Constipation is one of the most common intestinal problems in children, and is the number one cause of kids’ belly pain. Occasional mild constipation might be bothersome, but usually is nothing serious. But when it becomes chronic or extreme, constipation can negatively impact kids’ lives. Kids with chronic constipation suffer from bloating and discomfort which can cause them to miss school and activities, it even accounts for 3% of outpatient visits to general pediatric clinics and up to 25% of visits to pediatric gastroenterology clinics.
Chronic constipation is generally a signal that something is amiss in the digestive process. Dealing with the underlying problem is more effective than just dealing with the symptoms. Fortunately, most constipation in infants and children is not caused by serious medical disease, and can be treated with some simple changes to their diet.
Constipation can be caused by a long list of issues including:
Many cases of chronic constipation can stem from picky eating. Changing a picky eater’s diet may not be very easy. So tasteless and odorless medications like Miralax seems to offer an easy solution – just stir it into a glass of water or juice, and drink it down. But prescribing it to kids and for a long term basis is an off-label use, as Miralax is not FDA approved for use in children. According Miralax’s label – it is for use with people age 17 and over, and not for more than 7 days (without a doctor’s orders). Although many doctor’s prescribe it to children, the research on the long-term safety of propylene glycol (PEG) use in kids is limited at best. According to the NY Times, “the Empire State Consumer Project, a New York consumer group, sent a citizen petition to the F.D.A. on behalf of parents concerned about the increase in so-called adverse events related to PEG that health professionals and consumers have reported to the F.D.A. over the past decade.” And another downside to using prescription laxatives is that they only remove the symptoms, they do not identify or deal with the underlying problem causing the constipation.
The good news is there are lots of natural alternatives that are safe, effective, and offer lots of nutritional benefits. Ideally, the best way to handle constipation is with a long term foods-based approach, and try to prevent it before it happens. Because once constipation sets in, it can be habit-forming and hard to fix.
10 tips for preventing constipation/boosting digestion naturally:
1. Hydrate! Many kids who suffer from constipation do not drink enough fluids throughout the day. Without proper hydration, the stools will be hard and difficult to pass.
2. Increase Fiber.
Most Americans do not get nearly the amount of fiber they need each day. There are 2 types of fiber – soluble and insoluble. Soluble dissolves in water, creating a gel. Insoluble fiber passes through undigested, so it adds bulk. How much fiber should my child get each day? For kids ages 3-18, you should add the number 5 to your child’s age, and in general, that is the number of grams of fiber they need daily – so an average 11 year old, should have about 16 grams of fiber per day. A 6 year old needs about 11 grams. Adults need about 25 grams each day. Add fiber gradually and slowly over time, as it can cause discomfort if you add it too quickly. It is important to drink extra liquids as well when increasing dietary fiber, especially soluble fiber because it need to soak up water in order to work.
3. Identify Food Sensitivities:
When constipation is chronic, going on an allergy elimination diet might be prudent. Undiagnosed food allergies or sensitivities can cause inflammation, digestive troubles, problems absorbing nutrients, and constipation. It is also important to discover a food sensitivity because they can lead to damage in the small intestine, and many other very serious health issues.
4. Pitch out Processed & Sweetened Foods
– Processed or “enriched” foods lack enzymes, fiber and nutrients. Diets that are highly processed not only lead to constipation, but also malnourishment and hypoglycemia. Super sugary foods and drinks also work against digestion. Also – the more sweet foods a child eats, the less they will enjoy unsweetened foods like vegetables, so getting rid of the sugar for a little while helps to reset the taste buds and metabolism. High sugar consumption also raises our triglycerides, blood sugar, and increases our risk of many diseases.
