Constipation in children
Natural treatment for constipation in children
Constipation is one of the most common health issues I see in clinic, especially in children.
A child is considered to be constipated when they have very hard stools or fewer bowel movements than they normally do. The firmness and frequency of bowel movements varies among children but it is generally considered normal for a bottle-fed baby or older child to do a poo every 1-3 days (or sometimes several poos a day). Breastfed babies may poo after every feed or only have one poo per week.
Regular bowel movements are an important aspect of our body’s detoxification system as they allow toxins and waste products to be excreted through the stool. When there are limited bowel movements and the stool becomes backed up in the colon, toxins end up being reabsorbed into the bloodstream and this places strain on other detoxification pathways in the body, such as the liver, kidneys and skin.
In addition to reduced bowel movements and firm stools, other signs that your child may be constipated include:
Bloating and abdominal pain
Refusing to sit on the toilet
Seeming uncomfortable or in pain when trying to do a poo
Irritability
Disturbed sleep
Reduced appetite
Contributing factors
Lack of fibre
Diet high in processed foods and low in fruit and vegetables (constipation is very common in picky eaters who prefer bland white or beige foods like white bread, crackers, white pasta and nuggets).
Dehydration
Food intolerances, e.g. dairy, gluten
Imbalance of gut bacteria
Excessive milk intake (not enough solid food)
Deficiencies in vitamin C, vitamin D or magnesium
Limited physical activity
Medications, e.g. antacids (for reflux) or iron supplements
Holding-on behaviour (resisting the urge to poo), often due to a previous painful toileting experience
Natural treatment strategies
Increase fibre intake, e.g. fruit, vegetables, whole grains, dried fruit, chia seeds
Make sure your child has at least two serves of fruit and 3 serves of vegetables every day (note: a serve of fruit is one medium apple, pear, banana or orange or two small apricots, kiwi fruits or plums and a serve of vegetables is ½ cup of cooked vegetables or 1 cup of raw vegetables)
Encourage your child to drink water before each meal or snack (and reduce milk intake)
Reduce intake of processed foods and artificial additives
Develop healthy toileting habits by encouraging your child to sit on the toilet for at least 5 minutes after breakfast, lunch and dinner, even if they do not feel the urge to go.
Keep a food and symptom diary for 1-2 weeks to try to identify any potential food triggers for constipation
Consider eliminating gluten and/or dairy to see if the symptoms improve
Give your child lots of opportunities for physical activity as this stimulates the muscles in the gut
Try abdominal massage - https://www.activcore.com/blog/how-can-a-belly-massage-help-my-constipated-child-ilu-massage
Gut-stimulating exercises - place your child on the floor or bed on their back. Gently circle their legs in a cycling motion. This stimulates the stomach muscles and intestines to move.
Epsom salt baths - Epsom salt is a form of magnesium, which can be very helpful in treating constipation. Add a cup of Epsom salts to a warm bath and let your child soak for at least 20 minutes to allow the magnesium to be absorbed into their skin and work its magic!
Consider supplementing with prebiotic fibre, probiotics and magnesium. All of these are safe for children, however I recommend seeking guidance from a health professional to make sure that you are choosing the right supplement and the correct dose.
A quick word about laxatives and stool softeners:
Many paediatricians and paediatric gastroenterologists treat constipation by prescribing laxatives and/or stool softeners. Osmotic laxatives (e.g. Osmolax and Movicol) and stool softeners (e.g. Coloxyl) can be helpful for treating constipation in the short-term, particularly if a child is in pain or distress, however these medications do not address the root cause of the child’s constipation and are not ideal to use as a long-term solution.
If your child is dependent on laxatives and/or stool softeners in order to produce regular bowel movements, I recommend you work with a healthcare professional to determine possible causes for the constipation. I also encourage you to try the above strategies to treat the constipation naturally and eliminate the need for laxatives in the long-term.
Note: all the strategies I have talked about can be used by adults too! 😀
References
Australian Government, 2021, ‘Serve sizes’, eatforhealth.gov.au, Australia, viewed 6 June 2023, https://www.health.gov.au/topics/food-and-nutrition/about/eating-well#:~:text=fruit%20%E2%80%93%202%20serves%20a%20day,to%204%20serves%20a%20day.
Health Direct, 2022, ‘Constipation in children’, Health Direct, Australia, viewed 6 June 2023, https://www.healthdirect.gov.au/constipation-in-children
Kids Health Information, 2020, ‘Constipation’, The Royal Children’s Hospital Melbourne, Melbourne, viewed 6 June 2023, ‘https://www.rch.org.au/kidsinfo/fact_sheets/constipation/
Lytle A, 2021, ‘How can a belly massage help my constipated child? Learn the “I love you” technique’, Activcore, USA, viewed 6 June 2023, https://www.activcore.com/blog/how-can-a-belly-massage-help-my-constipated-child-ilu-massage
National Institute of Diabetes and Digestive and Kidney Diseases, 2018, ‘Symptoms and causes of constipation in children’, US Department of Health and Human Services, USA, viewed 6 June 2023, https://www.niddk.nih.gov/health-information/digestive-diseases/constipation-children/symptoms-causes
Parents, 2022, ‘Foods that cause and relieve constipation in babies’, Dotdash Meredith, New York, viewed 6 June 2023, https://www.parents.com/baby/health/constipation/foods-that-cause-and-relieve-constipation-in-babies/