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Dealing with Chronic Constipation in Children.

Constipation is a common problem in children, and one that can often be corrected at home. Common causes of constipation include lack of fiber in the diet, mild dehydration, pain with bowel movements, behavior, stress, and lack of physical activity. Certain medications and supplements may also cause constipation. The age of your child should help you determine which of the above causes is most likely. If constipation is a new problem for your child, your child is complaining of pain and has a distended abdomen or fever or it has been more than 4 days since having a bowel movement, your child should be seen by his or her healthcare provider.

If you the constipation is not severe enough to see the doctor yet or your child has already been evaluated and you want to help ease the discomfort, here are some age-related suggestions.

Newborns and Infants:

Breastfed infants may go for several days between bowel movements, which is completely normal as long as they don’t appear to be in pain and their abdomen is not distended. Babies use breastmilk efficiently, which is why it can go through the system with so little waste. Feeding infants probiotics (good bacteria) can ensure a healthy gut and prevent future problems with digestion.  Just be sure you get a high quality probiotic specifically formulated for infants (to ensure that it is not contaminated with bad pathogenic bacteria).

When solids are introduced, bowel movements will be more solid and are more likely to be uncomfortable. Allowing babies to eliminate in the warm bathtub can help ease the discomfort and prevent behavioral constipation. You should never give laxatives to babies unless directed by a qualified healthcare provider. Gentle massage of the abdomen in the clockwise direction (when facing the baby) can also be soothing and help move the bowels.

Toddlers and Preschoolers:

Behavior and diet are the two most common reasons for constipation in this age-group. In some cases, the problem starts around the time of potty training, when the child learns that elimination is something they can control. It is important for parents to realize that being too forceful about potty training may lead to a child holding their bowel movements, eventually resulting in painful elimination and a vicious cycle of constipation. It is healthier for your child to have a regular elimination schedule, even if it means they don’t use the toilet for this purpose (they will, eventually).

Diet is another common cause of constipation in toddler and preschool aged children. This can be partly behavior related (child is a picky eater and learns that food intake is something they can control), but ultimately, the parent determines the food options for the child and should always make an effort to offer healthy foods such as fruits, vegetables, whole grains and lean meats. Packaged and processed foods low in fiber and nutritional value should be avoided altogether. Lack of fiber and fluids can lead to constipation–a good standby to have on hand is prune juice, since it is a safe, natural laxative.

Food sensitivities may also cause constipation (dairy and wheat are the top two pediatric food allergies/sensitivities). Probiotic supplementation can also be helpful. Also, foods fortified with iron or multivitamins containing iron may contribute to constipation–talk to your child’s healthcare provider if you have specific concerns about your child’s nutrient intake. Essential fatty acids, specifically omega 3 fats, found in fish oil may be helpful. One teaspoon daily is a typical dose, but you should follow instructions on package and/or consult a healthcare provider to find out what is best for your child.

School Aged Children:

Lack of physical activity is becoming more common in this age group. Children should have at least an hour of physical activity daily in addition to recess and PE at school. Of course diet may also play a considerable role and should be addressed in conjunction with physical activity.

Stress may also be part of the problem. Encouraging open communication with your school aged child can help provide an outlet for concerns and anxiety they may have and give them healthy coping mechanisms, so that stress does not result in physical ailments. Some school aged children may even be on regular prescription medications that can contribute to chronic constipation. You should talk to the prescribing healthcare provider or a pharmacist to find out more information about side effects of medications.

If you are desperate enough to give your child laxatives, you should talk to a Naturopathic Doctor or Pharmacist about natural options. Magnesium and Vitamin C are both nutrients that can help promote bowel movements with minimal side effects. Herbal laxatives can be just as dangerous as pharmaceutical laxatives if taken incorrectly, which is why it is best to seek the guidance of a trained healthcare professional if the constipation gets to this point.

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