Families Bowel problems How to prevent constipation in children 1. Drink plenty The most important way to maintain healthy bowels is to drink lots of fluids. Keeping well hydrated ensures poo stays soft and easy to pass. Children should have at least 6-8 drinks a day, preferably of water or a water-based drink like well-diluted fruit juice or squash. 2-3 drinks of milk a day are fine as part of a balanced diet. The size of the drink will vary depending on their age: a 120-150ml cup is about right for a two year-old and a 150-175ml cup for a four to five year-old. Avoid drinks containing caffeine like tea, coffee and cola, and sweetened and fizzy drinks. 2. Eat a balanced diet Having a balanced diet that includes fibre from fruit, vegetables, cereals (like oats, wheat and bran) and wholemeal bread also keeps the bowels healthy. Fibre helps to retain fluid in the poo, keeping it soft and easier to push out. 3. Keep active Exercise sends blood to the gastrointestinal tract which helps move food waste through the bowels quickly and easily. Running around and playing will help keep the bowels healthy. 4. Get into a good toileting routine Children who have poo problems often have trouble knowing when they need to go to the loo so it’s important to get them into a good toileting routine. This should involve sitting on the toilet at the same times each day, ideally 20-30 minutes after each meal. This makes the most of the natural squeezing that happens after eating. Your child should also go to the loo before bed. Other tips for the toileting routine are: Explain constipation to your child: This will help them to understand what’s going on in their body and what needs to happen for them to get better. Take a look at our Poo and Wee section together and the books for children about poo problems available in our shop. Have a go at playing our poo game and singing Dr Ranj’s Poo Song. Get into position: When they’re sitting on the toilet, make sure your child’s feet are firmly supported flat on a box or stool. Knees should be above the hips in a secure position. You might need a children’s toilet seat to help with this. Your child should lean forward slightly, rest their elbows on their knees and gently push out their tummy. Make it fun! We need to relax to let the poo out, so distracting your child with toys, games and books whilst they’re sitting on the loo can help. Keep these ready by the toilet, so they can sit for 5-10 minutes at a time. Stay relaxed: Gently rocking forwards and backwards and massaging the tummy in clockwise circles can help. Help the bowel muscles to push down: Laughing, coughing or blowing can help with this. Try blowing bubbles – then it’s fun too! Give lots of praise for sitting on the toilet regularly and getting into a good routine. Your child obviously won’t poo every time they go, but they should be praised for trying. For some children, being rewarded for every small, achievable step can make all the difference, so have a 'goody bag' of little, inexpensive rewards or treats at the ready. Keep a poo diary: This will help you record the different types of poo your child is doing and the time of day they do them (ideally the poo should look like a smooth sausage – Type 4 in the Bristol Stool Form Scale). By keeping a close eye on your child’s poo habits, you’ll be able to spot the signs of constipation early - download ERIC’s Poo Diary to help track your child's pooing. Be patient: It will take lots of practice to get the poo in the loo! 5. Don’t forget the bladder! The bladder and bowels are closely related. If a child is constipated their bowel may be so full of stools that it presses against their bladder and causes bladder problems such as urinary tract infections (UTIs), urgency and frequency during the day, and bedwetting. See our section on bladder problems for more information on how to deal with daytime wetting and bedwetting.