Constipation treatment for children

Fibre makes the poo softer and easier to do. Giving your child more fibre in their diet can help prevent constipation and also treat short-term or very mild constipation. Fibre is also important long-term for regular bowel functioning. If your tamariki has had constipation a long time, just increasing fibre without other treatment is unlikely to fix their constipation. 

To add more fibre to your child's diet, you can:

• give at least 3 servings of fruit each day – fruit with the skin on, such as apples, pears, plums, apricots, peaches and kiwifruit
• give at least 3 servings of vegetables each day
• give cereals high in fibre, eg, bran cereals, Weet-Bix, whole grain cereals, porridge  – avoid refined cereals and those with added sugar
• give wholemeal breads instead of white bread
• try adding bran to muffins and other baking, or add it to your child's regular cereal
• try adding 1 to 2 tablespoons of ground flax seed/linseed meal to cereals, soup or mixed into a smoothie
• give legumes (beans and peas), including baked beans, hummus, lentils
• give strained prunes to babies, up to 3 tablespoons a few days each week.

It's also important to give your child plenty of water with the increase in fibre.

Encourage your child to sit on the toilet for 5 minutes twice a day about 10 minutes after a meal (breakfast and dinner). Even if they don't do a poo, still encourage this.

• Make sure your child is comfortable on the toilet.
• Get a stool or box for them to rest their feet on to make sure your child's knees are higher than their hips.
• Use a child's toilet seat for pre-schoolers – if your child isn't relaxed because they're worried about falling into the toilet, this makes it difficult to have a relaxed successful poo.
• Encourage your child to lean forward and rest their elbows on their knees.
• Teach them to push their tummy out when trying to poo.
• Make the toilet interesting and child-friendly with books and toys.
• Incentive or 'star' charts can help encourage your child to sit on the toilet even if they don't always do a poo.

You should take your child to your healthcare provider if:

• simple measures and sitting on the toilet regularly haven't worked
• your child has had constipation for a long time
• your child has tummy pain
• your child is pooing their pants (soiling).

If your child has any of the above, it usually means their constipation is more severe and they need medicine for constipation.

Laxatives are medicines that help your body to get rid of poo. They are an essential part of the treatment of long-lasting constipation and soiling. Most are available to buy at a pharmacy but it may be better to go to your healthcare provider first. They can give you advice about the best laxative for your child and how much to give them. Your doctor or nurse prescriber can also give you a prescription which usually means you won't have to pay for the laxative.

There are 3 ways laxatives for childhood constipation work

• Some soften the hard poo and make it easier to do (poo softeners).
• Some help the bowel push the poo out (stimulants or emptiers).
• Some wash the bowel out completely.

Read more about laxatives for children.

For as long as it takes. Children often need laxatives for months to years rather than weeks.

Remember that the purpose of laxatives is to allow your child to develop a normal habit of pooing regularly.

Ideally, your child should aim for 1 soft formed poo that's not painful to do, every day. Laxatives are necessary until their body can manage this without help. You may need to adjust the dose over time, but it's important to continue the laxative treatment.

Often children get sick of taking medicine, or dislike the taste. Try to make the medicine taste better by putting it with milk or juice, or ask your healthcare provider about an alternative laxative. Incentive or 'star charts' can be a good way of encouraging your child to take medicine regularly.

These are medicines given into the bottom to help to empty the lower bowel. This can be an unpleasant experience for children, causing pain and embarrassment. They are generally avoided in children and should only be used under medical direction.