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Toddler constipation: signs, causes and what to do to bring relief

Toddler constipation: signs, causes and what to do to bring relief

Constipation in toddlers is very common, says family GP Dr Lowri Kew. Here's her expert advice on what to do to help if it happens to your child – and when you need to call a doctor

toddler with constipation sitting on a potty

Published: February 10, 2023 at 3:15 PM

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In a nutshell: Constipation happens when your child doesn't poo regularly and/or has hard, dry poo that can be painful to push out into a nappy, the potty or the toilet. It's very common among 2 to 3 year olds and is often a temporary thing. Sometimes, though, it can last for longer and need medical treatment.

What are the symptoms of constipation in toddlers?

Your toddler may be constipated if:

They haven't done a poo at least 3 times in the past week
Their poos are big and hard or like hard, dry pellets or rabbit droppings
They're in pain or straining when trying to poo
There is blood on their poo or on the toilet paper when they wipe
They have a poor appetite or a stomach pain that disappears once a poo is done
If they're potty trained, liquid poo is leaking into their pants (runny poo may flow out around a stuck hard poo: this is called overflow soiling)
They are avoiding doing a poo – crossing legs, clenching buttocks, going red and sweaty, crying

What are the best remedies for toddler constipation?

If treated early, simple toddler constipation can usually be resolved. Here are 5 simple steps to try:

1. Make sure they're drinking enough

A good fluid intake will help soften your child's poo and make it easier to push out. Offer your toddler plenty of water throughout the day.

2. Big up the fibre

Foods full of fibre are nature's natural laxatives, helping your toddler's digestive system to work properly and making poos softer. Good fibre-rich choices include:

apples
ripe bananas
apricots
kiwi fruit
figs
prunes
pears
oranges
broccoli
sweet potato
beans, peas and lentils
wholemeal bread
baked beans
cereals
porridge

3. Chill out at poo time

You may be worried about your child's constipation but try not to let it show! Stay calm and reassuring when they want to do a poo. Give them lots of praise and encouragement when they do manage one, and don.t make a fuss over any accidents.

If your child is potty-trained and has moved onto using the toilet, get them a step to position under the toilet bowl, so they can sit comfortably with their feet flat on the step. This is a much better position for poo-ing than having your legs dangling in mid air.

If you toddler is holding onto their poo or is otherwise anxious about doing a poo, don't force anything. Suggest giving it a go a couple of times a day and let them sit for at least 10 minutes each time (provide some picture books for entertainment).

Don’t rush your child and aim for times when their bowel is at its most active – first thing in the morning and after meals – as times to do a poo

Dr Lowri Kew, expert family GP

4. Encourage lots of physical activity

Moving your body helps move food through your toddler's gut and can stimulate a need to poo. Aim for 30 to 60 minutes a day of walking, running and jumping around.

toddler lying on bed with parent holding legs and massaging with bicycle movements

5. Try some tummy massage

Lie your toddler on their back and move their legs separately in a cycling motion to put gentle pressure on their intestine and stimulate bowel movement.

What causes constipation in toddlers?

Toddlers can become constipated for a variety of reasons including:

Not drinking enough water: if your child doesn’t drink enough fluids this can cause or worsen constipation
Changes in routine: moving house, potty training, starting nursery or the arrival of a new baby sibling can cause temporary constipation
Diet: not eating enough high-fibre foods, like fruit and vegetables
Not getting enough exercise: children who aren’t very active are more likely to become constipated
Cow's milk protein allergy: if your child shows any signs of cow’s milk allergy, speak to your GP
Medicines: constipation can be a side effect of some medications, so if you suspect this is the cause, talk to your GP – it may be possible to find an alternative medication
Anxiety about doing a poo: once your toddler's become constipated and then tries to do – or does do – a large poo, it may hurt, and the skin in that area may split and bleed a little. Understandably, this can then make your toddler scared to do another poo – and you end up in a vicious circle where your child is trying to avoid doing a poo because they don’t want it to hurt again, but holding onto poo only make the constipation worse.

Other reasons your toddler becomes constipated may include feeling they don't have enough privacy to poo – or just not wanting to stop playing

Dr Lowri Kew, expert family GP

When do I need to worry – and when should I call a doctor?

If treated early with the simple remedies I've suggested, your child's constipation can usually be resolved. But if you think your child is withholding their poo, talk to your GP.

If your toddler isn't withholding but the constipation continues for more than a week, it can lead to what's called chronic constipation – where your child's rectum may become used to being full and your toddler then won't feel the urge to poo. Liquid poo can build up behind the stuck solid poo and may leak into your child's pants or cause diarrhoea. The pressure of a full bowel on their bladder can also lead to your child to wet themselves.

Do seek your GP's advice if you think your child has chronic constipation. Your doctor may prescribe age-appropriate doses of laxatives such as lactulose or macrogol (Movicol), which will soften your toddler’s poo. These can take a little time to work and get your toddler pooing regularly again.

Don’t be tempted to give your child a laxative without first consulting a healthcare professional – and never give your child an adult laxative: they're too strong for young children and could make your toddler unwell.

It's rare that constipation is a symptom of something more serious, but if your baby or child is unwell, not gaining weight, or vomiting along with the constipation, then you should always contact your GP.

About our expert Dr Lowri Kew

Dr Lowri Kew is a GP and the co-author of Your Baby’s First Year: Month-by-Month What to Expect and How to Care for Your Baby. She has a special interest in paediatrics and is also a GP trainer, with a passion for helping GPs stay up to date to ensure good patient care.

Pics: Getty Images