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Some signs to look out for are:
Fewer bowel movements than normal (less than 3 bowel movements per week in a child over 3 years of age)
Pain and straining when passing stools. When your child holds stools in or avoids going to the loo for a long time, they become hard and dry. This makes them hard and painful to pass. This can make your child get anxious and upset when trying to go to the toilet for a poo
Tummy ache. The build up of stools in your child’s bowels can give them cramps and make them feel bloated and queasy. This will go away after your child does a poo
Small, dry, hard stools. The bowel removes water from the stools (normal stools are usually about 70% water). This means that if the stools remain in the bowel for too long, they dry out and become hard
Avoiding the toilet. Your child may try to avoid going to the toilet
Not having any urge to do a poo. If your child becomes constipated for a while, they may not get the urge to pass a stool because the stools build up in the rectum and stretch it. This means that it takes more stools to make it full enough to trigger the need to go to the toilet
Feeling that a bowel movement isn't finished. If your child's stools are dry and hard to pass, some can stay in the bowels after a bowel movement so they may feel like they still have to go
Sore bottom. The skin around the anus can tear and become sore and cracked if your child has to strain. You might notice bright red blood or light red streaks on your child's stools or underwear. Treating your child's constipation should help by making the stools softer and allowing the skin to heal
Unpleasant smell. If your child is holding in stools, they may pass wind
If your child has more severe constipation, they may also get these symptoms:
Dribbling urine
If your child is constipated, the stools in your their bowels can press on the bladder and the muscles that control urination causing them to dribble urine into their underwear or to make them need to urinate more often than usual. They may also wet the bed.
Leaking of liquid or loose stools
When large stools get stuck and block your child's bowel, liquid stools above the blockage can flow around it and out causing them to leak watery stools into their underwear. This is often the first sign that parents are aware of that indicates their child has a problem with their bowels. Children can be constipated for many months before the soiling starts.
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