A constipated toddler is a common complaint and worry for parents. A constipated toddler crying in discomfort can be very distressing for the whole family. When toilet training begins around 2- 3 years (toddler years) problems can begin for a number of reasons. 

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 as well as what your childs normal bowel habits are is helpful when seeking further help. Below are some common signs that your toddler may be suffering. Constipation in children is very common and will no doubt happen at some point in your childs life from varying degrees of mild to severe.

Here are some common signs your toddler may be constipated.;

• They have had bowel movements three times or less in a week.  
• hard stools and/or maybe 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 or 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 for toddler constipation. Here are some of the most common ones.

• 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 cues 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 and they are less likely to poop. 

• 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.
• Diet changes 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.  

Does milk cause constipation in toddlers?

Milk can be a contributing factor to constipation. This is because if they are drinking lots of milk then they will be eating less foods such as fruit and vegetables which children need for fibre. I recommend limiting your toddler or childs milk intake to no more than 3 glasses a day.

Sometimes children can become constipated because of a cows milk allergy, which is an allergy to the protein in cows milk. However It is not clearly known how this happens exactly. If you suspect this may be happening then seek advice from a GP who can offer constipation relief in children and may recommend trialling a elimination diet of cows milk for 2 weeks to see if things improve. A registered Dietiitan will be able to help with this too.

What Can I Do To Help Relieve Constipation?

Quick toddler constipation relief

For those that are suffering with constipation for a week or more, or have chronic constipation which is painful. They are likely to need quick relief and it would be best to seek advice from a GP who can prescribe laxatives or other medications to help soften stools and increase frequency quickly.

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)

If you struggle to get your child to drink enough fluid each day then you may like to know some tips and tricks on exactly how to get them to drink more. Check out my blog. to find out more.

Daily physical activity – 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 minutes 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 or potty, 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)

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.

Pasta and rice – wholegrain and brown pasta and rice

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

Great added to breakfast cereals or toppings to salads.

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. 

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

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?

Avoiding these or eating them less frequently can help prevent further constipation.

• 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. 

How Can I Prevent My Child Becoming Constipated Again?

It depends on the cause of the constipation as to how to prevent it happening again. If it is medication related then asking your GP for an alternative may help relieve the symptoms. If it’s diet such as lack of fibre and fluid, then increasing these together will help. However changes to your toddlers diet will need to be made permanently to prevent constipation.

So you now know what foods are best for helping relieve 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