Fast Lane Version:
1. Consider paleo diet or at least eliminate dairy and gluten for a short time. Magnesium and/or probiotic supplement could be helpful.
2. Increase physical activity
3. 8-10 hours of sleep/nightly is key
4. Kids can get stressed too…mindfulness activities and family connection helps.
5. Get into a Pooping Routine! Set bathroom time with a foot stool, timer, etc.
6. Pursue testing if no improvement…try avoid thinking your child will just outgrow this.
The Nitty Gritty:
As a person who has struggled with digestive issues herself, I know how frustrating constipation can be. But when you have a child suffering from it, there is a whole new level of frustration. Your heart aches for their distended tummies and their cries of pain. You feel hopeless because your kiddo is at school where no one is following or verifying their bathroom routine. If it gets really bad, they start having poop accidents (I’ll explain the why more later) and their embarrassment keeps them from telling you.
AHHHH! Help!
Constipation affects up to 30% of kids and is defined as any of the following: less than 2 soft bowel movements per week, hard or large diameter stools that may obstruct the toilet, or fecal incontinence (aka poop accidents). Most people don’t think of poop accidents as a sign of constipation but it can be and here’s the science behind it…as stool sits in the rectum, water is drawn out of it, making the stool firm and harder to pass. More stool accumulates and the rectum starts to stretch to accommodate. This decreases the sensation that your child needs to poop. Eventually the stool coming down must go somewhere, and, thus, it leaks around the hard stool. Your child unfortunately cannot control this leakage (despite our thinking they can…trust me, in my times of frustration I’ve accused my child too!). While this is the conventional definition of constipation, the functional medicine world would argue having more frequent bowel movements is better for our bodies.
Investigating the cause for you child’s constipation can be frustrating as well. We hate to have our child go through a blood draw, stool test, etc. If there are no red flags (blood in the stool, weight loss, neurologic issues, etc), then starting with lifestyle changes can be a good first step. We’ll dive more into these in future articles but here is a 50 foot view:
1. Diet: Encourage a diet high in fruits, vegetables, and whole grains. When in doubt, I believe a Paleo diet is the most helpful (but also very hard to talk a kiddo into eating!). If your child isn’t quite up for Paleo, then removing dairy, bananas, gluten, rice and any other aggravating foods is a good idea. I recommend to eliminate any multi-vitamins if your child suffers from constipation. Most kid vitamins contain iron which can be constipating. I would also avoid fiber supplements…without enough water, fiber tends to cause constipation, and we all know most kids fight us on drinking water! A probiotic and/or magnesium supplement can be beneficial; however, I would always prefer to do testing first.
2. Physical Activity: Encourage your child to get at least one hour of physical activity daily. Activity helps stimulate the muscles that move food along (aka peristalsis). I am a huge fan of outdoor activity…studies prove it’s more beneficial than indoor play and who doesn’t love the sunshine and fresh air!
3. Sleep: I recommend 8-10 hours of sleep/night for most kids (some may need even more!). Sleep allows our digestive tract to rest and repair itself. There is even recent research showing the gut may play a role in controlling our sleep/wake cycles (aka circadian rhythms).
4. Stress Management: We all remember how stressful grade school, friends, sports, etc were. Mindfulness activities such as yoga, deep breathing, walks outside, etc. can be beneficial. I’m also a huge fan of staying connected as a family with nightly family dinners, game nights, praying together, and/or one on one time.
5. The Pooping Routine: Last but definitely not least! Reserve 5-10 minutes after each meal for your child to sit on the potty…and here is the key…RELAX! This means feet on a stool, book in lap, and no fidgeting. Setting a timer works great. If a body is in fight or flight mode, the last thing it will do is poop! This was one of the hardest steps for our family to accomplish because we are so busy, so be patient…overnight success will not happen…a routine takes time. Also, if your child is in school, please inform teachers of the constipation issue, so they will allow him/her to use the restroom when the urge presents. If a child is made to wait, it will only worsen the constipation.
If these steps aren’t productive, then testing is essential..remember “test don’t guess” especially with our little ones. Testing could include stool testing for good and bad bacteria, blood tests for food sensitivities, and/or breath tests for lactose intolerance or bacterial overgrowth. I also like to do routine labs for these kiddos to rule out a magnesium or vitamin deficiency, elevated iron, thyroid issue, etc.
Do you have a child who is suffering from constipation despite the above changes? If so, please contact me for an appointment…I would love to help you and your child pursue health. Become resilient, ever growing…MINT.
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