The issue of constipation is something that many parents have to manage from time to time. When a child is experiencing constipation or withholding poo, it can cause distress for everyone in the family. It can start to feel as though the issue is dominating the family life. Reminding yourself that many parents experience this as stressful and that you are not alone can be reassuring for some parents. Progress can be very slow, so trying to remain patient and positive will be important in overcoming toileting issues.

How do I know if my child is constipated?

Constipation is the inability to do a poo regularly or to completely empty the bowel. Constipation is the most common bowel problem for children. Your child may be constipated if they poo less than 4 times a week, if they are avoiding going for a poo, or if they have a bloated tummy, or a lack of energy/appetite.

Why is my child constipated?

Your child may withhold poo because they have had painful bowel movements in the past and they are afraid it will hurt again when they poo- this is the most common cause of constipation. Some children might start withholding poo because they are not emotionally or physically ready to start using the toilet yet. Others may find the experience intimidating — the size, sounds and location of a toilet are sometimes overwhelming for a toddler. Your child may have developed a fear of the toilet or a negative association with toileting. Changes in routine can cause anxiety which can contribute to constipation in children (e.g. moving house, starting playschool). An unbalanced diet or insufficient fluid intake can also result in constipation.

How do I help?

It is important to visit your GP if your child is constipated as they will be able to best advise how to proceed. They may assess your child and, if necessary, prescribe medication to improve gut movement. Constipation can be treated with a combination of medications and/or behavioural interventions that best suit your child’s developmental stage. These could include:

  1. Talk to your child about constipation: Talking to your child about how they are feeling about their constipation is really important. It is important to help them to understand what is going on in their body and how they can relieve their constipation. Make sure they know that they can talk to you about their toileting fears if they wish to do so, and that you can solve this together. As difficult as this can be, it is important to keep calm.
  2. Healthy, balanced diet: Ensure your child is eating a balanced diet and drinking plenty of fluids, especially water. Give your child fibre-rich foods (e.g. apples, pears, beans).
  3. Exercise: Keeping active is really important. Exercise sends blood to the gastrointestinal tract which helps move food waste through the bowels quickly and easily. Running around and playing outdoors will help keep the bowels healthy.
  4. Scheduled toileting routine: Encourage your child to sit on the toilet at least twice a day for 3-5 minutes, preferably 15-30 minutes after a meal. Make this time pleasant; do not scold or criticize your child if they are unable to poo. Follow this consistent routine every day, even during holidays.
  5. Use of encouragement and reward systems: Praise positive toileting behaviour. Try to be positive and encouraging. Give a hug or a hi-five. Leave some toys or books that they enjoy next to the toilet.
  6. Get creative! Distraction is a useful tool when helping children who are withholding or constipated. Try bringing the potty outside, in front of the TV, etc., until they pass their first poo. Blowing up balloons or bubbles, which opens and relaxes the muscles required for bowel movements, may be a way of helping your child to relax and have fun while sitting on the toilet.

This article was contributed by a member of Limerick.