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Constipation occurs when a child has a very hard stool that is difficult to pass or is not going to the toilet very often.

There is a lot of variation in what is normal for bowel motions in children, for example; breast fed babies can have a bowel motion with every nappy change or only once a week. Bottle fed babies and older children will tend to pass stools once every 1 – 3 days. This stool is soft.

Constipation is very common in children and it may start at weaning onto solids or when starting toilet training and may be as a result of withholding stools after a painful or frightening experience.

The signs include; difficulty with passing stools, passing very hard stools or large stools, abdominal pain, withholding behaviours such as crossing legs, crying or hiding with the urge to pass stools and sometimes overflow incontinence when small amounts of stool are passed into underwear without the child being aware.

There’s Lots of Things You Can Do to Help with Constipation: 

  • Encourage a healthy diet with lots of fruit and vegetables and natural fibre e.g. cereals.
  • Try prune juice which is a mild natural laxative that can work well in some children.
  • Encourage exercise.
  • Establish a regular toilet routine sitting on the toilet for 3-5 minutes, 3 times a day after main meals. ‘Bowel training’ requires motivation and encouragement – so use a star chart system of rewards to help your child to go and sit on the toilet. This will help your child get used to doing a bowel movement at a similar time each day.
  • If your child doesn’t like going to the toilet at school, ask them why? If it is a cleanliness issue, a problem with the doors / facilities or perhaps other children making your child feel uncomfortable – have a discussion with your child’s teacher.

Most children will improve, however, if you have concerns see your GP. They may recommend the use of laxatives that soften the stools to encourage regular soft motions. It is better to use the stool softeners daily for a longer period consistently as it takes a few weeks to months to establish a routine.


Story By: Dr Betty Wamola, Townsville Paediatrics