27 September, 2023

Constipation in babies and toddlers

Constipation can be a fairly commonplace event in the lives of many babies and toddlers.

Constipation: Explained

It rarely indicates any significant underlying health issues, though it can be a little distressing for the child and their parents.

What causes constipation in babies and toddlers?

The considerations are slightly different depending on the age of the child.

Once a baby moves onto solids, it may be attributable to them not getting sufficient fluids and/or dietary fibre. That fibre is usually found in grain-based foods, fruit and vegetables. It might also be due to the fact they have a small lesion around the anus, meaning it’s slightly painful for them to poo and understandably, they try not to do so by holding it in.

Constipation in younger babies is rare if they have been breast-fed. Where formula is being used, a constipated baby’s poo might appear pellet-like and crumbly. That usually suggests that insufficient fluid is being added to the formula but again, minor anal tears could be playing a part.

For any baby under 12 months of age, it’s normally a good idea to consult a doctor immediately if you suspect constipation.

The causes for toddlers can become more complex. It’s very common for children in these age ranges to see pooing as an annoying and time-consuming distraction from all those things they want to be spending time on. So, they’ll often deliberately hold their poo in – sometimes for days on end.

It’s also far from unknown for toddlers to suddenly decide they’re afraid of the toilet and indicate they don’t want to use it.
The end result of deliberately holding their poo in over time is that it becomes larger and more solid, therefore even more difficult to pass.
Of course, it’s also possible that they’re suffering from insufficient fibre in their diets or a lack of fluids – just as is the case with some babies.


It can be very difficult to state what constipation is by frequency alone. That’s because although most younger babies are moderately regular in their bowel movements, once they go onto solids, variations will become increasingly common.

By the time children are toddlers, those variations from one child to another can be substantial. Some may poo once a day, others may go as little as 3 times per week. To confuse things further, even an individual child’s bowel habits may vary tremendously from one week to the next.

Broadly speaking, it’s worth keeping an eye out though for:

  • apparent difficulty (or pain) in pooing – often expressed by very red faces, grunting or otherwise straining without any product;
  • a reluctance to want to go to the toilet;
  • ‘Holding it in’. This can be sometimes diagnosed by the child fidgeting in their chair, constantly crossing their legs and increased flatulence;
  • extended delays between poos – where this is being judged as a noticeable change in their normal toilet routine.

What to do

Assuming your child is over 12 months, most doctors would probably say there is no need for an immediate medical visit based on what is perceived to be a case of mild constipation. They will typically recommend increasing your child’s fluid consumption and waiting to see if nature takes its course.

It is also often recommended that the percentage of fruit and vegetables in the diet is increased.

Most experts will also advise against using laxatives as a first resort, whether they are natural or pharmaceutical. Some would say children should never be given laxatives without a doctor or pharmacist’s advice in advance.

However, you should consult your doctor if:

  • the constipation appears to have lasted for more than a few days;
  • it is accompanied by a loss of appetite or abdominal pain;
  • there are other symptoms such as fever, rashes, blood or mucus around the anus;
  • the attacks of constipation are becoming regular.

A quick call or visit to your doctor will put your mind at rest.

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