Constipation in Children:

Perfectly healthy children may not have to open their bowels every day. If your child experiences pain or has to strain hard when going to the toilet, then they may be constipated.

Normal Function:

Faeces (poo) collects in the rectum (large bowel). This can stretch so the faeces can be stored ready for excretion. Nerves send a message to the brain telling it that the rectum is getting full and time to have a bowel movement. The composition of faeces varies a lot depending on different factors, ie, what has been eaten, how much liquid has been taken, etc. Most young children go to the toilet anything from once every other day to three times a day so you shouldn't automatically be worried if your child isn't going every day – this can be completely normal for them.

Constipation:

Pain or straining when passing a motion is a sign of constipation. This pain could frighten your child and make them more likely to withhold going to the toilet. Another sign is when a child who only goes to the toilet occasionally, keeps soiling themselves by accident. This happens when the rectum gets so full with solid faeces that only the loose, watery faeces can squeeze past.

Constipation Causes:

Not drinking or eating enough.

The digestive system needs to have food and if your child doesn't eat or drink enough, this can lead to hard, dry faeces which are extremely difficult to pass.

Not eating the right type of food.

Fruit, vegetables and cereals (fibre) needs to be present in the bowel to help it work properly. Not eating enough fibre can cause hard-packed faeces that is painful and hard to pass.

Examples of a healthy high-fibre diet include:

Breakfast - High-fibre cereals (such as Weetabix/Bananabix)
Porridge or instant oats (such as Ready Brek)

Lunch/dinner - Jacket potato (with skin) and baked beans
Pasta (wholemeal, if they'll eat it) and vegetable sauce
Vegetables soup containing cereals and wholemeal bread

Pudding - Fruit: fresh, tinned, baked or stewed

Snacks - Sliced apple/banana
Dried apricot
Raisins

Certain types of medicines can cause constipation, ie, certain cough medicines.

Withholding:

Your child needs to go to the toilet but deliberately holds it in. This may happen if they have become frightened of the pain they have experienced when trying to go to the toilet. This pain may occur because their faeces is very hard or the straining has caused tiny cracks in the skin around the bottom. Children can also worry about using a toilet away from home and resist the urge to go. Withholding can also be linked to emotional problems, eg, family stress, starting school, etc.

Regular Routine:

To tackle the problem of constipation in children following weaning, encourage eating of fruit, vegetables and cereals. A general rule to follow is children aged 4-6 should drink a total of about 1½ litres daily (2½ pints). This can include milk, diluted juice and soup. Children can be quite fussy eaters and you may find it is difficult to get them to eat 5 portions of fruit and vegetables a day. Try incorporating fresh fruit as a pudding with ice cream if fruit is not a favourite item. Encourage your child to drink water with, or between, meals. Breakfast is important, it is sensible not to miss it. Try having breakfast earlier to allow your child time to go to the toilet before they leave for school.

When is Help Needed ?

When you have tried dietary and routine daily changes without success, you should seek advice from your doctor. At the consultation your doctor will ask about your child's eating habits, general health and whether there could be anything upsetting him/her (eg, home situation, bullying at school, etc.). An examination of the child's tummy will normally take place and possibly a look at your child's bottom and it is best to inform your child of this prior to seeing the doctor so they do not get upset. It is highly unlikely that an internal examination will be carried out.

Your doctor may prescribe laxatives to treat the constipation and will explain how these should be used, but remember to read the instructions on the packet and store these out of the child's reach.

Keep your Child Informed:

It is important to explain to your child why you have changed their diet, why you are encouraging them to eat more fruit and vegetables, why they should drink more water or why the doctor has prescribed laxatives. It is crucial your child doesn't feel the constipation is their 'fault'. Your Health Visitor should be able to supply you with a booklet to read with your child which helps explain constipation.

Website Link for constipation and bedwetting: www.enuresis.org.uk.

Disclaimer: This page is for informational purposes only and should not be considered as medical advice or substituted for professional advice. Always consult your doctor with your questions and concerns.