Constipation is a decrease in the frequency of bowel movements; characterized by the passing of hardened stools which may be large and associated with straining and pain.

Normal stool frequency in children: ranges from an average of 4 per day in the first week of life to 2 per day at 1 year of age. Passing between 3 stools per day and 3 per week is usually attained by 4 years of age.

Contributing factors include: Pain, fever, inadequate fluid intake, reduced dietary fibre intake, toilet training issues, the effects of drugs, psychosocial issues, and a family history of constipation.

Signs of constipation
Two or more of the following clinical features indicate that a child is constipated:

• Fewer than three complete stools per week (unless exclusively breastfed, when stools may be infrequent).
• Hard stools (see the Bristol stool chart)
• Large stool.
• Rabbit droppings’ stool.
• Overflow soiling in children older than 1 year of age (commonly very loose, smelly stools, which are passed without sensation or awareness).

Watch this animation from ERIC to understand how constipation affects children and how it should be treated:

Useful links
The organisations below can provide more information and support for parents and carers of children and young people with constipation:

ERIC (Education and Resources for Improving Childhood Continence): eric.org.uk

You can also go to NHS UK for more information about constipation in children