From infants to teenagers, constipation seems to be a problem for so many kids! I had a visit with a 9 year old and her mom about her stomach pain related to constipation problems. As soon as I left the room I realized that Dr. M was seeing a 2 month old for ongoing constipation issues. Then, at the end of the day, Dr. T’s first call of the evening came in before we ever left the office, and it was about a 3 month old with constipation problems. So, you see, this is a daily problem in pediatrics. Anyone that works in pediatrics will tell you that we talk about poop everyday, sometimes all day. Inadequate nutritional intake and hydration is usually the problem.
In my house, my kids are 2 for 2 on this topic. Drew Elizabeth has been as regular as clockwork until just a few months ago. I’m sure most of you remember my Paranoid Mom post about Drew Elizabeth’s chest pain. She has never had a problem in the past, but in the past few months she hasn’t been eating her veggies as she should, and as she used to for the past 5 years. Kids…I can’t always explain why they do the things they do… I usually have more problems with my own than with yours!
My poor Joshua has had constipation problems since he was an infant. Joshua is the child that taught me all about children’s constipation. Well, Joshua and a PNP GI specialist ! Joshua eats an apple almost everyday. He loves apple slices with cinnamon; I highly recommend this, it’s great for the bowels. Even with adequate fruits and veggies, Josh still doesn’t drink enough water (hence, the importance of hydration) to keep himself regular. Poor Josh has needed Miralax more often than not in the past few years. Miralax is a stool softener that can be added to any drink to help children with constipation.
Most kids do not eat enough fruits and vegetables. For proper nutrition information, you can check out Let Them Eat Cake…For Breakfast?? Not only do most kids need to eat more fruits and veggies, they need to drink more water. Yes, I’ve tried to cover that too, you can read more about hydration in The Importance of Hydration. If adequate amounts of fiber and hydration don’t help your child with their constipation problems, I would recommend an evaluation with your child’s medical provider. Ongoing constipation can cause the large colon to expand and cause nerve damage. This can be reversible with long term treatment (6-12 months) with Miralax.
By definition, constipation is having 3 or fewer bowel movements in a week that are hard, dry, and usually hurt.
A few facts about constipation:
- When kids are constipated, they usually eat less.
- When kids are constipated, they will usually have stomach pain, and usually on the left side.
- When kids are constipated, they may have nausea and vomiting.
- When kids are constipated, they may have more urinary incontinence (accidents), urinary frequency, and bedwetting.
- High fiber foods: fruits and vegetables (the crunchier, the better), beans, whole grains, brown rice, popcorn, baked potato w/skin, berries, bran cereal, oatmeal. (The one fruit to avoid with constipation is bananas, they can make stools harder.)
- Drink more water!!
- Decrease processed foods, like carbohydrates made with white flour.
- Getting normal exercise can help with bowel movements also.
- Do not rush potty time. Children will often not take the time that they need to sit and eliminate their bowels.
- Infants will frequently have temporary constipation problems when they are transitioning to new foods such as cereal, or from breastfeeding to formula feeding. Do not give cereal under 4 months unless instructed by a medical provider.
- In infants, try a couple ounces of 100% apple or pear juice, if this doesn’t work, you can try prune juice. Baby juice does not need to be diluted, adult juice should be diluted with half water.
- Abdominal massage. I recommend abdominal massage to all the infants I work with that have constipation issues as a first line treatment! Massaging clockwise around the belly button and then doing the I Love You massage can work wonders for infants. With the I Love You massage, start with a few strokes of the I (left of belly button), then the L is upside down (above and to the left of the belly button), and then the U (around the belly button). This helps massage the large bowel, and can be quite helpful. Be sure to use mineral oil and apply a moderate amount of pressure. Most babies will enjoy this once they start to relax.