Constipation in toddlers

Bowel habits change during infancy and early childhood; for example, babies in their first week of life will pass on average four stools a day, whereas a child of one year of age will pass on average only two a day.1 In contrast, when a child is constipated, they may have fewer than three bowel movements a week.2

Childhood constipation is a common problem thought to affect anywhere between five and thirty percent of children.2 Despite this, constipation can cause discomfort for your toddler, so it’s important to take appropriate steps such as increasing your toddler’s fruit and vegetable intake, and where necessary seek advice from your healthcare professional.

References

  1. Weaver LT and Steiner H. Arch Dis Child 1984;59(7):649-652.
  2. Patient.co.uk, 2013: http://www.patient.co.uk/doctor/constipation-in-children Accessed 17th February 2014.

What are the symptoms
of constipation in toddlers?

Children who are constipated may not only have less frequent bowel movements, when they do use the toilet, their stools may also be dry, hard and painful to pass.1

Other signs and symptoms which may suggest your toddler is constipated include:2

  • Reduced appetite
  • Lower energy levels
  • Feeling irritable, angry or unhappy
  • Unpleasant wind and stools
  • Stomach pain and discomfort
  • Soiling their clothes
  • Generally feeling unwell

If you notice more than two or more of the following within the past eight weeks, your toddler may be chronically constipated:3

  • Fewer than three bowel movements per week
  • Soiling themselves unexpectedly or at inopportune times more than once a week
  • Pain when passing stools
  • Your toddler ‘holds’ onto their stools and ignores their body’s natural reaction to try and empty their bowels; they may do so by dancing about or hiding when they need to go to the toilet

If your child has any of these symptoms or has spoken to you about having difficulty going to the toilet, seek advice from your child’s healthcare professional.

References

  1. WebMD, 2012: http://www.webmd.com/children/constipation-treatment Accessed 18th February 2014.
  2. NHS Choices, 2012: http://www.nhs.uk/Conditions/Constipation/Pages/Symptoms.aspx Accessed18th February 2014.
  3. Patient.co.uk, 2013: http://www.patient.co.uk/doctor/constipation-in-children Accessed 17th February 2014.

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RXANI130244g Date of preparation: February 2014

What causes constipation in toddlers?

Constipation can happen due to a variety of reasons and there are three main causes: nutritional or dietary, psychological and physical.1

Nutritional or dietary causes:1

  • Insufficient fibre intake due to low intake of fruit, vegetable and cereal based foods
  • Not drinking enough fluids
  • Excessive milk intake as this can reduce a toddler’s appetite for other foods such as those high in fibre

Psychological causes:1

  • Fear or phobia of going to the toilet, due to fear of experiencing pain and discomfort, which can result in the child ignoring the urge to pass stools
  • Potty training difficulties
  • Changes in lifestyle and routine

Physical causes: 1

  • Lack of exercise
  • Fever

If you have any concerns or think your child might be chronically constipated, speak to your healthcare professional.

Reference

  1. NHS Choices, 2012: http://www.nhs.uk/Conditions/Constipation/Pages/Causes.aspx Accessed18th February 2014.

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RXANI130244g Date of preparation: February 2014

Making the most of your appointment

Your child’s healthcare professional may ask you to keep track of your child's bowel movements — how often they occur, how big and hard their stools are, and whether there is any blood in your toddler's stools. To help your healthcare professional and to make the most of your appointment, it may be useful to take note of when your child experiences the symptoms, capturing the date and time to give your healthcare professional a clear picture of the situation.

You should also look for other symptoms that can occur along with constipation, such as: 1

  • Stomach ache
  • Bloating
  • Nausea
  • Loss of appetite
  • General crankiness
  • Crying or screaming during bowel movements
  • Avoiding the toilet (signs that your child is doing this include clenching their buttocks, crossing their legs, turning red, sweating or crying)
  • Smears or bits of liquid stool in their nappy or underwear (soiling)

You can help your healthcare professional diagnose and treat your child's condition by answering the following questions:2

  • When did the constipation begin?
  • How often does your child normally have a bowel movement?
  • Are their stools hard or soft?
  • Does your child have a history of constipation?
  • If your child has been toilet trained, has he or she had any leakage of soft or liquid stools that have stained his or her underwear?
  • Has your child had a recent change in diet, daily routine or environment?
  • Has your child recently started taking a new prescription or non-prescription medicine?
  • Are you giving your child any new herbal remedies or vitamins?
  • Has your child been under any added stress recently?

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RXANI130244g Date of preparation: February 2014

How to manage your toddler’s constipation

It is always best to speak to your health care professional to decide how to manage your child’s constipation.

Common ways of treating constipation include:1

  • Making sure your child is drinking enough fluids
  • Adding high-fibre foods to your toddler’s diet
    • Add at least two servings of fruit, such as apricots, peaches, pears, raisins, figs, prunes, dates, and other dried fruits every day
    • Add at least three servings of vegetables, such as cooked dried beans or peas (legumes), broccoli, or cauliflower every day
  • Increasing wholegrain foods, such as bran flakes, bran muffins, oatmeal, brown rice, and wholemeal bread
  • Encouraging your toddler to be physically active
  • Establishing a consistent routine to support regular toilet habits
  • Trying to make sure your toddler doesn’t feel stressed or pressured about moving on to use the toilet

For more information, please visit our section on Tummy Troubles.

Reference

  1. WebMD, 2010: http://www.webmd.com/children/tc/constipation-age-11-and-younger-prevention Accessed 18th February 2014.

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RXANI130244g Date of preparation: February 2014