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Constipation animation

Caption and credit

An animation about constipation, including symptoms and when you might need to see a health professional.
Source: KidsHealth

transcribeTranscript

Everyone poos differently, especially pēpi and tamariki.

If your child has firm, hard or painful poo, they are likely to be constipated.

This can cause tummy pain.

Constipation is common in tamariki.

There are many possible reasons why tamariki get constipated.

Constipation can often get worse for tamariki the longer it goes on.

If your child is constipated, there are a few things that may help.

Encourage your child to sit on the toilet for several minutes in the morning. Even if they don't do a poo, still encourage this.

Star charts can help everyone remember to do this.

Make sure your child is comfortable sitting on the toilet.

It may help to use a child's toilet seat for preschoolers.

For younger tamariki, put a stool under their feet so their knees are higher than their hips.

Encourage your child to lean forward and rest their elbows on their knees.

Make sure your child is drinking water regularly.

Encourage them to eat lots of fruit and veges.

You could try giving your child prunes or KiwiCrush (a kiwi fruit drink) daily.

Encourage regular activity.

Call Healthline on 0800 611 116 or see a health professional if:

  • your child has tummy pain
  • or the constipation is getting worse
  • or your child finds toileting very upsetting
  • or your child is having poo accidents

Your health professional may give your child medicine to help their constipation.

These are called laxatives. Follow your health professional’s instructions.

You may need to see your health professional again if the constipation doesn’t get better.

Most tamariki with constipation get better with things you can do at home.

Key points about constipation

  • constipation is when your child has firm, hard or painful poo
  • it's a common cause of tummy pain in tamariki (children)
  • constipation can often get worse the longer it goes on
  • drinking water, eating lots of fruit and veges and regular activity all help
  • regularly sitting on the toilet in the morning is also helpful
  • some tamariki need laxatives for several months to help their constipation
  • most tamariki with constipation get better with things you can do at home

Normal poo

Everyone poos differently, especially pēpi (babies) and tamariki.

Breastfed babies

Some healthy breastfed pēpi poo several times a day and others may only poo once every 10 days. The poo of breastfed pēpi is mustard yellow, soft and can look like it has seeds in it.

Formula-fed babies and older children

Most formula-fed pēpi and older tamariki poo every day or every second day. Poo should mostly be like a soft log, like type 4 in the diagram below.

Poo chart - different types of poo

A stool chart showing 7 different types of stools with type and description.

Chart showing 7 different types of poo. Adapted from the Bristol stool chart.
Source: KidsHealth
 

transcribeTranscript

An illustrated chart showing 7 types of poo. Each type is based on shape and texture. 

Type 1: separate hard lumps. 

Type 2: a lumpy log shape. 

Type 3: a log shape with cracks. 

Type 4: smooth soft log or snake shape. 

Type 5: soft blobs with clear edges. 

Type 6: mushy with ragged edges. 

Type 7: liquid with no solid bits. 

The chart is from KidsHealth New Zealand. At the bottom of the chart is the KidsHealth logo with the website: kidshealth.org.nz.

You can download and share or print a copy of the KidsHealth poo chart below.

Image
Adaption of a bristol stool chart showing the different types of stools with type and description.
Document
Caption and credit

Source: KidsHealth

What is constipation?

If your child of any age has firm, hard or painful poo, they are likely to have constipation. 

Some tamariki who poo less than every 3 days may also have constipation. 

 Illustration of a child with a normal digestive system and two close-up views of the intestines showing different stages of constipation. The first close-up shows constipation with the rectum overloaded with stool. The second shows worse constipation, with stool backed up through the large intestine. Labels identify the stomach, large intestine, small intestine, and rectum.

Illustration of a child showing the difference between constipation and worsening constipation.
Source: KidsHealth

transcribeTranscript

This is an illustration of a child showing their digestive system. The organs are labelled as:

  • Stomach
  • Large intestine
  • Small intestine
  • Rectum

There are 2 close-up pictures:

  1. Constipation: The rectum is stretched and overloaded with poo.
  2. Worse constipation: Poo is backed up through the large intestine.

At the top right is the KidsHealth logo with the website: kidshealth.org.nz.

Signs and symptoms of constipation

Signs of constipation in tamariki include:

  • small hard lumps of poo (like type 1 on the poo chart)
  • firm, hard poo (like type 2 on the poo chart)
  • poo that is large and hard to pass
  • not pooing for 3 or more days
  • pain or crying when pooing
  • bright red blood on the toilet paper after wiping
  • tummy pain that comes and goes
  • poo stains ('skid marks') in underwear
  • liquid poo (soiling) that leaks out in between harder poo
  • poo accidents
  • feeling sick or not eating as much

Tamariki with constipation are also more likely to:

  • have urinary tract infections (UTIs)
  • wet themselves
  • wet the bed

Causes of constipation

There are many causes of constipation. Sometimes it is more than one thing. 

Causes include:

  • not eating enough fruit and veges
  • not drinking enough water
  • not being active
  • weaning from breastmilk to formula or starting solids
  • having a naturally slower moving gut

Toileting habits are important. Tamariki can get constipation if they:

  • don't sit on the toilet regularly
  • ignore the urge to do a poo
  • don't let all the poo come out when going to the toilet
  • avoid pooing because it's painful or scary

The painful constipation cycle

When your child feels the urge to poo, they may hold on to the poo to avoid pain. This makes the poo harder, larger and even more painful to pass. Your child can become even more scared to poo. This creates a cycle of worsening constipation.  

Graphic showing the cycle of constipation

Illustration of the constipation cycle.
Source: KidsHealth

transcribeTranscript

This illustration shows the common cycle that can occur with constipation. 

The cycle has 3 stages connected by curved arrows:

  1. Pain - The starting point at the top
  2. Hard Poo - On the right side
  3. Trying to avoid pain by 'holding on' to poo - On the left side

The arrows show how this creates a cycle. 

The key to stopping this cycle is making the poo soft and easier to pass. 

Find out what you can do to make your child's poo softer and easier to pass.  

Constipation Treatment

When constipation continues for a long time

Constipation that continues for a long time can cause an overloaded and stretched bowel. Tamariki may then lose the urge to poo. This can lead to soiling accidents. 

Soiling In Children 

When to get medical help for constipation

Call Healthline on 0800 611 116 or see a health professional if:

  • your child has tummy pain
  • the constipation is getting worse
  • your child finds toileting very upsetting
  • your child is having poo accidents

You may need to see your health professional again if the constipation doesn’t get better.

More information

Acknowledgements

Illustrations and stool chart adaptation by Dr Greta File. Property of KidsHealth

References
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