Q: Help! I think my child is seriously constipated!
A: Constipation is more frequent in kids than most of us think, and it comes in many forms — infrequent hard stools, but also large stools, intermittent abdominal pain and even urination and bedwetting problems.
If you’re not sure if your child is suffering from constipation, check out the Bristol stool chart online: It’s optimal to have at least one stool every day that’s Type 4 or softer. (A chart at goodmix.com.au can be posted in the bathroom to help kids know when to consult a parent about worrisome stools.)
If your child might be affected, remember everyone can benefit from bumping up healthy habits like these:
- Eat at home: Family meals at home are guaranteed to pack more fiber and whole foods than eating out or on the run.
- Increase water: Drink at least ½ ounce of water per pound of body weight per day: A 50-pound 7-year-old should drink 25 ounces of water daily. Don’t forget a glass of water with breakfast! Teach your kids that their urine should look like “light lemonade.”
- Increase fiber: Add ground flax seed to muffins, pancakes and oatmeal. Use chickpea, lentil, quinoa or high-fiber pasta. Prunes are a natural laxative, so give prune juice or soak some dried prunes in water and hand over these juicy treats. Other “P” fruits, such as pears and peaches, will help.
- Be wary of dairy: Some gastrointestinal tracts are sensitive to dairy, so consider swapping out that glass of milk at dinner for water. You might also consider a dairy-elimination trial. Kids can obtain calcium through alternative milks, nuts, beans, greens or supplements.
- Stay active: Exercise not only moves the arms and legs, but also the gastrointestinal tract, so keep it all moving!
- Set aside toilet time: Make sure your child has time during the day to relax on the toilet. Being constantly on the go doesn’t give the parasympathetic nervous system a chance to “rest and digest.” Children may need a daily routine such as a 10-minute story or screen time on the toilet.
- Choose the right potty: See how unstable the child above is? Make the toilet a stable place to sit. Floor potties for little ones are more stable than toilet seat rings. You can also elevate kids’ feet with a stool, such as a Squatty Potty, a stool that straddles the toilet and raises the feet (see below image), putting the colon in a better position for elimination, which can also be useful for adults.
- Magnesium: When constipation becomes an ongoing problem for your child, talk to your doctor about adding magnesium and probiotics. Magnesium is found in foods such as nuts and seeds, beans, quinoa, avocados, bananas, figs, dark leafy greens and dark chocolate. Magnesium can be absorbed through the skin by adding ½ cup of epsom salts to a bath tub. Ask your doctor about a daily magnesium citrate supplement (typically 50 to 200 milligrams a day for kids), which has also been associated with less anxiety and improved sleep.
- Probiotics: Obtain probiotics through foods — kiefer, fermented miso paste broth, real pickles (not shelf stable), tempe or sour kraut — or give your child a refrigerated probiotic supplement (liquid, powder or chewable).
- Aloe and vitamin C: You can also try aloe vera juice (add real lemon juice and dark honey or mix with mango juice as a treat). Vitamin C softens stools and comes in chewable tablets or powder (200 to 500 milligrams a day).
- See a doctor: If constipation causes acute symptoms such as abdominal pain or a painful/bloody stool, your child’s doctor should be involved to consider treatments such as polyethylene glycol, a suppository or an enema.
When it comes to constipation, be aware of “transition” times when it can creep up, such as starting school or traveling. Above all, be aware of your child’s routines, eat real food and keep your child’s gastrointestinal tract moving!
Dr. Allison Golnik is a board-certified pediatrician who cares for children and teens at Fairview Clinics–University Children’s.