5. Balance minerals –
Too much calcium and not enough magnesium can lead to constipation (it also has been linked to increased risk of heart attack, due to calcifications of the arteries). As many as 70% of Americans are deficient in magnesium. This can result in constipation, headaches, sore muscles, nerve troubles, restless legs, nervousness, and even increased fractures. Taking magnesium before bedtime is helpful with constipation. For some kids, taking magnesium before school is helpful – as it can help them to be calm in school. If you are craving chocolate, it could be your body telling you that you need magnesium, cacao is one of the highest known food sources for magnesium. You can take magnesium supplements, such as Natural Calm, or you can eat foods rich in magnesium – cacao the main ingredient in chocolate is one of the richest known sources of magnesium. You can also take magnesium salt baths – which is a wonderful way to relax before bedtime too. I like the brand Dead Sea Warehouse, they have high quality sea salt products for a reasonable price – including bath salts, soaps, and lotions. I also recommend that people toss out the table salt, and get high quality sea or pink Himalayan salt, which has many natural minerals that the body needs.
6. Boost Good Bacteria.
We need to balance out the bacteria in our gut – probiotics boosts the good bacteria, which is very important for healthy digestion, a balanced weight, and a strong immune system. Fermented and cultured foods and drinks such as kefir can provide natural probiotics, or you can add a probiotic supplement to the daily routine. Read The Importance of Good Bacteria to learn more.
7. Boost Enzymes!
The body naturally produces hydrochloric acid (HCL) and enzymes to digest foods. If we are low on HCL or enzymes, food may not get properly digested, so it will be harder to pass through the digestive tract, and also the body will absorb less of the nutrients. If you suffer from acid reflux, you might think that you need to reduce the acid in your stomach. But usually, it means you do not have enough acid or enzymes.
– kids who spend too much time in front of a screen and not out being active can suffer from constipation. Regular exercise is important for promoting regularity.
It is important to make sure your child has enough time each morning to sit and relax on the potty before going off to school. Sometimes kids will “hold it” at school, traveling, or if they are out in public. Some teachers might restrict bathroom breaks, to limit disruptions to the school day. If your child suffers from urinary tract, constipation or digestive troubles; make sure to inform the teacher so he knows to not to restrict your child’s access to the bathroom. If the teacher does not agree, bring your issue to the principal, there is a disabilities act that prevents kids who have continence issues from being restricted from using the bathroom.
One of my favorite ways to sneak lots of good nutrition, fiber and hydration into a glass are smoothies. Especially good for picky eaters – smoothies are a great way to sneak in healthy ingredients!
Orange Dream Smoothie:
Makes one 8 oz. smoothie
Put the liquid in the blender and add the chia seeds, let soak for a few minutes to soften. Then add the rest of the ingredients, blend well, and serve this delicious smoothie that tastes like an orange creamsicle! It contains probiotics, 8 grams of highly nutritious chia fiber, which promote healthy digestion, and 2.5 grams of omega 3s, which is brain food. Pour any extra into popsicle molds for a healthy snack for later. This recipe is picky eater tested and approved!
As a child, I was a picky eater and suffered from chronic constipation. But today, following a gluten-free and a mostly dairy-free diet, along with a high fiber, high plant-based diet; I rarely suffer from constipation or digestive troubles. The first thing to permanently change my digestion was the addition of 2 Tablespoons of chia seeds every day. For me, chia seeds were truly a miracle.
Digestion is extremely important to our health. Poor digestion over time can lead to problems with sleep, hormones, mood/depression, weight, and potentially serious diseases. There is an expression: “All disease begins in the gut.” Symptoms like constipation can be a warning sign that something is amiss and we need to take steps to improve our nutrition and health. Rather than removing the symptom with a prescription, we should look deeper for a solution. Promoting good digestion with a foods-based plan, is a step in the right direction towards long-lasting health.
Realize that digestion issues may take a while to resolve, and it might be a good idea to slowly ease into the changes. If the constipation and digestion issues continue to persist, it might be prudent to schedule an appointment with a holistic or integrative practitioner to see if there is an underlying issue that needs to be addressed – such as an infection, parasites, SIBO, or another issue.
Read more: Miralax, a Popular Cure, But Never Approved for Children.
“Let food be thy medicine, and medicine be thy food.” – Hippocrates
*This content is not to be construed as providing medical advice. All information provided is general and not specific to individuals. Persons experiencing problems or with questions about their health or medications, should consult their medical professional. Persons already taking prescription medications should consult a doctor before taking the above foods, herbs, vitamins or supplements to be sure there are no interactions.
