be constipated because they are:

• not eating enough high-fibre foods like fruit and veg
• not drinking enough fluids
• feeling pressured or being regularly interrupted while potty (or toilet) training
• feeling worried or anxious about something – such as moving house, the arrival of a new baby, or starting nursery or school

If your child is constipated they may find it painful to poo, which may mean they do not want to try to poo. This can create a vicious circle; the more they hold back, the more constipated they get.

• Make sure your child has plenty to drink - encourage your child to drink 6-8 glasses of water squash or sugar free juices. Drinking more water based drinks increase the water content of the poos and make them softer and easier to pass 
• Give your child a variety of foods -  including plenty of fruit and vegetables, which are a good source of fibre.  
• Encourage your child to be physically active 
• Get your child into a routine of regularly sitting on the potty or toilet - after meals or before bed, 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 
• 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 
• Ask if they feel worried about using the potty or toilet – some children do not want to poo in certain situations, such as at nursery or school 
• Stay calm and reassuring - so that your child does not 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 

If you'd like advice about taking the stress out of going to the toilet for your child, speak to a health visitor.

If you think your child may be constipated, and you have tried the above strategies, take your child to your GP or other health professionals for further advice. The treatment for constipation depends on your child's age. 

The longer your child is constipated, the more difficult it can be for them to get back to normal, so make sure you get help early. 

Your childs doctor or nurse may prescribe medicines called laxatives to clear out any poo which has built up inside your bowel and also help your child’s bowel to work normally.  Most commonly prescribed laxatives are macrogols (like Movicol, Cosmocol, Laxido etc) which pull the fluid into the bowels keeping the stool soft.  With the macrogols, the medication is prepared by mixing it with water or juice, click the link for information on how to prepare macrogol

Sometimes, children may need other types of laxatives which encourage the bowels to pass the stools out (stimulant laxatives) in addition to above treatment.  

Dosages for your medications will be provided by your healthcare professionals

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 before it gets better. 

Once your child's constipation has been dealt with, 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.