Children’s bowel habits can vary greatly. Going once or more a day or every couple of days is considered normal, but less than once every few days can be a signal of constipation. Other signs can include loss of appetite, feeling unwell or unhappy, unusually bad smelling wind and abdominal pain or discomfort.
The causes of constipation in children are usually the same as those in adults :
- Diet or medication
- Balance of good and bad bacteria
- Emotional wellbeing
Diet or medication
Your children may not be getting enough fibre in their daily meals. Good sources of fibre include bran cereals and porridge, fruit (including the skin), beans and peas, leafy green vegetables, dried fruit, and brown rice. Knowing how fussy children can be about their food, you may have to be a bit creative about how to get them to eat more fibre. One tip we would suggest is to add crushed bran flakes to yoghurt. You might also want to take a look at some great Jamie Oliver tips on making veggies fun for kids!
It's also important to bear in mind that many medicines will affect the digestive system, and can cause constipation, diarrhoea or nausea, but usually these are only temporary. Cutting down on high fat and high sugar foods will also help.
Fluid is an essential part of a healthy digestive system and can help prevent constipation as well as a number of other conditions. Water is best, however you could also encourage pure fruit juices over fizzy drinks. Some juices can have a laxative effect and they also contain fibre, which helps to keep things moving. Keep an eye out for too much sugar, though, because even too much fruit sugar can be bad. If in doubt, always try water!
Colds & Flu
Colds and flu as well as other illnesses can easily upset the regularity of your child's digestion. They might have a loss of appetite, and might refuse to eat altogether. Drinking water is particularly important during periods of illness, because lack of fluids causes dehydration which then leads to constipation. Make sure that your child continues to drink water and eat plenty of fibre whilst they're feeling unwell.
Everybody knows that exercise is important for general health and wellbeing because it’s good for the heart, the muscles and for burning calories. But it’s also good for avoiding constipation, because it stimulates the whole digestive system and encourages movement of the bowel. Encouraging walking with the whole family is a great way of getting some exercise, and simultaneously benefiting from quality time as a family!
Balance of good and bad bacteria
The large intestine is host to a whole range of bacteria, some of which are essential to healthy digestion. The good bacteria (probiotics) help to break down food and extract goodness and nutrients from the food we eat. The gut is also host to bad (or pathogenic bacteria), which can trigger digestive conditions like diarrhoea and constipation if they're left unchecked.
When the balance is tipped in favour of the bad bacteria, you can restore the natural balance in your child's gut by giving them a probiotic supplement. Not only do probiotics help with constipation, but they strengthen your child's immune system and even stimulate the production of Vitamins B and K (which is vital for building healthy bones). Find out more about the benefits of probiotics.
We would recommend a probiotic supplement which is free from artificial colours, flavours, and preservatives. A strain called Bifidobacterium lactis BB-12® has been researched for its benefits in preventing and alleviating constipation    and can be found in the powdered supplement Bifidobacteria & fibre for children aged 1 year and up.
More than people realise, constipation in children can be caused by emotional factors. If you had any problems during toilet training, then your child may still have memories and negative associations with going to the loo. They might be feeling anxious or nervous, and the stress of knowing that they 'have' to go only makes it worse. Of course, it will be doubly stressful if they have previously experienced any pain when going to the loo before, in which case they will try and hold on to it for as long as possible. This only makes constipation worse because the contents of the bowel will continually dry out and create hard stools. You might also find that when your child starts nursery school, they become reluctant to go to the toilet and just hold it in until they get home. Some might even lie about going to the toilet, and hope that nobody notices.
It's important to remember to be relaxed and practical when it comes to going to the toilet, because your child might pick up on your own anxiety. Try not to worry about the subject and follow the tips and advice above. The main thing is not to rush, stay relaxed and wherever possible, try not to fuss! Most constipation will resolve after a period of time, but if you are concerned, or if there are any signs of vomiting or severe pain, you should talk to your doctor or nutritionist.
References & Footnotes
Cazzola, M. et al. (2010) Efficacy of a synbiotic supplementation in the prevention of common diseases in children: a randomized, double-blind, placebo-controlled pilot study; Therapeutic Advances in Respiratory Disease 0(0) pp. 1-8
Matsumoto M, Imai T, Hironaka T, Kume H, Watanabe M and Benno Y. Effect of Yoghurt with Bifidobacterium lactis LKM512 in Improving Fecal Microflora and Defecation of Healthy Volunteers. Intestine Microbiology Magazine 2001;14:97-102.
Murakami T, Miyahara H, Yukisato S, Nakamura R, Kanno H, Kotakemori M, Kamei T and Kobayashi O. Safety and effect of yoghurt containing Bifidobacterium lactis BB-12 on improvement of defecation and fecal microflora in healthy volunteers. Food, Health and Nutrition Research (Journal of Nutritional Food) 2006;9(1):1-12.
Uchida K, Akashi K, Kusunoki I, Ikeda T, Katano N, Motoshima H and Benno Y. Effect of fermented milk containing Bifidobacterium lactis BB-12 on stool frequency, defecation, fecal microbiota and safety of excessive ingestion in healthy female students -2nd report. Food Health and Nutrition Research (Journal of Nutritional Food) 2005;8(1):39-51.