Constipation

Constipation is when a child has a hard poo, has difficulty passing poos or goes to the toilet less often than usual. Constipation is very common and affects up to 1 in 10 children. In most cases, there is nothing wrong with your child’s body and the condition can easily be treated at home.

What causes it?

Your child can develop constipation when there has been a change to their daily life. For example, starting day care, kindergarten or school, toilet training or the arrival of a new sibling.

Constipation can start quickly or happen over time.

Signs and symptoms

What is normal?

• Children 3 years and older usually do one poo every day.
• Children under 3 years usually can do many poos a day or may not.
• Breastfeeding babies and infants may not do one poo every day, but if the poo is soft, your child is not constipated.

Your child may be constipated if they:

• have large, hard or painful poo
• are not doing a poo as often
• avoid going to the toilet or be afraid of going to toilet, usually because of pain
• have small amounts of liquid poo in their underwear (known as overflow incontinence).

Treatment

Constipation can be treated at home with medicine (laxatives) and a toileting program. It should be treated early to avoid other health problems.

Laxatives

Laxatives allow poo to pass easily through the bowel. Your GP will tell you the recommended dose and your child should keep taking the laxatives for as long as they have constipation issues.

• Laxatives containing Macrogol 3350 (called Osmolax and Movicol) are the best choice for your child. You can mix these powders into drinks. Osmolax does not have any flavour.
• Laxatives containing lactulose (sweet liquid such as Duphalac) may also be used.
• Other medicines are not as effective.

Behaviour program for preschool children

Start a routine with your child where they sit on the toilet for a few minutes and try to do a poo. Do this for 15 minutes after breakfast, lunch (or afternoon tea if your child goes to school) and dinner. This is called sitting practice.

The correct sitting position is important. Smaller children may need a toilet seat insert and a foot stool under their feet. Encourage your child to tighten their tummy muscles while sitting on the toilet.

Encourage or reward your child for sitting practice even if they can’t do a poo. You can also use a sticker chart to keep track of their progress. Do not get angry at your child for pooing their pants.

Things to remember

• You should not toilet train your child while they have constipation, the pain from this will make toilet-training harder.
• Make sure your child eats foods that are high in fibre and lots of fruit (e.g. prune or pear juice), and drinks plenty of fluids.

When to see a doctor

See your GP if your child has any common symptoms, including:

• blood in their poo
• bad stomach pains
• poos that are hard and less regular
• symptoms that are getting worse after treatment.

Your GP will diagnose constipation by checking your child and talking to you. Most of the time, constipation does not need any additional tests but if the doctor thinks there is a problem, they will refer your child to a specialist.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by the Emergency Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS152. Reviewed: July 2022.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.