Constipation in children – symptoms, causes and treatment
Hard or painful stools are one of the most common stomach symptoms in children. Here you will find answers to what constipation is, why it occurs, and how it can be treated.
Constipation in children is a condition in which stools become hard, infrequent or painful to pass. The condition is very common in childhood – around 20 percent of children between the ages of 4 and 18 have had constipation at some point, and in children aged 0-2 the figure is around 3 percent. In the vast majority of cases – around 95 percent – there is no underlying disease, and the condition is then called functional constipation.
What are the symptoms of constipation in children?
Most symptoms are related to stools being hard, lumpy, or infrequent. Children may have stomach aches, a reduced appetite, and generally seem unwell—especially before going to the toilet.
There is a wide range of normal variation in how often children have bowel movements. Most children over one year old go once or twice a day, but some only go every two or three days. This is perfectly fine as long as the stools are soft and pass easily. In infants, the pattern is even more variable: breastfed babies can have anything from several bowel movements a day to just one a week, and both are completely normal.
A sign that many parents overlook is a bowel movement accident or a sudden, loose stool. This can actually mean the rectum is full of hard stool and liquid stool is leaking around the accumulated mass. Older children will also consciously tighten their pelvis and buttocks to hold back a bowel movement, typically because they have had a painful experience on the toilet in the past.
What causes constipation in children?
The most common reason is that the child has had a hard or painful stool at some point and then consciously or unconsciously begins to hold the stool in to avoid the pain again. This makes the stool even harder the next time, establishing a vicious cycle.
Other contributing factors may include too little fiber in the diet, insufficient fluid intake, changes in diet (e.g., transitioning from breast milk to formula or introducing solid foods), fever, or other illness. For older children, poor or changing toilet habits—such as when starting school or daycare—can also play a role.
In rare cases—around 5 percent—constipation may have an underlying organic cause, such as a congenital intestinal condition. These cases typically appear very early on and are more difficult to manage with general dietary and toilet instructions. The doctor will always pay attention to whether the symptoms fit the general, functional picture.
How is constipation diagnosed in children?
The diagnosis is made primarily on the basis of a conversation with the parents about the child's bowel movements, symptoms, and duration. In the vast majority of cases, this is sufficient, and there is no need for blood tests, X-rays, or other imaging studies.
The doctor will typically ask how often the child has a bowel movement, what the stool looks like, if there is pain, and when the problems started. A physical examination may be performed—such as checking the abdomen—to determine if there is a build-up of stool in the intestine. Further investigations are only considered if the symptoms do not fit the typical picture or if treatment does not work as expected.
Can constipation in children go away without treatment?
Mild and short-term cases can often resolve on their own or with simple changes in diet and habits. More persistent or severe constipation, on the other hand, often requires more structured treatment over a longer period of time, as the vicious cycle of retention is otherwise difficult to break.
Treatment is always planned individually and is based on how severe the constipation is and how long it has been going on. In mild cases, it may be sufficient to adjust the diet to include more fiber – e.g. whole grains, vegetables and fruit – and ensure that the child drinks enough water. For older children, regular toilet habits, where the child sits on the toilet at the same times every day without time pressure, can also make a big difference.
If diet and toilet habits are not enough, the doctor may assess the need for a laxative that softens the stool and makes it easier to pass. Such treatment should always be done in consultation with a doctor, as it is often necessary to continue for a longer period of time to completely break the retention pattern.
How long does it take to treat constipation in children?
Treatment can last for several months, and it is common for constipation to return periodically, even after a good start. The most important thing is to break the pattern of retention and painful bowel movements, so that the child regains confidence that going to the toilet does not hurt, and that treatment is not terminated prematurely.
When should you see a doctor about your child's constipation?
It is a good idea to have your child evaluated by a doctor if the constipation has lasted more than a few weeks, if the child is in severe pain, or if there is blood in the stool.
Other signs that should be evaluated by a doctor include:
- The child is losing weight or is not thriving as expected.
- A bowel movement accident occurs in a child who was previously potty trained.
- Symptoms start very early in infancy.
- You are in doubt as a parent, or something simply feels wrong.
If you are unsure whether your child's symptoms require medical assessment, it is always a good idea to contact a doctor or a health visitor.
Treatment at Charlottenlund Private Hospital
At Charlottenlund Private Hospital, you can get a thorough assessment of your child's stomach symptoms from a specialist. We listen to your concerns, review your child's symptoms and bowel movements, and together with you create a plan for how to best manage the constipation - with a focus on what suits your family and your child's needs.
Book an appointment online if you want a specialist assessment.
Experience and skills at Charlottenlund Private Hospital
At Charlottenlund Private Hospital, children with constipation are assessed by pediatric specialists. The assessment is based on a thorough conversation about the child's bowel movements and symptoms, and the treatment is planned individually with a focus on diet, toilet habits and, if necessary, stool softening medication. You will find an overview of all departments on our department page.
Sources:
- Danish Paediatric Society: Constipation and fecal incontinence in children and adolescents (2025).
Frequently Asked Questions
How often should a child have a bowel movement?
There is a wide range of normal variation. Many children have a bowel movement once or twice a day, but some only have it every two or three days without it being a problem if the stool is soft and comes out without difficulty.
What are the signs of constipation in children?
Typical signs are hard, lumpy stools, pain when going to the toilet, abdominal pain, decreased appetite and the child avoiding going to the toilet. Some children also have bowel movements in their pants.
Can constipation cause stomach aches in children?
Yes, constipation is a common cause of stomach pain in children, and the pain typically goes away quickly when the child has a bowel movement.
What can I do myself if my child is constipated?
You can increase the amount of fiber in the diet with, for example, vegetables, fruit and whole grains, make sure the child drinks enough water, and help with regular toilet times without time pressure.
Is constipation in children dangerous?
Constipation is uncomfortable but rarely dangerous. However, in rare cases it can be a sign of an underlying condition, so prolonged or severe constipation should always be evaluated by a doctor.
Why is my child holding back stool?
Often because the child has previously had a painful bowel movement and is therefore afraid that it will hurt again. This creates a vicious cycle where the stool becomes harder if it is held back.
What causes bowel accidents in a previously clean child?
This could be a sign of constipation, where loose stools are seeping past a buildup of hard stool in the intestines. It should always be evaluated by a doctor.
Should my child take medicine for constipation?
It depends on the severity of the constipation. In mild cases, changes in diet and toilet habits may be sufficient, while other children need a laxative for a period of time. This is assessed individually by the doctor.
How long does it take to treat constipation in a child?
Treatment can take several months, and it is common for constipation to return periodically. A good result often requires continued focus on diet, habits and possible medication over a longer period of time.
Can constipation in children be caused by diet?
Too little fiber and too little water intake can contribute to constipation. It is also seen more often when there are changes in diet, such as transitioning to solid foods. Any dietary changes should be discussed with a doctor.
Read also about
- Stomach pain in children
- Food allergies in children
- Celiac disease in children