HealthInfo West Coast-Te Tai Poutini

Overview of constipation in children

Mō te kōroke ki ngā tamariki

 

Constipation is a very common problem for tamariki (children). For most tamariki, constipation means passing hard stools (poo) with difficulty and less frequently than normal.

Soiling (also known as faecal soiling or encopresis) is also a common problem that affects many tamariki. Soiling is when a tamaiti (child) poos in their pants after the age you would expect them to be toilet trained. It can happen to any toddler or tamaiti.

Symptoms of constipation in children

Your tamaiti may be constipated if:

• their poo is hard and pebble-like
• they have not had a poo for 3 days or more
• they complain of pain or cry when having a poo
• there is bright blood around the poo. This can be caused by tears in the skin around the back passage (anal fissures)
• they complain of tummy pain, which is often relieved by having a poo
• they have soiling accidents.

Causes of constipation in children

There are many reasons why your tamaiti might be constipated.

• Not eating enough fibre. Fibre-rich foods help to keep their bowels working regularly. Fibre-rich foods include wholegrain breads and cereals, fruit and vegetables. See Fibre & fluids for children for more information.
• Not drinking enough fluids.
• Less activity than normal and not eating and drinking as much. For example, when your tamaiti is unwell.
• Holding on. Constipation often starts after one hard poo has caused pain. The natural response to a painful experience is to try to avoid it in the future. So, the next time your tamaiti feels the urge to poo, they hold on to try to avoid passing another painful poo. This results in the poo becoming firmer, larger and even more painful when it is eventually passed. And your tamaiti becomes even more reluctant to poo in the future.

Diagnosing constipation in children

Tests are not normally needed to diagnose constipation.

Your general practice team is likely to ask you questions about your child's bowel habits and diet and examine your tamaiti. They may also look at your child's anus to check there are no small splits or tears. Splits or tears can cause bleeding and make it painful for them to pass a poo.

Your general practice team may also check that there is no underlying disease or condition that might be causing the constipation.

Treating constipation in children

You can help your tamaiti by increasing the fluid and fibre in their diet and encouraging daily physical activity.

Support your tamaiti to develop a regular toilet habit.

• Encourage them to sit on the toilet after a meal. After breakfast and dinner is often best.
• Make sure they are comfortable on the toilet. They may need an inner seat.
• Get something for them to rest their feet on to ensure their knees are higher than their hips.
• Encourage them to lean forward and rest their elbows on their knees.
• Teach them to push their stomach out when pushing.
• If your tamaiti is younger and is prone to holding-on, consider using a reward system (such as a sticker or star chart) to help them go to the toilet more regularly. Reward sitting on the toilet, not clean underwear.
• Show your tamaiti the correct position for sitting on the toilet.

Sometimes tamariki will also need medication known as laxatives.

KidsHealth has detailed information about types of laxatives and how they are used.

  HealthInfo recommends the following videos

• Pediatric Gastroenterology Clinic at Primary Children’s Hospital – Constipation in Children

  This video will teach you why constipation happens to tamariki and what you can do to fix it.

  HealthInfo recommends the following pages

• KidsHealth
  • Constipation in children

    Information about the signs and symptoms of constipation and what you can do about it.

  • Soiling in children

    Information about what causes soiling in tamariki and what you can do to help.

• NZ Continence association – Faecal incontinence (soiling)

  Information about soiling in tamariki including treatment and advice about diet and fluids.

• The Royal Children's Hospital Melbourne – Constipation in children

  Information about the causes and treatment of constipation in tamariki.

  The factsheet is also available in Arabic, Assyrian, Burmese, Chinese (simplified), Chinese (traditional), Karen, Persian, Somali, Turkish and Vietnamese.

On the next page: Fibre & fluid for children

Written by HealthInfo clinical advisers. Last reviewed January 2025.

Sources

Page reference: 394427

Review key: HICOC-14683