A constipated toddler is a common complaint and worry for parents. When toilet training begins around 2- 3 years (toddler years) problems can begin for a number of reasons. However it can occur at any age. 

The good news is that there are lots of ways to help relieve a constipated toddler. For most children it is ensuring they are getting enough fluid into them alongside more fibre in the diet. 

This blog will give you the requirements for fluid intake and the best foods in each food group to help relieve them. There are also some other tips related to other causes. 

Is my toddler constipated?

Knowing what to look for and if they are constipated is helpful when seeking further help. Below are common signs that your toddler may be constipated.

Below are common signs your toddler my be constipated.

• They have done a poo three times or less in a week  
• Their poo is hard and large
• Their poo looks like hard little rabbit droppings
• They find it painful and strain when they go to do a poo.
• If they have a little bleeding during or after a poo
• Lose of appetite but improves after a poo.
• They have tummy ache but improves after a poo (1)

What are other possible symptoms?

• They may get soiled underwear from any leakage (runny poo around harder poo).
• They may have a change in mood and be cranky, irritated
• Screaming and crying whilst trying to have a bowel movement
• Uncomforable sitting on their bottom/sore bottom.
• Nausea (feeling sick) (2)

What causes constipation in toddlers?

There are a number of reasons why some toddlers become constipated.

• Diet is a common reason, whether this is a change in diet or not eating enough fibre rich foods to help bulk up the poo. So eating a diet that is too high in fat, sugar and salt such as processed type foods are also usually lower in fibre. 

• Fluid intake -If they are not having enough fluid in the day, its likely their poo will not be soft and harder to pass through. 

• Medications or supplements– Some medications or supplements can cause constipation or upset the digestive system. For example iron supplements. 

• Exercise/activity- There are also some children that don’t do enough exercise. This is important because exercise will help digested food move through the intestines. This is discussed more further below.

• Missing cues – some children don’t recognise their internal cue to go to the toilet. This could be because they are busy playing or doing something else.

• Reluctance to use toilet – For some children who suffer with anxiety or a reluctance to use the toilet in certain places like nursery or school then this withholding makes it longer before they use the toilet again. 

• Bad experience – If they have had a painful or uncomfortable bowel movement previously they are more likely to hold it in (also called withholding). So they do not go through the same experience and this can make it worse. 

• Medical problem – Rarely there can be some underlying problem such as with the intestinal tract, rectum, anus or nervous system. 

What can I do to help relieve constipation?

For Immediate/short term relief 

Seek advice from a GP who can prescribe laxatives to help soften stools and increase frequency. 

Longer term solutions

Diet – by eating more fibre rich foods such as 

• Wholegrain cereals (wholegrain bread, brown rice, wholegrain pasta)
• More fruit and vegetables with skin on (at least 5 a day) and these can be a mixture of tinned, frozen or fresh.
• Include more legumes like lentils, chickpeas and beans

Examples of which foods are discussed below. 

Fluid intake – depending on their age will depend on exactly how much they need to drink. 

1 – 2 yrs – 880 – 960ml per day (or around 5 x 200ml glasses)

2 – 3 yrs – 1040ml per day (or around 5 x 200ml glasses)

4 – 8 yrs – 1280ml per day (or around 6 x 200ml glasses)

9 – 13 yrs – 1520 – 1680ml per day (or around 6 x 250ml glasses)

For tips and tricks on exactly how to get them to drink more you might like to check out my blog. 

Daily activity/exercise. The recommendations for daily exercise of children aged 1 – 4 years is at least 3 hrs a day. This can be spread out across the day and include a variety of differing exercise. (3)

Children 5 years or above require less exercise but still at least 60 mins a day. 

Routine– so getting your child to regularly sit on the toilet at regular times like in the mornings after breakfast or before bed. They dont necessarily need to go but a routine of this will help particularly for children who resist or want to spend time doing other activities. Let them sit for 10 minutes and it will help relax the bowels too. 

Correct sitting position – by sitting in the correct position on the toilet it can help stools to move through the bowels more easily. See this useful guide 

What are the best foods to help with constipation?

All of the below food groups are good but some particular foods in these food groups contain high amounts of fibre which helps pass poo along the digestive system quicker. (4)

1. Bread & cereals – wholegrain or other grains like rye & spelt varieties found in loaves, bagels and other types of bread. Cereals like oats, oat bran and shredded wheat.

2. Pasta and rice – wholegrain and brown pasta and rice

3. Seeds – linseeds, flax, pumpkin, sunflower & chia seeds. 

Great added to breakfast cereals or toppings to salads.

4. Fruits -especially pears, prunes, plums, figs but also other fruits with skin on help with increased fibre. Try these on their own or in juice versions, mixed in smoothies too. 

5. Vegetables – particularly broccoli, green beans, carrots, brussel sprouts, cabbage, sweet potato, avocado, spinach. 

6. Pulses such as lentils, chickpeas and different types of beans. If they are not keen on these then using them in dips, hummus, sauces may work better. 

A nutritious, fibre rich breakfast can help to get things moving.  You can include three of these food groups for example something like a oat bowl or other type of cereal with seeds, and fruits will increase fibre uptake. 

How much fibre does my child need to have a day?

This depends on the age of your child but for toddlers or children aged between 2 – 5 year-olds: they need about 15g of fibre a day (5) 

What foods are best avoided if constipated?

• Avoid not having too much milk, as this replaces drinking more water
• Bananas are fine sometimes but a variety of fruits is better. 
• Refined foods, processed foods particularly those high in fat. These tend to be low in fibre. 

So you now know what foods are best for constipation and which are best avoided. For a fussy child then it can make it even more difficult for you to get them to eat the best foods.

References given on request