The woman’s voice over the phone was urgent. “My 4-year-old grandson tends to get constipated. What can I do to help?”
Constipation afflicts up to 30 percent of children. It tends to run in families, leading some researchers to look at genetics or simply a poor diet in common. In addition, picky eaters who thumb their noses at fiber-rich fruits, vegetables and whole grains may become constipated.
It’s not uncommon for those who eat few high-fiber foods to also be excessive milk drinkers. Little ones who fill up and obtain a majority of their calories from milk may eat very little actual food, leading to the problem.
Constipation may also result from undiagnosed celiac disease, according to Chicago pediatric feeding specialist Lara Field, MS, RD, who blogs at feedkids.com. “Celiac disease, sometimes labeled gluten intolerance, has about 300 associated symptoms, one being constipation.” Field says it’s vital for proper testing purposes to determine if this diagnosis can be made prior to initiating a gluten-free diet.
When it is common
There are three periods in a child’s life to look out for, according to Field, mom to a toddler and an infant.
- Transition to milk-containing formula and foods. Babies with a milk protein allergy/intolerance can become constipated at any time during infancy-birth-12 months. Removal of the milk protein will resolve these symptoms
- Transition to table foods. At 12-15 months, when toddlers transition from primarily drinking for their nutrition to eating, they may not be getting enough fiber due to picky eating.
- Transition to potty training. From age 2-4, many kids withhold their stool due to fear of potty training. Parents must stay vigilant. If this habit continues, it could cause future problems, such as stool impaction.
Dietary advice for all
Whether or not constipation is a problem, children should consume at least three to five servings of fruits and vegetables every day-and as many whole grain foods as possible.
Serve whole fruit rather than juice. Fruit can be fresh, frozen or canned. Fruits especially high in fiber are raspberries, blueberries, blackberries and strawberries. Buy frozen-they are easy to keep on hand for smoothies, stirred into yogurt, as toppings for hot cereal or on top of pancakes or waffles. Pears are also fiber rich.
Abandon refined starches, such as goldfish, pretzels and crackers that are made primarily from white or “wheat” flour, Field recommends. Look for whole grain choices instead. She says children can be taught to enjoy whole grains. Choose brown rice (there are several brands you can cook in 90 seconds), whole grain pasta and whole grain cereals.
Beans are great finger foods for tots and are wonderful choices to toss into pasta and soup.
Serve veggies and dip, such as hummus, as a snack or part of a meal.
If your child does become “stuck,” here are a few suggestions:
Serve two ounces of fruit nectars, such as pear or apricot, or prune juice two to three times per day.
Offer your child a probiotic-rich yogurt, such as Activia.
Limit cheese as it can be constipating for some.
As to the worried grandmother? I reassured her that her grandson’s problem was not uncommon and suggested she seek out a registered dietitian to review his diet.
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Christine Palumbo, a
mother of three, is a registered dietitian in Naperville and
an adjunct faculty member at Benedictine University.