Parenting Q & A | Constipation in Children & how to support them with Caroline O’ Connor
Constipation affects many children and is a lot more common than we think, over the years of working with families, I have seen how it impacts both the child and adult. Some experience constipation for a short period and it’s resolved without any medical assistance like laxatives, whereas others can have a tough time, for example, it can start to impact their diet, behaviour and toileting experience.
I am delighted to have Caroline O’Connor, registered paediatric dietitian, lactation consultant, mum of four and founder of Solid Start as the next guest of my expert Q&A blog series to answer the most common questions on constipation in children.
It is so informative and reassuring to know that there is a lot you can do to help and support your child feel more comfortable before having to consider a visit to the GP. While this might be inevitable at some point, Caroline certainly provides you with the reasons why this is the most ideal solution if it gets to that point when you need the extra help.
Sign up to the Preparing to Toilet Train Workshop on 16th September
Constipation in Children - Causes & Treatment
In this blog we chatted about
What causes child constipation?
How do you know when a child has constipation?
Can constipation be resolved by dietary changes only?
If so, what are the ideal foods to encourage regular, soft poos?
At what point should a parent or caregiver take a child to the GP?
What do you recommend if a parent is worrying that constipation is due to a poor diet?
Fear of pooing due to constipation is common for children, what are the top tips to avoid constipation and what are the remedies to help ease the discomfort easily?
What causes child constipation?
Unfortunately, constipation is prevalent in young children. And there are lots of possible causes,
however, in many cases, there’s no particular reason.
Some possible causes of constipation include:
Not eating enough foods that are high in fibre
Not drinking enough fluids
Stress or fear during toilet training (some children don’t like the splashback of water from the toilet when they do a poo)
Anxiety or stress at home or school
A vicious cycle of events. If your child is straining to poo, this can lead to pain and tears. This means that they often suppress the urge to go because they’re afraid.
How do you know when a child has constipation?
Constipation can show itself in different ways:
Here are 12 signs your child might be constipated!
1. Massive poos - that are much larger than normal
2. Firm poo - It may look like rabbit droppings
3. Poo accidents- When the rectum is overfull, poo can fall out
4. Bedwetting or wee accidents- Lots of poo in the bowel squishes the bladder
5. Recurrent UTIs - Bacteria from overflowing poo crawl up to the bladder
6. Extremely frequent and urgent urinating
7. Infrequent pooing - But daily pooing doesn’t rule out constipation
8. Pooing more than twice per day - A stretched out rectum lacks tone, so it doesn’t empty fully
9. Tummy pain - Constipation is the number one source of tummy ache in kids
10. Skid marks or an itchy bum - Clogged kids can’t empty their bowel fully
11. Very loose poo or diarrhoea - Some poo can ooze by the large constipation poo
12. Continued trouble toilet training or hiding to poo in their nappy
Can constipation be resolved by dietary changes only?
No, it can’t. Understandably many parents want to treat constipation with diet only rather than using laxatives. For some children, if there are lots of dietary changes to make, this may be enough. However, for other children already eating healthy, high-fibre foods making dietary changes alone may not be enough to treat constipation. Sometimes laxatives are needed alongside diet, and your GP will advise you on this.
Sign up to the Preparing to Toilet Train Workshop on 16th September
What are the ideal foods to encourage regular, soft poos?
Fibre is found in many different foods and helps your baby's poo move more easily and quickly through their bowel.
Top Tips for increasing fibre in your family’s diet
1. Serve a fruit and/or vegetable at every meal and snack
2. Choose whole grains most of the time. In your baking, try to use a mixture of white and wholemeal flour. You can also use instant oat cereal in place of some flour in muffins and pancakes
3. Use foods like beans (baked beans are handy, hummus), peas and lentils (in soups, stews, curries) in meals and as snacks
4. Leave the skin on fruits, vegetables and roast or baked potatoes
5. Add milled seeds (chia/flaxseed), ground nuts and smooth nut butter to breakfast cereals, yoghurt or in baking and cooking
6. Choose wholegrain cereals like Weetabix, Porridge, Instant Oat Cereal, low sugar Cheerios and Shredded Wheat. You can add extra fibre with add-ins like milled seeds, nut butter, dried or fresh fruit and even vegetables (like porridge with apple, grated carrot and cinnamon!)
You’ll find more information here on how to manage constipation during weaning.
At what point should a parent take a child to the GP?
See your GP if your child is showing ANY of the above signs of constipation. It may be necessary to clear a build-up of poo first before making changes to the family diet, activity and toileting behaviours.
What do you recommend if a parent is worrying that constipation is due to a poor diet?
Keep a diary of what your child eats over a week. Are they eating a range of high fibre plant-based foods? Could you add anything extra to their diet? Or could you increase the diversity of plant-based foods like wholegrains, fruits and vegetables, legumes, nuts and seeds? A registered dietitian can help you come up with suggestions for maximising your child’s diet and gut health.
Fear of pooing due to constipation is common for children, what are your top tips to avoid constipation? And do you have any remedies to help ease the discomfort easily?
Toilet Tips!
It can be hard to get kids to sit on the toilet, let alone sit properly. However, sitting on the toilet correctly helps your child (and you!) to poo more efficiently. Here are a few tips for how to do this:
• Make sure the bathroom is warm. No one likes sitting on a cold toilet!
• Use the body’s natural ‘gastrocolic reflex’. When we eat, the bowel starts to move in preparation for incoming food. So, the urge to go to the toilet is most active in the morning and about 20-30 minutes after meals.
• Try to keep to a routine, use the toilet around the same times each day, and when your child says they need to go - always respond to the body’s urge to poo!
• Stay with your child. Don’t leave them sitting on the toilet by themselves for long.
• Make sure the toilet is comfortable to sit on. It's common for small children to fear falling into the toilet, so an add-on seat is helpful for small children.
• A footstool is very important. When your knees are higher than your hips, it makes it easier for the poo to come out. This works well for adults too, try it. You’ll be amazed at the difference it makes. You can buy little stools or use any footstool that allows the feet to be higher than the hips.
• Put some toilet paper into the toilet first so that there is no splashback.
• When sitting on the toilet, your child should be able to lean forward and rest their elbows on their knees.
• Your child should be relaxed and not straining.
Sign up to the Preparing to Toilet Train Workshop on 16th September
When it comes to constipation, there is no quick fix to resolve it straight away, however, when you have found an approach or diet plan that your child responds to along with the parent or caregiver feeling more reassured, confident and in control, this will gradually take that pressure off you.
About Caroline
Caroline O’Connor is a registered paediatric dietitian, lactation consultant, mum of four and founder of Solid Start. She has over 20 years of experience working with babies, toddlers, children and families. Caroline is passionate about sharing professional advice on food, feeding and nutrition through baby weaning and feeding toddler online courses and one-to-one consultations on a range of feeding issues.
If you are feeling overwhelmed or facing challenges with your children, I am here to help, I offer tailored 1 to 1 parent support sessions and corporate parenting talks. Get in touch with me today at aoife@parentsupport.ie, or if you are interested in creating a happier and calmer home I offer a Video Based Positive Parenting eLearning Course.