Most of us are aware that a healthy diet, adequate fluid intake, an active lifestyle and correct toilet habits can reduce the chances of constipation. Infants on solids can be particularly vulnerable to constipation and many parents are surprised by the sudden pellet-like appearance of their bub’s poo when they start on solids. In young children, toilet training can also be followed by bouts of constipation.
Constipation is the passing of dry, hard poos. This can be accompanied by discomfort or pain. Yes, it’s upsetting for everyone concerned.
Part of our fluid intake each day comes from the fluid in food. However, if there is a lack of fluid intake (or a drop in fluid levels) in the body, the intestinal canal can ‘wring’ out even more fluid than usual, leaving dry, compacted faecal (poo) matter. The longer that poo sits in the bowel, the more water/fluid is reabsorbed by the body.
Poo should be formed, soft and easily passed. Keep in mind every person has their own, individual bowel habits – children are no different. Some children poo once every two or so days, others every day, some two to three times a day – whatever is usual for your child should be your benchmark. So, it is important to be aware of any changes. A little one who poos daily and then suddenly doesn’t go for days may well be constipated.
But also remember that constipation is signalled by more than just frequency. Other signs of constipation include:
In young children, persistent constipation can cause runny poo to leak into their underpants; this is termed ‘soiling’.
Constipation can be caused by a few things; even weaning and early potty training can be a reason. The common causes of constipation include:
Of course, prevention is always better than the cure.
Breastfed babies don’t tend to become constipated as long as they are thriving, gaining weight and having plenty of breast milk. If you sense that your baby (who is not yet on solids) is experiencing constipation without an obvious reason, consult your GP or child health nurse as soon as possible.
Of course, hotter weather can be an issue. If you are wondering about offering baby (who is not yet on solids) some water, check with your child health nurse first. Generally, breastfed babies don’t need extra water as long as they are breastfeeding frequently.
It is difficult to offer a definitive guide on how much a baby will drink; this can depend on whether they are breast or formula-fed, how often they feed, what types of solids they eat, the temperature, and more. Regularly offering your little one water may help, especially on very hot days.
For more on why juice is not recommended in infancy or early childhood, see our tip sheet on juices.
Offering your baby fruit juice to help with constipation is not advisable. Any benefits gained from fruit juice tend to be counter-productive to nutrition. Likewise, the addition of sugar or sweeteners is not recommended.
Sipper cups can be introduced around the time of solids. Offer cooled, boiled tap water around eating times. Just a few sips can make a big difference. Even if baby takes a while to adjust to the taste of water, continue offering.
Children can also be prone to constipation.
Not all fibre is the same; some will increase the passage of stools through the intestines whereby types of fibre slow it.
Not all starch is digested and absorbed. Some starch, termed resistant starch (RS), passes undigested through the small intestine to the large intestine where it can be fermented by bacteria in our intestines. RS has known benefits such as glucose and insulin control and colon health. Foods that contain RS include: grains (excluding rice) and foods made from whole grains such as wholemeal bread and wholegrain cereals, bananas, potatoes and legumes.
Mild constipation will generally resolve itself by one or more of the above suggestions. If, however, the problem persists and/or your child seems uncomfortable, it’s important they are examined by a doctor.
IF YOU ARE UNSURE OR SYMPTOMS PERSIST, SEE YOUR MEDICAL PROFESSIONAL
Children should always be supervised when given nuts and seeds due to risk of choking.
Edited and reviewed by Jane Barry, Midwife and Child Health Nurse July 2021.