Constipation: Q & A
Is constipation common?
Babies and infants often suffer from constipation (sometimes swinging between constipation and diarrhoea) and up to one third of children aged 3-12 years will report constipation in any given year.
How often is “normal”?
It is healthy for children to have one or more well formed bowel movements a day that they do not have to strain.
Why does my child get constipated?
There are a number of reasons that a child may suffer constipation
Possible cause: Not enough fibre in the diet
what to do: Eat lots of fruit and vegetables – raw, cooked and pureed. Some particularly good choices are prunes, apricots, kiwi fruits, apples with their skin, broccoli and celery. Beans are very high in fibre as are porridge oats. Eating a small piece of aloe vera plant (1-2 cm) or adding linseed/flaxseed, slippery elm or psyllium to breakfast cereal can aid in moistening and adding bulk to the stool.
Possible cause: Food intolerances
What to do: The most common food intolerances implicated in constipation are to soy, cows milk or gluten (found in bread and grains). If you suspect that a food intolerance may be aggravating your child’s constipation you can see a qualified practitioner who can test to find which food(s) are the cause.
Possible cause: Medications and antibiotics
Antibiotics disrupt the gut bacteria and can result in constipation (and/or diarrhoea) for months and even years afterwards. Medications such as opiates, Phenobarbital and tricyclic antidepressants prescribed for children with developmental or behavioural disorders can also cause constipation.
What to do: If your child is taking antibiotics they should ALWAYS take a good probiotic at the same time or directly following the course of antibiotics. This helps restore the good gut bacteria, preventing constipation/diarrhoea and boosting the immune system so they don’t get sick again. If they are on other medications you might like to discuss the side effects with your medical practitioner. You can also minimise the side effects by ensuring a diet with plenty of soluble fibre, regular exercise and eliminating food intolerances.
Possible cause: Sluggish liver or low bile production
What to do: Eat plenty of bitter vegetables that stimulate bile production. This includes things like rocket, kale, endives and lemon. Dandelion herbal tea gently stimulates the liver and can be had warm or cool mixed with honey or juice for children. Drinking the juice of ½ a lemon mixed with 1 tablespoon of olive oil can also relieve constipation caused by low bile production.
Possible cause: functional constipation
Sometimes due to a previous bad experience of constipation, children avoid defacating because of fear of the pain, which in turn leads to further stool retention – this is called functional constipation and is 3 times more likely to occur in boys than girls.
What to do: If this has been happening for a while your child will possibly need the assistance of some gentle laxatives or an enema, but this should always be done under the supervision of a qualified medical practitioner. Strong laxatives are not recommended for young children and can cause extreme fluid loss and dehydration. Even once their constipation is resolved and you are ensuring a diet high in fibre and regular exercise, your child may avoid defecating from fear of the pain they remember. You may need the assistance of an occupational therapist as you implement strategies to help them overcome this fear.
Possible cause: Other causes
Hypercalcaemia (high calcium levels in the blood), hypothyroidism (low thyroid function) and lead toxicity can cause constipation.
What to do: If you have eliminated all other causes of constipation and suspect there may be something more serious causing your child’s discomfort, see a qualified practitioner to assist with testing for and treatment of these conditions.