Constipation: Advice for children

What is constipation?

Constipation is having difficulty doing a poo regularly or being unable to completely empty the bowel. It is the most common tummy problem in children, especially among toddlers. A child is constipated if they poo less than three times per week. These poos can often be hard and painful to pass which can lead to children avoiding the toilet and withholding their poo, which can make the problem worse.

What causes constipation?

There may be no physical or medical reason to explain your child’s constipation. Sometimes it can be affected by:

• Lack of a toilet routine
• Resistance to potty training
• Withholding poo
• Change in routine or emotional upset
• Medicines
• Poor fluid intake
• Limited diet
• Lack of suitable mix of foods in the diet.

Managing Constipation

Childhood constipation can be distressing for both children and parents. Current evidence states that diet alone is not usually the cause of constipation in children. It is recommended that changes in diet should be made alongside medicines such as laxative treatment, as well as behavioural techniques.

Medicine to Help your Bowels Move

Laxatives are a type of medicine used to treat ongoing difficulties with constipation in children. They work by softening your child’s poo, making it easier for them to pass, and encourage your child to push their poo out. It is common for children who are constipated to need a laxative to first fully empty their bowel. They may then need a laxative for a period of time to keep them pooing regularly.

Speak to your child’s GP or doctor if you think they may be suffering from constipation. The earlier constipation is recognised the easier it will be to treat.

Toilet Routine

Children who suffer with constipation often find it hard to know when they need to do a poo. When their poo builds up in their bowel, it can cause the bowel and bottom hole to become stretched and they no longer feel the urge to do a poo.

Making sure your child has a really good toilet routine can help prevent and treat constipation.

Here are some tips to help get your child into a good toilet routine:

• Toilet time: Set out time for your child to sit on the toilet a number of times each day. Ideally this should be at the same time every day and 20 minutes after a meal. This is because meals can wake up our bowels making it a perfect time to go to the loo!
• Position makes perfect: lifting up your feet using a flat stool or box when on the toilet actually puts your child’s body in the perfect position to poo without straining. Encourage your child to lean forward with their elbows on their knees and push out their tummy.
• Potty humour: Letting your child read a book, play a game or with a toy while on the toilet will actually help the muscles in their bowel to relax, making it easier to push out a poo. Bonus points for laughing or coughing as this helps bowel muscles to push down!
• Hip-Hip-Phooray: Make going to the toilet a positive experience for your child by praising them, not just when they do a poo but when they spend time on the toilet. This will help make them to want to go to the toilet. Using a poo diary/star chart will also help you to see changes to their poo pattern.

Drink Plenty

When our body is finished breaking down our food into energy, the remaining liquid is moved along our bowel. This is when water is drawn in to help make a poo. When your child’s poo sits there too long this means more water will be drawn in making it hard and painful to pass. This is why plenty of drinks are needed, especially when your child is constipated.

You should encourage your child to have 6-8 glasses of fluid every day. Such as:

• Water
• Milk
• Sugar-free diluting juice
• Unsweetened fruit juice (limit to one glass)

Eating a Balanced Diet

The foods we eat can also help your child to poo regularly. Making sure your child eats a balanced diet with plenty of fibre can help with constipation. There are two different types of fibre and they affect our poos differently.

Soluble fibre is found in fruit, vegetables, beans and oats. This type of fibre mixes with water in our bowel to form a gel. Including more foods containing soluble fibre, will help to soften your child’s poo and make it easier to pass.

Insoluble fibre is found in wholegrain cereals and wholemeal products. This type of fibre doesn’t mix with water and instead makes our poos bigger, helping to remove all the waste from our body. To keep this type of fibre moving through our body it is important we drink enough fluids.

Here are some tips to help your child eat more fibre:

• Porridge or wholegrain cereals such as wheat biscuits are a quick way to increase fibre at breakfast.
• Letting your child pick a different fruit in the weekly shop may make them excited to try it!
• Cut up veggies like carrots, peppers or cucumber to have with salsa or hummus.
• Keep skins on homemade chips or roasted veggies.
• Pick a vegetable or lentil soup for your child to try.
• Have baked beans on toast or try beans in a casserole or  and cottage pie or blend them into sauces or have in homemade soup.
• Try best of both or a wholemeal bread.
• Choose flapjacks or cereal bars with oats, dried fruit or nuts as   a snack.
• The browner the better – choose wholemeal pasta, rice and bread where you can, especially for children older than 5 years of age.

Keep Moving

Making sure your child gets regular exercise can help make their poos stay regular too. This is because when we exercise our body sends more blood to our digestive system which encourages our poo to move along too!

Useful info

ERIC, The Children’s Bowel and Bladder Charity, has brilliant resources for parents to help manage constipation in young children.

Free-phone:  0808 169 9949

Website:  www.eric.org.uk

If you need this information in another language or format, please e-mail:

Translation.Services@lanarkshire.scot.nhs.uk