Constipation in Children

Constipation is a common dilemma in people of all ages, but is especially common in children. Constipation can include hard, painful stools that are difficult to pass, and can have multiple causes rooted in behaviour, hydration, medication and nutrition. The good news is that there are several lifestyle modifications we can implement to prevent or resolve constipation in children, and these can have other great benefits beyond their bowels.

Today we will focus on how nutrition and hydration affect bowel movements, and how this problem can be avoided with food.

What’s the scoop on poop?

As food travels down your digestive system, it leaves the stomach and enters the small intestine (sometimes called small bowel) where vitamins and nutrients are absorbed. It then enters the large intestine (large bowel) where water is reabsorbed into the body as needed. The amount of water in the stool has a big impact on the ease of its travel through the large intestine. Another key component affecting the texture of stool is fibre. In the large intestine, fibre makes up the bulk of the stool and can impact its texture.

The ideal stool is soft and easy to pass. It should have a smooth exterior and not be lumpy. It should not be liquidy or greasy- if these occur regularly, consult your family doctor. Frequency of bowel movements can vary quite a bit from several times a day to every few days. Consider your child’s normal, and if you have any doubts, discuss with your family doctor.

What is fibre?

We talked about fibre in the large intestine, but what is it, and how does it get there?

Fibre is the indigestible part of the plants we eat. Fibre can be found in grains, legumes, seeds, nuts, fruit and vegetables. There are two kinds of fibre: insoluble and soluble fibre.

Soluble fibre acts as a sponge in the digestive tract and helps slow down digestion. This allows our bodies to extract as many nutrients from our food as possible. Soluble fibre can be found in oats, barley, peas, beans, carrots, psyllium, apples and citrus.

Insoluble fibre does not absorb water, and it makes up the bulk of our stool. Insoluble fibre keeps things moving and speeds up the travel of the stool through the intestines. As you can see, both are key for a healthy digestive system. insoluble fibre can be found in whole wheat products, nuts, beans, potatoes, and cauliflower.

Earlier we talked about water, which helps keep the intestines lubricated and prevents sticky or hard, painful stools. When adding more fibre to the diet it is key to add more water to prevent the bulk from building up and not being able to pass, actually leading to constipation. Signs of too much fibre and not enough water can include bloating, gas and difficulty passing stool. The following table can give you an idea of how much of these your child needs.

Encourage regular hydration. Help them get into the habit of having a drink regularly, not just when they feel thirsty. Water is the ideal choice, but milk or fortified soymilk is also a good option. For additional flavour, add fresh or frozen berries, cucumbers, melon, or herbs like mint. Keep in mind that children under the age of 12 months should not drink water, they should get their hydration from breast milk or infant formula.

Incorporate more fruit and vegetables at their meals and snacks. Foods like melon, berries, cucumber, tomato, bell peppers, pears, citrus and plenty of others contain both water and fibre, the perfect combination for healthy bowels. Make the healthy choice the easy choice by washing, peeling and cutting fruits and veggies for the week. These can keep for several days in the fridge and can make for a quick and healthy snack.

Choose fruit pieces or whole fruit more often than fruit juice, since these contain much more fibre than juice

Look for grain products with 2-4 grams of fibre per serving. Consider making a big batch of a whole grain to serve multiple times throughout the week. Experiment with different whole grains like wild rice, barley, bulgur, and quinoa. These can be included in dishes like pilaf, stir frys, soups, salads or even prepared like oatmeal.

Mix bran flakes, nuts, seeds and berries into your child’s (or your own) favourite cereal or yogurt for extra fibre at breakfast.

Constipation can be a real “bummer”, but with a few simple changes, it can be improved. Other healthy habits like regular exercise and stress management can also help keep things running smoothly. By leading by example, you can also improve your own bowel movements and your general eating habits. It’s a win-win!

If your child continues to suffer from constipation after these changes, speak with your family doctor to discuss further options.

Sources: https://www.cps.ca/en/documents/position/functional-constipation

https://www.unlockfood.ca/en/Articles/Fibre/Focus-on-Fibre.aspx

By Laura Thibodeau, BScFN, Dietetic Intern at the Northern Ontario School of Medicine