For constipation in children, what helps is fruit with plenty of fibre and water: pears, plums, kiwi and berries, wholegrain bread, porridge and vegetables, together with water at every meal and less milk. What makes it worse is large amounts of milk, white bread, rice and too little to drink. Regular trips to the toilet after breakfast and plenty of movement do the rest. If it lasts more than a couple of weeks, contact BVC (the child health clinic every family in Sweden is enrolled in).
Constipation is common in children, especially at three points: when they start solid food, when they come out of nappies, and when they start förskola (municipal preschool, from age one) and do not want to poo there. It easily becomes a vicious circle: it hurts, the child holds it in, the stool gets harder. In most cases, food breaks the circle.
What helps
| Food | Why |
|---|---|
| Pears, plums, prunes, kiwi, apricots, berries | Fibre and fruit sugar that draw water into the gut |
| Wholegrain bread, oat porridge, muesli | Fibre that adds bulk |
| Vegetables, cooked for small children | Fibre, and the child drinks more |
| Water, at every meal and in a bottle during play | Fibre without fluid makes constipation worse |
| Lentils, beans, peas | Fibre and fullness |
| Fil (Swedish soured milk) and yoghurt in moderate amounts | Good for the gut flora, without crowding out other food |
What makes it worse
- Lots of milk. More than half a litre a day for a child over one crowds out other food and gives hard stools.
- White bread, white rice, pasta in large amounts without vegetables alongside.
- Lots of banana in some children.
- Too little to drink, especially at förskola where the child forgets to drink.
- Holding it in. A child who does not want to poo at förskola holds it all day, and the stool dries out.
By age
| Age | Common cause | What usually helps |
|---|---|---|
| Under 6 months | A change of formula, välling (Swedish cereal drink) mixed too thick | Mix according to the instructions, call BVC. Breastfed babies can poo rarely without being constipated. |
| 6 to 12 months | Starting solids, lots of rice and banana | Pear and plum purée, oat porridge, water in a cup with meals |
| 1 to 3 years | Too much milk, potty training | Milk down to half a litre, water, a step by the potty, no pressure |
| 3 to 6 years | Will not poo at förskola, too little to drink | The toilet after breakfast at home, a water bottle for förskola, talk to the staff |
| 7 to 12 years | Stress, school toilets, little movement, lots of white bread | Breakfast with porridge or wholegrain bread, fruit in the bag, movement after school |
A day of food that helps
| Meal | Example |
|---|---|
| Breakfast | Oat porridge with apple sauce or plum purée, water. The milk in the porridge is enough. |
| Snack | A pear or a kiwi, a wholegrain sandwich |
| Lunch | Whatever förskola serves. Ask for water with it. |
| Snack | Wholegrain bread with butter and cheese, cucumber sticks, water |
| Dinner | Potatoes or wholegrain pasta, vegetables, lentils or meat, water |
| Supper | Fil with muesli and berries, a small cup of milk |
Routines that work
- The toilet after breakfast, every day, five minutes, with no demand for results. The gut gets going after food.
- A footrest. A step under the feet so the child sits with the knees higher than the hips. It changes everything.
- Movement. Running, jumping, cycling. A sedentary afternoon makes for a sedentary gut.
- Talk to förskola if your child does not poo there. Many groups can arrange a quieter toilet.
- No pressure. A child who is pushed holds it in more.
Potty training and constipation
The two go together more often than you would think. A child who has just come out of nappies may find it uncomfortable to poo sitting down, hold it in, get hard stools, find it hurts and hold it in even more. That is not stubbornness, it is fear that it will hurt again. The solution is to get the stool soft first, with food and sometimes medicine from BVC, and then go back to the potty at a calm pace. Letting your child poo in a nappy for a while is perfectly fine. How to go about it is in our guide to Potty training.
Förskola
Many children do not poo at förskola. The toilets are open, there is noise, someone might come in, and the teacher is busy. Tell the staff that your child is holding it in, and they can help: a toilet with a door, an adult waiting outside, a quiet moment after lunch. And send a water bottle. A child who drinks water during the day rarely needs as much help with the rest. Ask what your child drinks with lunch too: at many preschools the milk is on the table and the water is not, and then it is milk three times a day without anyone having thought about it.
When diet is not enough
If your child has had hard stools for more than a couple of weeks, is in a lot of pain, bleeds, or gets poo stains in their pants even though they are out of nappies, contact BVC or your vårdcentral (local health centre). A stool softener is often needed for a few weeks or months to break the circle, and that is not a failed diet, it is a full bowel that needs emptying before the habits can help. Do not stop the medicine too early just because it has started working, that is the most common reason the problem comes back.
How we do it with our families
The after-förskola snack is the nanny's best opportunity: a pear and wholegrain bread instead of a bun, water on the table, and some time running around at the playground before dinner. She also notices if the child has been holding it in all day, because it shows in the mood at four o'clock. With a family in Vällingby, Nike and the parents have a simple arrangement: she writes on the note whether the three-year-old pooed during the afternoon and how it went, and after a week the parents can see what has helped. It sounds like an odd thing to write notes about, and it is not at all. It is exactly the information BVC asks for when you call.
This text is general information and does not replace advice from BVC, your vårdcentral or 1177 (the national healthcare helpline). If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows what is normal for them and notices when something is different? Book a free first meeting with the nanny in your home.
Read more: Potty training · Stomach bug in children · Food children actually like · Frequently asked questions
Frequently asked questions
How do you know if a child is constipated?
Hard, dry stools that hurt, fewer than three bowel movements a week, a child who holds it in and tenses up, tummy ache and sometimes poo stains in the pants of a child who is out of nappies. The last one is usually a sign that the bowel is full, not that the child is being careless.
Which fruit helps most?
Pears, plums, prunes, kiwi, apricots and berries. Apple and banana help less, and lots of banana can bung up some children. For small children, pear and plum purée works; for older children, the fruit as it is, ideally with the skin on where possible.
How much should the child drink?
Water with every meal and between them. Limit milk to about half a litre a day for children over one, as more milk crowds out other food and fluids. Fibre without fluid makes constipation worse, so never add wholegrain bread and porridge without adding water at the same time.
When should we seek medical help?
If it has gone on for more than a couple of weeks despite a change of diet, if the child is in a lot of pain, if there is blood in the stool, if the child vomits or loses weight. BVC and the vårdcentral can help, often with a stool softener for a period. A baby under six months who has not pooed for several days and seems unwell: call 1177.
Can constipation be caused by potty training?
Yes, it is one of the most common causes in two- and three-year-olds. A child who finds the potty uncomfortable holds it in, the stool gets hard, it hurts, and the child holds it in more. Go back to a nappy for poos for a while if needed, it is no setback, and focus on soft stools before you carry on.