Article written by Nutritionist Sara Vance, author of the book The Perfect Metabolism Plan A regular guest on Fox 5 San Diego, you can see many of Sara’s segments on her media page. She also offers corporate nutrition, school programs, consultations, and affordable online eCourses. Download her free 40+ page Metabolism Jumpstart eBook here.
©2015, all rights reserved. Sara Vance.
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This is so helpful. I have switched doctors 3 times now because they keep recommending miralax for my 16 month old who poops every 3-4 days and cries with pain by day 3. They did an x-ray and said she was impacted and put her on miralax. (I had to fight for the x-ray) prior to that they said there was no problem. (I think they would have a problem if they held their feces for 4 days at a time.) I have been extremely worried about the miralax specifically because the directions state age 17 and up and no more than 7 days. I will definitely do the smoothie and the chia seeds. It is hard when noone seems to think this is a big deal!
I can not agree more. It’s ridiculous that the medical world doesn’t have a better solution. It’s like they withhold solutions and take just the easy route first instead of the route that’s most gentle and safe for our little ones. I have been trying to help my son since 3 months old and he is now almost 5. His condition has only worsened over the years and now his body is probably addicted to Miralax. I am tired of the medical route so I am going to take this in my own hands to get him off the meds after he’s been on them since 9months. No one explained to me his condition could turn to worse things like encropsesis and make living day to day a real struggle. He has now been release from school partially from soiling his pants. Doesn’t seem fair for any involved. To the point I felt like I needed to seek legal advice. Currently, we r weaning him off meds hopefully permanently by supplementing with Natural Calm (magnesium supplement). I am trying this on me first. Other than this we do everything we are expected to do with a chronically constipated child. It’s so frustrating and it’s even harder when at first as a mom you don’t receive the support you need from others even when you step outside yourself to ask for help. Thx for this article. I also knew about the Chai seeds and feel its a great natural food based solution. There are so many more as well. Unfortunately even using food based solutions a child can still have a problem with no answers.
G – So sorry about what you and your son have been through. I hope that this information can help, keep me posted!
Jennifer – Thank you for your comments, and I hope your daughter is doing better!
Actually, your article would be a lot more helpful if you’d investigate why the body doesn’t produce enough hydrochloric acid, and thus how to restore natural HCL production. I hope you’ll do another article on this topic.
GoodBelly contains gluten in the form of barley malt. Just an FYI on the smoothie recipe.
Thanks – I have revised the recipe!
This is a great post. I have a few questions:
1 – How much water should they drink daily? I have heard half of the child’s body weight?
2 – Different docs have suggested grape juice, apple juice, or prune juice. My son won’t drink the prune juice (but he does eat 3-4 prunes daily), but we have started letting him drink apple or grape. What do you think about those? Should we quit those and stick to water?
3 – How much magnesium and what form do you like? We started a pill (250mg), but we are not sure how much is ok. We try to get a lot of natural magnesium from beans and seeds, etc. but I don’t think it’s enough.
If he will eat them – whole prunes are great, better than apple or grape juice. Half body weight in water is roughly a good guide – also foods with high water content are great – like cucumbers, watermelon, etc. Magnesium dose can be determined by bowel tolerance – if they get loose stools, back off. I like citrate, rotate, malate, or glycinate forms.
How can I add the fruits, veggies and other foods to my 2 year olds’ diet when he is SO picky and won’t even touch most new foods?
Check out this article I wrote, it offers some additional ideas:
What I did for my daughter for a long time? Sneak vegetable purees into foods. It takes a bit of effort, but it worth it. Do not give up on your picky eater. Also – have you tested his/her zinc levels? That can often lead to picky eating. You can use a zinc status test.
