Constipation in Children: Causes, Signs, and Natural Ways to Relieve Constipation

Main points summarized

Childhood constipation is defined primarily by stool texture and strain or discomfort during bowel movements.
Constipation is often caused by low fiber intake, inadequate fluids, starting solid foods, routine changes, or withholding stool after experiencing a painful bowel movement.
"P fruits", vegetables, whole grains, legumes, and probiotic-containing foods are helpful for constipation relief and prevention.
Healthy Digestion Is More Than Food - Staying physically active and establishing regular, stress-free toilet routines encourage healthier bowel habits.
Don't Ignore Persistent Symptoms - Parents should consult a doctor if constipation persists despite diet changes, or if accompanied by red-flag symptoms such as abdominal pain, vomiting, blood in stool, or fever.

What Is Constipation in Children?

Constipation is a common digestive problem in young children. It occurs when stools become hard, dry, painful, or difficult to pass. Some children may pass stool less frequently, while others may have daily bowel movements but still experience constipation due to hard stool consistency.^1,2

Constipation is usually identified based on stool texture, discomfort, and bowel habits rather than frequency alone.

Most cases of childhood constipation can improve through simple dietary and lifestyle changes.^2,3

Common Signs of Constipation

Your child may be experiencing constipation if they have:

Hard, dry, or pellet-like stools

Difficulty passing stool

Straining during bowel movements

Bloated tummy

Reduced appetite

Fussiness or irritability

Complaints of tummy discomfort

Small streaks of blood due to hard stools

Stool withholding behaviors such as crossing legs or hiding^1,3

Little ones may strain, grunt, or turn red during bowel movements. If the stool remains soft, this is usually normal behavior and not necessarily constipation.¹

Why Does Constipation Happen?

1. Starting Solid Foods
When little ones begin solid foods, the digestive system needs time to adapt to changes in texture, nutrients, and fiber intake. This transition may temporarily slow bowel movements and contribute to harder stools.²

2. Not Enough Fiber
A diet low in fruits, vegetables, legumes, and whole grains may contribute to harder stools and reduced stool bulk. Fiber helps retain water in the stool, making it softer and easier to pass.^2,3

3. Inadequate Fluid Intake
Without enough fluids, stools may become dry and difficult to pass. Adequate hydration is especially important when fiber intake increases.²

4. Changes in Routine
Travel, illness, changes in feeding schedules, starting childcare, or stressful situations may temporarily affect bowel habits.¹

5. Holding Back Stool
Some toddlers avoid passing stool after experiencing a painful bowel movement. This stool withholding behavior may worsen constipation over time because stools remain longer in the intestines and become harder.^3,4

Common withholding signs include:

Crossing legs

Standing stiffly

Hiding during bowel urges

Refusing toilet use

Evidence-Based Nutrition Tips to Relieve Constipation

Offer More “P Fruits”

Many healthcare professionals recommend “P fruits” because they naturally contain fiber and sorbitol, a natural carbohydrate that may help soften stool and support bowel movement. 2,5

Helpful examples include:

• Pear

• Prune

• Peach

• Plum

• Papaya

These fruits can be served:

• Fresh

• Mashed

• Blended into smoothies

• Mixed into porridge or yogurt

Prunes are particularly well known for supporting stool regularity due to their fiber and sorbitol content.²

Include More Vegetables

Vegetables provide fiber, water, and important nutrients that support healthy digestion.

Good choices include:

• Pumpkin

• Sweet potato

• Broccoli

• Spinach

• Carrot

• Green peas

• Lady’s finger (okra)

Try adding vegetables into:

• Porridge

• Soups

• Pasta

• Fried rice

• Omelets

Cooked vegetables are often easier for younger children to accept and digest.

Choose Whole Grains

Whole grains contain more fiber than refined grains and may help improve stool consistency.

Examples include:

• Oatmeal

• Wholemeal bread

• Brown rice

• Whole grain cereals

• Barley

Gradually increasing fiber intake may help reduce bloating or gas discomfort.²

Include Legumes

Beans, lentils, and chickpeas are excellent sources of fiber that help increase stool bulk and support regular bowel movements.

You can add legumes into:

• Soups

• Porridge

• Pasta sauces

• Mashed spreads

Encourage Adequate Fluid Intake

Water helps keep stools soft and easier to pass. Inadequate fluid intake may worsen constipation, especially when dietary fiber intake increases.²

Helpful tips:

• Offer water regularly once complementary foods have started

• Encourage frequent small sips throughout the day

• Increase fluid intake during hot weather or active play

• Offer water and drinks with no added sugars instead of sugary beverages.

