Constipation in kids: how to relieve this problem

Better Nutrition, April, 2005 by Mary Bove

Three-year-old Rebecca was brought to the office, complaining of constipation. Her mother reported that Rebecca had had trouble with constipation off and on for the past year. Rebecca had a small, hard stool one or two times a week accompanied by stomach discomfort and irritability.

Childhood constipation is most commonly due to functional causes--rather than an organic, physical abnormality--that include intestinal flora imbalance, a lowfiber diet, low fluid intake, food allergies, irregular bowel habits or emotional stresses. Most often, constipation occurs in combination with other digestive disturbances, including stomachache, cramps, loss of appetite and gas. Moodiness and irritability are also seen.

There are several important factors that should be addressed initially: dietary fiber, fluid intake and regular bowel habits.

Dietary fiber plays several roles in digestive health. Primarily, it provides a bulking agent, which keeps the stool soft and moist, and it encourages growth of beneficial flora. Good sources of fiber include fruits, vegetables, legumes, whole grains and whole-grain products. Processed-grain products have little fiber content and should be avoided. Encourage your child to eat foods such as nut meals or ground flaxseeds added to hot cereals, figs, prunes, blueberries, raisins, apricots, rhubarb, applesauce, wholegrain cereals, oat bran and beans. Keep it child-friendly by pureeing beans or using bean flours, which are easier to mix into recipes.

Adequate fluid intake keeps dehydration from being a contributing factor to constipation. Water, of course, is No. 1. Good choices for fruit juices, which should be diluted 50 percent with water, are black cherry, blueberry or prune. Avoid giving too much fruit juice, and don't substitute juice for fresh fruit.

Herbal teas offer a variety of flavors and can be sewed as warm or cool drinks. A favorite blend is equal parts of spearmint, chamomile flowers, fennel seeds, catnip and lemon balm. Give it several times a day warm, or, for a delicious herbal punch, mix it with an equal amount of blueberry juice.

Tummy Rub

Focus on making bowel habits regular. Work with the child to help her get in the habit of responding to the urge for stool. One suggestion is to encourge the child to sit on the toilet at the same time each day--preferably after a meal--which may help facilitate the occurrence of a regular urge. Of course, you'll want to use your parenting skills to make sure the child does not feel either rushed or marooned. Common sense applied with love works best.

And remember: Your child needs physical movement for bowel muscle health. Send her outside to play with other kids. Once she's active, you might try gently massaging her lower abdomen in a clockwise motion with massage oil to stimulate bowel activity.

Additional Hints

* Healthy bowel flora are essential for normal bowel function. The addition of Lactobacillus bifidus and Lactobacillus acidophilus to the diet supports flora colonization.

* Digestive plant enzymes can be given before meals one to three times a day to help fat, protein and carbohydrate digestion.

* Liquid cod liver oil or hemp seed oil daily, straight or mixed into food, helps to keep the stool moist and soft.

* Magnesium citrate powder, 75150 mg daily mixed into juice or applesauce, can help relax the bowel muscle and soften the stool.

* Serve oatmeal, which is high in fiber. Add 1 teaspoon each of ground flaxseeds and ground almond meal plus 1/4 teaspoon of cinnamon powder at the end of cooking. Cover, and let stand 1 minute. Figs soaked overnight and pureed can also be added to the mixture before serving.

* Common food allergens that may factor into constipation include cow's milk products, wheat, eggs, corn and soy.

Mary Bore received her doctorate of naturopathic medicine and midwifery certification from Bastyr University of Natural Health in Seattle. She currently practices naturopathic family medicine at the Brattleboro Naturopathic Clinic in Vermont.

Internationally known lecturer and author, Mary Bove, ND. offers real-life case studies from her clinical practice in Vermont.