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Constipation

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

Some children go to the toilet two or three times a day. Others may go only once a week, without problems. "Constipation" describes how hard your child's bowel poos are and how difficult or painful it is to pass a bowel motion, not just how often your child goes to the toilet.

What's the Problem?

Your child may be constipated if he or she:

Says it hurts to poo

When this happens, your child will not want to go to the toilet as often. Pain makes it more difficult to poo. Hard poos may tear the anus (back passage) causing pain and bleeding. This may also lead to a pattern of holding on.

Poos in his / her pants without meaning to

Sometimes kids who are constipated have runny poos which they can't control due to overflow of liquid poo around constipated older poo. If this happens regularly see your doctor who may prescribe medication.

Has tummy pains that may come and go

What causes constipation?

1. Holding onto poos. Sometimes children put off going to the toilet because they are too busy or it hurts. Waiting too long to go to the toilet can cause the poo to build up in the bottom and get harder than it should which results in this area becoming stretched and then it doesn't work normally.
   
   
2. Not enough fibre from food. Fibre helps our bowels to work properly and regularly. We all need to eat fibre-containing foods such as wholemeal or grain bread, fresh fruit and vegetables every day. Having foods with fibre will help to keep your child's bowels working regularly after the constipation has been properly treated.
   
   
3. Not drinking enough.
   
   
4. An intercurrent illness where your child eats and drinks less.

What to do

It is important to get rid of the hard poo. A laxative usually helps - ask your doctor or hospital for advice and follow their instructions carefully.

Note: It is important that laxatives are not over-used. Always follow the advice of your doctor.

How to prevent further problems

Having enough fibre is a good lifelong habit for everybody. To prevent constipation, combine food containing enough fibre with enough drinks and daily exercise. Encourage children to go to the toilet regularly - after breakfast is a good time. Teach them to go to the toilet when they feel the urge to.

Ways to increase fibre... you may like to try some of these ideas....

Try wholegrain breads and cereals

• For breakfast cereals include Weetbix^TM / Vitabrits^TM, Shredded Wheat^TM,
• Puffed Wheat^TM, muesli, porridge, Mini Wheats^TM, Fruity Bix^TM
• For breads, muffins, cereals and crackers, use wholemeal, wholegrain, high fibre white or rye.
• Try wholemeal pasta or brown rice.
• Try adding some wholemeal flour and fruit when cooking biscuits or cakes. (We recommend that you use ground nuts in cooking for children under 5 years of age so that there is no risk of them accidentally choking.)

Eat plenty of fruit and vegetables

• Include fresh, frozen and canned varieties.
• Dried fruit can also be included, eg dried apricots, dried apple, prunes.
• Prunes and kiwifruit also contain a natural laxative (you can also try prune juice, start with about 50 ml per day and increase gradually if necessary).
• Legumes and pulses contain large amounts of fibre, eg baked beans, lentil soup, pea and ham soup, lentil burgers, chilli beans, chilli con carne and burritos.

Include nuts

For example, spread peanut butter or other nut pastes on bread or crackers, include nuts in cooking, eg, stir fries or in cakes and biscuits or as a snack (whole nuts not for under five years of age so that there is no risk of choking).

Try a soluble fibre supplement in drinks

Benefiber^TM and Metamucil^TM are soluble fibre supplements that can be purchased from pharmacies without prescription. Follow the instructions on the packaging carefully. Either may be used in children 2 years and older.

Special note on bran

• Bran is another source of fibre, but is NOT recommended for infants and toddlers. It is always better to eat high fibre foods than take supplements such as bran. This is because bran may interfere with the absorption of minerals, such as iron and zinc.
• Small amounts of bran can be used cautiously in older children (over 10 years) and remember to provide plenty of fluid at the same time.

Ways to include enough fluid

• Include four to five glasses of fluid each day, eg water, milk and diluted juice.

• Make sure that your child eats a fibre-rich diet, drinks plenty of fluids and has regular exercise.
• Constipation can, and often does, happen again.
• Treatment of constipation often takes time.
• Plan a toileting program.
• Avoid overusing laxatives.

The Children's Hospital at Westmead Tel: (02) 9845 3585 Fax: (02) 9845 3562 http://www.chw.edu.au/	Sydney Children's Hospital, Randwick Tel: (02) 9382 1688 Fax: (02) 9382 1451 http://www.sch.edu.au/