Constipation in children may develop for various reasons, but most of them are quite harmless. If children are short of fluids or fibre in their diets, or they are feverish, then constipation may become a short-term illness. Some toddlers that feel pressurized to be potty-trained as well as children who become so engrossed in play they forget to go to the toilet are vulnerable to developing constipation. Younger babies that are breastfed may not move their bowels for days, but this may not necessarily indicate that they are constipated. In rare cases, constipation may be a sign of another underlying physical problem. It is always advisable to deal with constipation in children immediately as waste matter that is built up in the rectum dries out quickly, making it worse, more painful and difficult to pass.

Some signs for you to note if you suspect your child is constipated:

• Poor appetite and complaining of a stomach ache
• The child goes longer than normal without passing a stool
• Smelly soiling, with traces of old stools mixed in with the fresh faeces
• Streaks of blood in underwear, nappy or in stool
• Wetting the bed at night again
• Lethargy
• When they do pass a stool it is large and very hard in appearance

Take note of your child's stools and if you are concerned think back to what your child has eaten or drunk and their behaviour pattern since their previous motion. Please do not get upset if your child doesn't have a bowel movement every day; for some children as well as adults their normal rhythms are every few days. Boost fluid intakes with homemade ice-lollies and extra drinks. Try to not give fizzy cool drinks every day. Water is always the best drink to quench thirsts. Establish regular meal patterns, with more wholemeal foods, fruit and vegetables. Serve whole breakfast cereals such as porridge or bran flakes. Start gradually introducing wholemeal flour, pasta, cereals and rice into your diet. Offer fresh fruit every day and include at least one fruit in their lunch containers. Dried fruits such as raisins, apricots and figs make great snacks. If your child is complaining of stomach ache, massage their abdomen in circular motions using baby lotion. Encourage your toddler to use the toilet by placing a step next to it. Show them how to position the step and push with their feet.

If your toddler does become constipated during potty training then put them back in nappies for approximately a month. When you re-start make the training fun with rewards for their performance - such as a hug or quality time. Try to not emphasize or make a fuss if accidents are made. Never give a child any laxatives, drugs or suppositories except on medical advice.

Consult your doctor if the above doesn't work, or if you notice any blood in the stools. Don't delay in asking for help as the sooner the constipation is addressed the easier it is to rectify. If a mild softening laxative is recommended by your doctor, ensure that your child drinks six to eight glasses of water a day which will also help to clear the bowels within 24 hours. Some children need senna, which is a bowel stimulant to help establish regular habits. If these don't work, your doctor may refer the child to hospital for further investigation.

Michael Russell

Your Independent guide to Constipation

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