“A child who’s eating, drinking, and playing rarely needs an emergency department for their poo.” Constipation is one of the most common reasons parents seek urgent care and one of the least likely to require a hospital work-up. A calm framework helps separate reassurance from red flags. 🍏 1️⃣ The well-looking child is your anchor If they’re: Eating and drinking Playing normally Sleeping okay Walking around comfortably …their bowels can almost always be managed safely at home or in primary care. 🚫 2️⃣ Not all “no poo for days” is dangerous Kids can go: 3–7 days between stools Change patterns with diet, illness, routines Hold stool because of toileting anxiety It’s uncomfortable, not usually unsafe. 🚨 3️⃣ When bowels do need escalation Constipation is usually benign, but watch for red flags: 🚩 Severe abdominal pain not settling 🚩 Vomiting (especially bilious) 🚩 Abdominal distension that looks tense/abnormal 🚩 Weight loss or failure to thrive 🚩 Ribbon-like stools (possible obstruction) 🚩 Blood mixed through stool (not just on wiping) 🚩 Delayed passage of meconium (<48h) in newborn history 🚩 Neurological symptoms or concerns for Hirschsprung’s If a child looks unwell, pale, listless, or in persistent pain → get help. Context is everything. 🧃 4️⃣ First-line management that actually works Osmotic laxatives (e.g., Movicol) Plenty of fluids Regular toileting routine Encouraging movement Treating withholding behaviours gently Education for parents: this is a slow fix, not a quick win Most constipation needs time + consistency, not urgent care. ✨ Clinical pearl: If the child is well, the tummy is soft, and there’s no vomiting you’ve got time. Constipation can be uncomfortable, but it’s rarely an emergency. Eric.org.uk is a great resource to use for parents