Chronic constipation affects 15-30% of Canadians with the majority being children and the elderly. Only a small portion of parents actually seek medical support for their kids. At Ignite Nutrition our Pediatric Dietitian is an expert in digestive disorders and pediatric nutrition. It is common to find a lot of misinformation about constipation. Keep reading to learn more about nutrition and lifestyle tips for constipated kids.
What is constipation
Constipation is generally described as having fewer than 3 bowel movements per week. Chronic constipation would be if your child has infrequent bowel movements or struggles to pass stool for several weeks or longer.
What is a normal bowel habit?
As dietitians, we often get asked a lot what is a normal bowel habit. Here is a list of completely normal stooling behaviours:
It is perfectly normal for your baby or toddler to grunt or have a pink/reddish face when having a bowel movement.
Bowel movements will start to decrease in frequency at around 2 months of age to 3 years. You will notice the new norm will be 1-3 bowel movements per day. Children that are 3 years of age and older should be having at least one bowel movement a day.
The colour and thickness of their poops will change dependent on what they eat. You will see a noticeable change in colour, smell, thickness or texture when they go from breastmilk or formula to cow’s milk and then eventually to solids.
Indications of constipation in kids
As dietitians, we often get asked a lot what constipation looks like in kids. Here is a list of indicators of constipation:
- Passing fewer than 3 bowel movements per week
- Dry or hard pellet like stool
- Straining when trying to pass the stool
- Pain while passing stool
- Abdominal pain
What are some causes of constipation?
Dietitians often get asked what the main causes of constipation are. Parents often want to know the best way to prevent their children from becoming constipated. Here is a list of common causes of constipation:
- Inactivity or low activity
- Low fibre diet
- Dehydration
- Fear after a painful bowel movement – some kids will try to hold the stool in for fear of pain if they’ve been struggling to pass their stool
- Fear of using the bathroom in certain places or situationally
Dietary strategies for constipation in kids
When it comes to dietary strategies fluid and fibre are going to be your best friend in combating constipation.
Fibre and Fluid
Fibre and fluid work hand in hand when combating constipation. It is important to increase fluids as you increase your child’s fibre intake. It is also important to slowly increase fibre to allow their bodies to adjust to it. There are two main types of fibre soluble and insoluble fibre. Soluble fibre forms a gel and slows down digestion, while insoluble fibre is indigestible and helps to bulk up the stool and push it through the body. Insoluble fibre helps to improve symptoms of constipation and is found in whole grains, fruits and vegetables.
Recommended fibre intake:
- Children 1-3 years of age: 19 grams per day
- Children 4-8 years of age: 25 grams per day
- Girls 9-17 years of age: 26 grams per day
- Boys 9-13 years of age: 31 grams per day
- Boys 4-17 years of age: 38 grams per day
A few of my favourite ways to bump up fibre in children’s diet are:
- Adding ground flax or chia seeds to homemade muffins, or banana bread
- Try chopping up raw vegetables and fruit so they are a easy go-to snack
- Making trail mix with nuts or seeds and dried fruit
- Switch white based breads, pasta, and rice for whole wheat products pasta, bread and brown rice
Fluid
Ideally, the majority of fluid should come from water. The recommendations for fluid are:
- Children 1-3 years of age: 4 cups per day of fluids
- Children 4-8 years of age: 5 cups of fluids per day
- Children 9-13 years of age: 6-7 cups of fluids per day
- Children 14-17 years of age: 7-10 cups of fluids per day
Other foods that can help with constipation
Certain foods are helpful in managing constipation the following are the most common foods to help with constipation.
Prunes
Prunes are one of the most commonly known foods to help with constipation. Prunes a good source of insoluble fibre as well as sorbitol which is a natural laxative. 3-4 prunes for little ones a day can help to alleviate constipation. Prunes can be incorporated into muffins, zucchini or banana bread, energy bites or morrocan spiced stews.
Kiwis
New evidence has shown that 2 kiwis a day can help to improve constipation as they are high in an enzyme called actinidine which increases movement in the digestive tract. Kiwis can be added into fruit salads, fruit kabobs, kiwi sorbet or smoothies!
Lifestyle changes that can improve constipation
Physical activity along with increasing fibre and fluid in the diet can help with decreasing the amount of time it takes for food to move through the body. Children and babies should be active daily listed below are the Canadian Physical Activity Guidelines.
0-1 year of age
- At least 30 minutes of tummy time per spread out throughout the day for little ones not yet mobile
- No more than 1 hour at a time in a stroller, or high chair
Toddlers 1-2 years of age
- At least 180 minutes of physical activity throughout the day more is better
- No more than 1 hour at a time in a stroller, or high chair
Preschoolers 3-4
- At least 180 minutes of physical activity throughout the day more is better, with at least 60 minutes being energetic play
- No more than 1 hour at a time in a stroller, or high chair
Ages 5-17
- At least 60 minutes of physical activity throughout the day more is better
- No more than 2 hours at a time sitting, trying to break up sedentary time
Medication
There are pharmalogical medication options that can help with treating or managing chronic constipation in kids. Pharmalogical medication may include laxatives or motility agents. It is important to talk to your family doctor or pharmacist to find the right medication for your child.
Stress or anxiety
Stress or anxiety can certainly make bowel issues much worse by disrupting the gut and brain connection which can lead to constipation. Stress itself can lead to stool withholding, and fear of going to the bathroom can worsen constipation. If you think your child is struggling with stress or anxiety we have an amazing psychologist on our team that can help your child better cope with their stress.
When to seek medical help for you child’s constipation
While constipation isn’t necessarily harmful, there are a few red flags to watch out for when it comes to your children’s bowel movements if any of the following occur it’s important to seek medical help:
- Blood in stool
- Blood when wiping
- Fever or vomiting
- Dehydration (dark urine, significant decreased number of wet diapers, dry skin, dry lips, and/or sunken eyes)
- Tears in skin around the anus
There are several things to consider when talking about chronic constipation. Your pediatric dietitian can help create a customized plan with practical tips that fits your child’s and family’s need to get them feeling their best! Book an appointment with our pediatric dietitian today!
Categorized: Kids Nutrition