Clear soups and fruits with high water content may also support hydration.

Consider Probiotic-Containing Foods

Some studies suggest that certain probiotics may help support gut microbiota balance and digestive comfort in children, although evidence remains mixed. 3,4

Examples include:

• Yogurt with live cultures

• Fermented milk products

Probiotic foods should complement, not replace, a balanced high-fiber diet.

Keep Your Child Active

Physical activity helps stimulate bowel movement and supports healthy digestion.²

Encourage:

• Tummy time

• Crawling

• Walking

• Outdoor play

• Running

• Active games

Reducing excessive screen time may also help encourage more physical movement.

Create Healthy Toilet Habits

For toddlers and older children:

• Encourage toilet sitting after meals, especially after breakfast

• Allow enough time without rushing

• Keep the toilet experience positive and stress-free

• Praise effort rather than focusing only on results

• Use a small footstool if needed to support proper posture

Creating a regular toilet routine may help train healthy bowel habits over time.³

Foods That May Contribute to Hard Stool

Try to reduce excessive intake of:

• Processed snacks

• Fast food

• Cakes and pastries

• Sugary beverages

• Highly refined grains

• Excessive low-fiber snack foods

A balanced diet is more important than completely avoiding any single food.

Sample 1-Day Meal Plan for Constipation Relief

Breakfast

Oatmeal with sliced pear
Water

Morning Snack

Kiwi fruit

Lunch

Brown rice
Fish or chicken
Steamed broccoli and carrots

Afternoon Snack

Prunes or papaya

Yogurt with fruits

Dinner

Vegetable soup
Wholemeal bread

Before Bed

Water

When Should Parents Seek Medical Advice

Consult a healthcare professional if your child experiences:

Persistent constipation despite dietary changes

Severe abdominal pain

Repeated blood in stool

Poor growth or weight gain

Vomiting

Significant bloating

Fever

Refusal to eat

Constipation beginning very early in infancy^1,3,5

Medical evaluation is important to rule out underlying medical conditions if symptoms are severe or persistent.

Key Takeaway

Most childhood constipation can improve through simple dietary and lifestyle changes. Offering more fruits, vegetables, whole grains, legumes, adequate fluids, and regular physical activity can help support healthy digestion and comfortable bowel movements. Building positive toilet habits early may also help prevent constipation from becoming a long-term problem.^1,2,3

Frequently Asked Questions on Constipation in Children

1. How do I know if my child is constipated?

Look for hard, dry or pellet-like stools, difficulty passing stools, straining, tummy discomfort, bloating, reduced appetite or stool-withholding behaviours such as crossing their legs or hiding.

2. Is it normal for my child to strain when passing stool?

Sometimes. Young children may strain, grunt or turn red when passing stool. If the stool is soft and your child is otherwise comfortable, this is usually normal and does not necessarily mean constipation.

3. Can my child be constipated if they poop every day?

Yes. Constipation isn't determined by frequency alone. A child who goes every day can still be constipated if their stools are hard, dry, painful or difficult to pass.

4. What fruits can help with constipation?

The article highlights pear, prune, peach, plum and papaya. These fruits provide fibre, and some contain sorbitol, which may help support softer stools.

5. Does drinking more water help with constipation?

Adequate fluid intake helps keep stools softer and easier to pass. This is particularly important when increasing fibre in your child's diet.

6. What vegetables are good for children with constipation?

Good options mentioned in the article include pumpkin, sweet potato, broccoli, spinach, carrot, green peas and okra.

7. Can whole grains help?

Yes. Oatmeal, wholemeal bread, brown rice, whole-grain cereals and barley provide more fibre than refined grains and may help improve stool consistency.

8. Why does my toddler hold their poop?

Some children may start holding their stool after experiencing a painful bowel movement. They may cross their legs, stand stiffly, hide or refuse to use the toilet. Holding stool can make it harder over time, creating a cycle of discomfort and withholding.

9. Can probiotics help with constipation?

Some studies suggest that certain probiotics may support gut health and digestive comfort, but the evidence is mixed. Probiotic-containing foods such as yogurt with live cultures can complement—not replace—a balanced diet.

10. When should I take my child to see a doctor?

Seek medical advice if constipation persists despite dietary changes, or if your child has severe abdominal pain, repeated blood in the stool, vomiting, significant bloating, fever, poor growth/weight gain or refuses to eat.

References

American Academy of Pediatrics. Constipation in Children. HealthyChildren.org.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Eating, Diet & Nutrition for Constipation in Children.
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN).
European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN).
Johns Hopkins Medicine. Constipation in Children.