Constipation

Constipation is common in childhood, particularly when children are being potty trained at around 2 to 3 years old.

 

What are the symptoms of constipation in children?

These can be tricky to spot. Your child may be constipated if:

  • They don't poo at least 3 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. This is 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

For further information and support see ERIC's guide to children's bowel problems

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 5 years.
  • Get your child into a routine of regularly sitting on the potty or toilet after meals or before bed (for 5 minutes). Praise them whether or not they poo. This is particularly important for 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 on 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 for a picture of how to sit to get the poo in the loo!
  • 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.
What to do if you think your child has constipation

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. Staying positive and relaxed is the best attitude to help your child and praising positive steps is important.

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.

If your child remains constipated despite the measures listed above, speak 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. 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. 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.

If you think it’s serious
  • 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 or specialist nurse needs to be involved in their care.
  • If your baby/child develops a new-onset severe tummy ache, visit our Healthier Together page for advice about what to do.
More information and support:

nhs.uk information on constipation in children.

Contact the ERIC helpline on 0808 1699 949 (free to call from mobile and landline), Monday to Thursday 10am to 2pm.

ERIC's guide to children's bowel problems leaflet.

​​​​​Contact your local community pharmacist. All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice about a range of healthy living matters which includes eating a healthy diet. They can also provide information leaflets and give parents/carers, and young people more information about other organisations that might be able to also help with healthy eating.

Visit our Healthier Together page on Healthy Eating. 

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?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice about a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents/carers and young people more information about other organisations that might be able to also help them with healthy eating.

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

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. 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 the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 01924 310130

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

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 about what Health Visitors do: 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.

Contact your local school nursing team:

Bradford School Nurses01274 221203

Wakefield School Nurses01924 310130

Leeds School Nurses - 0113 843 5683

Calderdale School Nurses030 3330 9974 (local rate number)

Kirklees School Nurses0300 304 5555 (local rate number)

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.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. 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.

Please note, the online version of NHS 111 is only recommended for children over the age of five. If your child is under five years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

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
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance