Constipation in Children: Signs, Causes, Treatment, and Prevention

Constipation can be difficult to identify in children because normal bowel patterns vary widely. One child may go several days without a bowel movement and not be constipated, while another may have daily bowel movements but still struggle to pass stool.

Constipation may go unnoticed when a child passes small amounts of stool daily, allowing stool to gradually accumulate in the colon. Caregivers should monitor bowel habits and watch for signs that may indicate constipation.

Signs and Symptoms of Constipation

Constipation may be suspected if any of the following are present:

• Newborns: Firm stools occurring less than once per day (this may still be normal in exclusively breastfed infants)
• Older children: Hard, compact stools with 3–4 days between bowel movements
• At any age: Large, hard stools that are painful to pass
• Abdominal pain that improves after a large bowel movement
• Blood on or in the stool, often from small tears caused by straining
• Soiling between bowel movements, due to stool leakage around hardened stool

Common Causes of Constipation

Constipation usually develops when the muscles at the end of the large intestine tighten, preventing stool from passing normally. When stool remains in the colon for too long, it becomes dry, firm, and difficult to pass.

Because bowel movements can be painful, a child may begin to withhold stool intentionally, which further worsens constipation and creates a cycle that is difficult to break without intervention.

Management of Constipation

Mild or occasional constipation can often be managed with simple measures:

• Breastfed infants: Constipation is uncommon; consult a doctor before making feeding changes

• Infants: A doctor may recommend small amounts of water or prune juice

• Toddlers and older children: Increase dietary fibre, including:

  • Prunes, plums, apricots, raisins

  • Whole-grain cereals and breads

  • High-fibre vegetables and fruits

In more severe or persistent cases, a doctor may prescribe a mild laxative or enema.

Prevention Strategies

To reduce the risk of constipation:

• Encourage adequate fluid intake
• Provide a high-fibre, balanced diet
• Promote regular physical activity
• Help establish a consistent toilet routine, especially after meals

When to Seek Medical Advice

If a child continues to struggle with constipation, experiences pain, blood in the stool, or frequent soiling, a doctor should be consulted. Many cases can be managed with dietary and lifestyle adjustments when addressed early.

Important First Aid & Caregiver Education Notice

This information is provided for educational purposes only and is not a substitute for professional medical advice. Persistent constipation, abdominal pain, or blood in the stool should always be assessed by a healthcare professional.

Understanding common childhood health concerns is an important part of first aid training for parents and caregivers. St. Mark James Training, Canada’s largest 100% Canadian-owned and operated first aid and CPR training provider, covers child and infant care topics in its Childcare First Aid programs across Canada.