Is my toddler constipated?

Constipation (difficulty with pooing) is common at all ages, and can be treated at home by putting some simple changes in place.

What does constipation look like in a child?

• Pooing less than 3 times a week
• Your child may avoid going to the toilet
• When they go to the toilet their poos may be large and harder for them to push out
• Poo which is hard and/or lumpy
• Your child may be tired and lack energy
• Your child may soil his/her clothes. This happens when there is a large amount of hard poo trapped at the end of their bowel. Fresh poo leaks out around it.

If your toilet trained child is soiling regularly, see your GP for an assessment.

Causes of constipation

Constipation in toddlers can have many different causes. Sometimes there’s no obvious reason. Some causes include:

• Not drinking enough water
• Not eating enough fruit and vegetables
• Change in routine (such as starting nursery or potty training)
• Resistance to potty training
• Fear of the toilet

What you can do to help

The most important way to keep the bowels healthy is to drink enough fluid; 6-8 cups of water or well diluted fruit juice or sugar-free squash a day is recommended. Avoid drinks containing caffeine (tea, coffee and cola) and other sugary, fizzy drinks.

Eating a balanced diet, including fruit, vegetables and cereals, can help keep the bowel healthy. These foods keep fluid in the poo so it’s easier to pass.

Keeping active will also help get the bowel moving. Running around at the park, playing in the garden or around the house are all great ways to get things moving!

Having a good toilet routine is really helpful. Get your child to sit on the toilet or potty around 20-30 minutes after eating. Make it relaxed and fun, and remember to give praise for sitting on the toilet or potty, whether they poo or not.

A good sitting position on the toilet is important too. Make sure your child’s feet are supported on a box or stool so their knees are above their hips. If the toilet seat is too large, smaller seats are available that might help them to feel more secure.

To push out a poo, we need to be relaxed, so play with your child to help them relax. Laughing and blowing bubbles help them use the muscles that push the poo out.

Finally, ask your child if they feel worried about using the toilet; it might be that they don’t like the toilets they use regularly, for example at nursery, or that something has changed which is upsetting them.

It’s important to remember that your child isn’t constipated or soiling on purpose. Try and stay calm and relaxed, giving them the reassurance they need.

Your health visiting team will be able to give you advice and guidance on further techniques to help.

Useful links

• ERIC- Poo and Wee
• NHS- Constipation in young children
• NHS – Poo goes to pooland (colouring book)