Constipation occurs when your child doesn’t do a poo regularly and the resultant hard poo causes excessive straining and possibly pain. There isn’t a normal frequency with which your toddler should poo – every child is different – however, constipation is very common.
What causes constipation?
Sometimes, your toddler may hold on to her poo. This occurs for various reasons and is commonly a problem when potty training starts because she doesn’t like pooing in the potty. Other reasons may include the lack of a private toilet or just not wanting to stop playing.
Diet affects constipation too. Normal digestion requires fibre to work efficiently (for example, in wholegrain cereals, fruit and vegetables) and fluid – aim for about six cups a day. Exercise encourages bowel activity, while certain medicines and any change in routine, such as a holiday, can upset things and have the opposite effect.
What if it’s a regular problem?
If your child doesn’t poo for several days, a large solid mass of stool accumulates which can’t easily be passed. When she tries to do (or does) a large poo, it may hurt, and the skin may split and bleed a little. This creates a vicious circle where she avoids trying to do a poo because she doesn’t want it to hurt again.
If left untreated, this can soon lead to chronic constipation. Her rectum may become used to being full and your toddler won’t feel the urge to poo. Liquid stool can build up behind the solid poo and may leak into her pants or cause diarrhoea. It can also lead to urinary incontinence as her full bowel presses on her bladder.
What should I do?
Try to encourage her into good toilet habits. Make sure that she has plenty of time to poo, don’t rush her, and aim for the times when the bowel is at its most active – first thing in the morning and after meals – as times to use the toilet. Having her feet on the ground or on a step will help her push.
You may also want to increase her fluid and fibre intake, and make sure that she’s getting plenty of exercise.
If treated early, simple constipation can usually be resolved.
Don’t give your child adult laxatives. These are too strong and could make your toddler unwell.
“We’d beg her to let ‘Mr Poo’ come out!”
“Alice was never ‘regular’, but at 2 she started pooing just once every four to six days. She learnt to hold it in and ate less and less. It was very painful for her and eventually a paediatrician put her on laxatives, warning that it could take up to a year to break the cycle. Initially, she was on huge doses, but slowly we were able to cut down until, eight months later, the problem had gone. Luckily, she was fine with potty training (sitting on the loo actually helped). I just wish we’d sorted things before it got so bad.”
Mel, 32, mum to Alice, 3