Constipation in Children: Part Three - 10 Tips for Prevention and Treatment

The following is a guideline to handle constipation in kids. Remember to talk with your pediatrician. Believe me they are familiar with constipation and want to see your child feel better.

1. Drink plenty of water: If you drink a lot of water your colon doesn’t need to take it from your food. If you have a hard time getting your child to drink then have them eat fruit. Fruits have a lot of water naturally.

2. Increase fiber: This means whole grains, fruits, and vegetables. Fiber holds in the water and can make it easier to go. But if you increase fiber without increasing water they will get more constipated!

3. Get plenty of exercise: Kids should have an hour a day. Make sure they exercise outside of school. One PE session a week is not enough!

4. Decrease refined food: Such as cracker and chips. If you don’t watch it, it’s easy for the kids’ diet to consistent mostly of refined foods. Don’t cut the carbs just make sure they are whole grains. Look at the label it should say greater than 3 or 4 grams of fiber per serving. Don’t eat “white” foods such as white bread or white rice.

5. Decrease your dairy: No more than 24 ounces of dairy in one day.

6. Limit bananas: This advice is mixed. I see so many people will say no, it causes no problem and others will say yes, it does. I’d welcome any comments that people have.

7. Get a bathroom schedule: Remember that the body wants to go to the bathroom after eating. It’s nature. Don’t fight it! Give kids plenty of time in the morning to go before school. Some kids will be constipated after starting school or camp because they withhold going.

8. Go when you need to go: Don’t ignore the urge. The colon will only expand and adjust to the stool, and then it’ll keep doing its job. The colon will extract more water from the stool, and the stool will become harder. This, for obvious reason, makes it even harder to go.

9. If your child is chronically constipated then evacuate the stool to begin with using enemas or suppositories. Don’t overuse enemas. It can mess up the colon’s natural ability to function. Stool softeners are not habit forming and can be taken for a long time without any problems.

10. Keep the stool moving by using oral agents: Such as mineral oil, Lactulose, milk of magnesia and polyethylene glycol which is also known as Miralax. Miralax and Lactulose work by keeping water in the intestine. You may need to adjust the dose because the stools can get runny. Lactulose can cause cramps. Mineral oil works by coating the stool and helping it glide out. It doesn’t taste great but by keeping it cold it can be made more palatable. Do not give mineral oil to a child under 4 years of age or a child who has swallowing problems. They may accidentally get it into their lungs and cause a serious type of pneumonia. Let your pediatrician guide you!

Good luck! Remember again that if you increase fiber without increasing water your child will get more constipated! Make a plan with your pediatrician and then stick with it. If it isn’t working call them! The may be able to tweak the plan a little and answer questions so that your child can be successful.

Sheila Cason, MD

Sources: The North American Society for Pediatric for Gastroenterology, Hepatology and Nutrition http://www.naspghan.org/

Read Part One - Constipation in Children