This is a fantastic article. Our daughter has been on Miralax since she was an infant! Our doctor told us it was fine and then my husband read about a recent study related to the PEG levels in it. We immediately stopped using it and asked her pediatrician for suggestions. In my search for natural laxatives, I found your very informative article. In addition to our daughter’s picky eating habits, she is also allergic to peanuts, tree nuts and most seeds so as much as I was excited to read about the chia seeds, we can’t use them. Are there any alternatives? She is able to tolerate flaxseed. Thanks so much!
Thanks Kelly! Flax seed is a good alternative to chia seeds, and offers similar ALA omega 3 benefits, as well as fiber – but it does not have the same hydrophyllic properties as chia seeds, so it does not soak up quite as much water to create the same kind of gel texture – nor is it as stable/does it have the same antioxidant capacity as chia seeds (so flax should be refrigerated after it is ground to prevent it from going rancid). And it is important to note that flax does contain lignans – considered phytoestrogenic – but the majority of research points to it being a positive influence – because it tends to balance out hormones. Here is more info about that: http://www.med.nyu.edu/content?ChunkIID=21801
Sara thank you so very much!! For all this information. My twins will be having better night sleep every night without the Miralax and acid reflux meds.
Hi Claudia! Glad you found it helpful – I hope some of the suggestions work for your twins. Just remember – digestion issues typically are not “cured” overnight. So it might be prudent to wean off slowly while gradually implementing the new changes.
I have an 11 year old boy diagnosed Aspergers in the first grade. He has dealt with constipation all his life and within the past 3 years it has been really severe and life altering. He’S been seeing the “best” meteorologist around for the past two years. Problem is: He’S 2 hours away and we don’t get to see him often. My son has been on Miramax now for 2 years or more and it’s not helping. I’m at my wits end. It is so bad. He is in so much pain when he’s constipated. Headaches, shaking, numbness in the lower extremities…He frequently wears pull ups…at the age of 11! I just don’t know what to do to help him. We try to eat healthy, but I really need more help than just a few tips on healthy eating. I myself struggle with my weight and eating healthy. The poor kid has been dealing with this for so long. My gut tells me it’s something more and everything we’ve tried so far is not working.
correction: that’s enterologist not meteorologist
I am sorry for your son’s struggles. Has he had extensive testing done? Food intolerance testing, checking for parasites or an infection? Even thyroid? If it has been over a year, it might be worth repeating. Are you using magnesium? That can be very helpful once the right dose is found.
My son has severe constipation and Dr says Miralax and GERD meds not helping at all he even soils his pants now as well
Who does parasite n food intolerant test?
Hi I found this so useful I have got a 8 year old who has been suffering for 3 and a half years with this condition constantly off school and missing activities I am certainly going to give the dairy and gluten free a go starting Monday try cut some of his meds down as he’s on 6 a day many thanx
When my boys were young and struggled with constipation, we found that adding a fruit and veggie concentrate (Juice Plus+) and increasing water did the trick! We had been using miralax and I was so happy to get rid of that! As a pediatric OT, I love offering Juice Plus to my kiddos who are picky eaters… fills in that nutritional gap!
Please also consider fructose intolerance and/or malabsorption when dealing with these issues
I wanted to address anyone who has written about using miralax. My daughter is 6 now and I have been dealing with her constant constipation since age 2. we did miralax for a year with horribly inconsistent results. the doctors told us more fiber, more liquid etc. nothing every really seemed to be consistent for her. at age 5, a friend suggested I try using probiotics and nothing else. and that’s exactly what I did. I can’t tell you the difference in just a few days. it was amazing. after dealing with this for years and being horribly frustrated with the doctors giving us no options, this was a life saver! she has been on them for over a year now and goes every day. I now this might not work for everyone, but for us it’s made her life and ours sooo much better! probiotics are nothing but great things for our bodies, so trying can’t hurt! hope this helps someone who might be having the same problems!!
Nicole – thanks for sharing, and I am so glad that probiotics worked so well for your daughter! It is such a tragedy that more doctors do not recommend them/see the benefit. Although probiotics alone may not work for everyone, it is definitely an important part of a natural approach to healthy digestion – and offers so many other benefits too – including an immunity boost.
© copyright 2016 Sara Vance