What is constipation?

Constipation refers to difficulty passing stool, or not passing stool regularly enough. This might be because the stool is too large or too hard or is not being moved through the bowel quickly enough.  

There are many causes of constipation in children, including:

  • Withholding (holding onto their poos) following previous painful bowel movement,
  • Stress and anxiety,
  • Certain medical conditions,
  • Eating and drinking habits (including lack of regular food, fibre or fluids)
  • and in some cases food allergies or intolerances.  

Sometimes, the cause is not clear.

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Why is constipation a problem?

Short-term effects include:

  • tummy discomfort,
  • pain when trying to pass a stool,
  • and loss of appetite (this may also affect mood and behaviour)

Long-term effects include:

  • small tears around the bottom (anal fissures),
  • swollen veins (haemorrhoids),
  • faecal impaction (when lots of hard stool becomes stuck in the bowel),
  • and a deterioration in nerves and muscles in the bottom leading to more toileting accidents (like faecal incontinence).

Managing constipation at an early age can help to minimise these complications.

What are some of the common signs and symptoms?

These may include:

  • passing stool 3 times or less per week
  • abdominal discomfort or pain, particularly on the left hand side
  • stool being either large and hard, or in small pieces like rabbit droppings
  • straining or feeling pain in the bottom when trying to pass stool
  • bleeding from the bottom whilst passing stool, or afterwards
  • and having tummy pain or a poor appetite which improves after passing stool

How can diet help?

The best way to control constipation is with diet. Even making some small changes can make a big difference.

Getting enough fibre is especially important as most people don’t have enough in their diet. However, it is also possible to have too much fibre, so here are the general recommendations:

15g/day for 2 year olds, increasing up to 30g/day for 18 year olds.


To get more fibre, try some of these foods:

  • fruits & vegetables,
  • oats & cereals,
  • beans & pulses
  • and wholemeal bread.

Optimise fibre intake

And remember, it is important to increase your child’s fibre intake gradually, whilst also aiming to increase fluid intake. Fibre and fluid work as a team to help keep the stool soft and easy to pass.

Remember, any small changes you can make will be really helpful.

NOTE: Dietary changes on their own are unlikely to be helpful in treating constipation that has been going on for a long time (>3 months).

Children will likely be given medication from their nurse or doctor, usually taken as a drink. These medications are helpful for many children and often need to be taken in large doses to help soften the stool enough to make it painless to pass.

So here are few little Nutribyte tips to help get your child to eat more fibre:

Breakfast:

  • Wholemeal toast with any topping
  • Bran flakes, Weetabix, Shreddies or shredded wheat-type cereals (if your child prefers other cereals, try a 50/50 mix with a higher fibre option)
  • Porridge
  • Try sprinkling a little dried fruit or some mixed seeds on to cereals, porridge or yogurt

Lunch:

  • Try using wholemeal or 50/50 bread, seeded wraps or wholemeal pitta for sandwiches
  • Use hummus, avocado or any salad vegetables as sandwich fillings
  • Include a portion of fruit with lunch - fresh, dried or tinned are all great

Dinner:

  • Add some pulses to homemade meals. eg. tinned lentils in bolognese, kidney beans in chilli, chickpeas in curries
  • ‘Hidden veg’ pasta sauce is a great option for children and you can add some beans or lentils to this too, before blending to hide everything
  • Include a side of vegetables or baked beans
  • Include fruit in puddings eg. fresh or tinned fruit with yogurt, fruit crumble or banana with custard

Snacks:

  • Any fruit, or vegetable sticks
  • Cereal bars with oats, seeds or nuts
  • A slice of wholemeal toast with any topping
  • Sweet or savoury oatcakes

Fluid:

It’s really important that your child’s fluid intake gradually increases as their fibre intake increases. Extra fibre without extra fluid can make constipation worse. Fluid requirement increases gradually with age, from around 900mls per day at 1 year old up to around 2 litres per day at 14 years old, though individual requirements vary. Drinks of water are ideal, but if your child doesn’t like drinking water then weak sugar-free squash/cordial or some diluted fruit juice are good alternatives.

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The following websites will provide you with more information and support to help you understand and manage your child’s constipation:

NHS Choices https://www.nhs.uk/conditions/pregnancy-and-baby/constipation-and-soiling/

Infant and Toddler Forum https://infantandtoddlerforum.org/toddlers-to-preschool/common-nutritional-problems-in-toddlers/constipation/

Eric: The Children’s Bladder and Bowel Charity https://www.eric.org.uk/Pages/Category/bowel-problems?gclid=CjwKCAiA_Kz-BRAJEiwAhJY72qzQbUVpZacN_ltZ09PUZuOk56XzKPwjnLPQ_qzhNA0pMvHHGVIRBoCrfgQAvD_BwE  

https://gutscharity.org.uk/advice-and-information/symptoms/constipation/

BDA Food Facts: Fibre https://www.bda.uk.com/resource/fibre.html

BDA Food Facts: Fluid https://www.bda.uk.com/resource/fluid-water-drinks.html

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