Constipation in kids: what parents need to know

Constipation in children is very common and, while often uncomfortable, it is usually manageable with the right support. Understanding what’s normal, what’s not, and how constipation affects a child’s body and behaviour can help parents respond early and confidently.

A child is considered constipated when their poo (faeces) is hard, painful to pass, or happens less often than is comfortable for them. Importantly, “normal” bowel habits vary widely between children.

What is normal when it comes to poos and babies?

Before 6 weeks of age, most babies will poo around 3 times a day, often with feeds. After 6 weeks, the frequency of poo's may change.

Breastfed babies (older than 6 weeks) may poo after every feed but it's also normal if breastfed babies only poo only every 2-7 days (because breast milk is highly digestible). 

Bottle-fed babies and older children typically pass a bowel movement every one to three days.

What matters most isn’t the number of poos, but whether your baby's poo is soft and the baby is comfortable and gaining weight.

It is normal for babies under 6 months to struggle, grunt, go red and hold their legs up  prior to passing a stool. This is because they are learning to coordinate the contraction of their tummy muscles with relaxing their anus/pelvic floor. Also, we have to generate a significant amount of pressure to pass a poo (we do this as adults by bearing down to increase intra-abdominal pressure while passing a stool but many adults squat to create a posture that supports stooling- obviously babies can't do this so they have to use grunting, and pulling legs up to generate that pressure).

If your baby is passing blood in their stool, losing weight, vomiting, lethargic or refusing food, or if you have any worries, always consult a health professional.

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Signs and symptoms of constipation in children

Constipation often appears during key developmental stages such as starting solids, toilet training, or starting school. It can also begin after a child has had a painful or frightening bowel movement, leading them to avoid going to the toilet altogether.

Constipation doesn’t always look like “not pooing”. Many children continue to pass stools but still experience constipation-related discomfort.

Common signs of constipation in children include:

• Tummy pain or cramps that come and go

• Reduced appetite or early fullness

• Irritability, emotional changes, or increased behavioural challenges

• Pain, bleeding, or small skin tears around the anus (anal fissures) caused by straining

• “Holding-on” behaviours such as squatting, crossing legs, hiding, rocking, or refusing to sit on the toilet

Some children may appear bloated, and in some cases you may be able to gently feel hard lumps in their abdomen.

Chronic constipation and soiling (encopresis and sneaky poos)

When constipation lasts a long time, it can lead to soiling or poo smears in underwear. This happens when the rectum becomes stretched from being full for extended periods, reducing the child’s ability to feel the urge to go. Soft poo may then leak without the child noticing.

This is known as encopresis or faecal incontinence. It is a medical issue, not a behavioural problem, and children should never be blamed or punished for it.

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What causes constipation in children?

In most cases, childhood constipation does not have a serious underlying cause. Common contributors include:

• Natural gut motility: Some children simply have slower bowel movement patterns

• Ignoring the urge to poo: Young children may delay going because they’re busy playing or don't want to pass a poo at school

• Avoidance after pain: A painful bowel movement can lead to fear and withholding, creating a painful cycle

• Environmental changes: New toilets, school bathrooms, or being told to “hold on” can disrupt bowel habits

• Dietary factors: Diets low in fibre, high in processed foods, or high intake of cow’s milk may contribute

• Medical causes: Rarely, issues affecting the bowel, spine, or metabolism may be involved and will be assessed by a doctor if needed

Supporting constipation at home

You only need to be concerned about how often or how firm your child’s poo is if it’s causing discomfort, pain, or distress. Many children can be supported at home with consistent routines, reassurance, and patience.

Building healthy bowel habits

For toilet-trained children, regular toilet sitting is one of the most effective strategies:

• Encourage sitting on the toilet after breakfast, lunch, and dinner, even if they don’t feel the urge

• Aim for three to five minutes on the toilet. Ensure the child is not straining while seated. This sitting is making the most of a gut-brain reflex that supports digestion after eating, which can gradually support the body to retrain and recognise the urge for toileting. After 5 minutes if no poo has come, the child gets off the toilet.

• Praise the behaviour, not the result. Sitting calmly is a success, even if no poo happens

• Encourage children to respond when their body signals the need to go

• Ensure the setup feels safe and stable, a toilet insert and foot stool help children relax their pelvic floor

Reducing fear and discomfort around toileting

Many children associate toileting with pain or fear, particularly after constipation. Addressing emotional safety is just as important as addressing routine or diet.

Helpful strategies include:

• Using a foot stool, toilet insert, or rails for stability

• Keeping a favourite book, toy, or calming activity nearby

• Talking gently about fears around school or childcare toilets

• Advocating for toilet access and support in early learning or school settings

When fear is reduced, the body is better able to relax and pass stools comfortably.

Nutrition and constipation in children

Fibre and fluid intake (water) can support bowel function in children.

Helpful nutrition strategies include:

• At least two servings of fruit daily, especially high-fibre options like prunes, plums, apricots, peaches, and raisins, berries and legumes

• Prune juice, a gentle natural laxative mixed with other juices or frozen into icy poles

• At least three servings of vegetables per day

• Choosing wholegrain cereals such as oats, bran, or shredded wheat

• Using wholemeal bread instead of white bread

For children over 18 months, limit cow’s milk to no more than 500 ml per day, and avoid sweet drinks before meals to support appetite and gut movement.

When to Seek Medical Advice

Constipation can be stressful for both children and parents, but with patience, consistency, and support, most children can develop healthy, comfortable bowel habits.

Seek advice from your GP or child health professional if:

• Constipation persists despite home strategies

• Your child has ongoing pain, any bleeding, or significant distress

• There is frequent soiling or concerns about growth, weight loss or development

Early support can prevent constipation from becoming a long-term issue so if you have any concerns, always talk to your child health professional.

Dr Claire Gibbons

Paediatrician and Founder, Base Kids Health