Baby struggling to poo? How to cure constipation in babies & children
As a mother and dietitian, I often deal with chronic constipation in children and infants. Two out of three of my own babies suffered for months after starting solids. It’s difficult to watch your little one in pain while trying to pass stool because they are so backed up!
In this post, I’ll share tips for dealing with constipation in kids from diet to fluid and laxatives for kids.
What is constipation?
The definition is the first thing to assess if you think your young child is constipated. The Canadian Pediatric Association defines constipation as “ bowel movements that occur less often than usual, hard and dry, and/or painful or difficult to pass.”
So it’s not the frequency of bowel movements as much as the consistency. Your exclusively breastfed infant isn’t constipated when they don’t poo for two weeks, as long as their poo is regular breastfed-baby-poo consistency!
Causes of constipation
Constipation in infants and children can be due to potty training, starting daycare or starting solid foods. It seems a tough transition for most babies to go from breastmilk to starting solids.
If constipation is a constant problem (chronic constipation), take your baby to the doctor to make sure there is no medical condition or underlying causes. Especially if your babe also has more symptoms of severe constipation like fever, abdominal distention, has stopped eating, has blood mixed with stool, slow weight gain or weight loss.
As for diet, here are some natural foods and supplements that can help prevent functional constipation:
Natural Laxatives for Kids
1) High Fibre Foods:
Insoluble fibres like bran bulk up the stool. The old dietary fibre recommendation that I often still use is your child’s age +5g per day.
The newer Dietary Reference Intakes include all fibre in the child’s diet (including extra fibres added to many foods now, like inulin). These recommended intakes are 19g of fibre per day for a 1-3-year-old and 25g per day for a 4-8-year-old.
As many adults struggle to get this amount of high fiber foods, I feel this level of fibre intake is too lofty a goal for young children. Besides, their tummies are small, and 19g of fibre wouldn’t leave them hungry for more calorie-dense foods.
But offer one fibre-rich food at each meal, and your child should get adequate fibre. Here are some examples of high-fibre foods:
- Fruits and vegetables (with the skins on),
- Whole grains instead of refined (try this Apricot Oatmeal Bran Muffin),
- Beans and legumes (these are the best source of fibre!)
- Ground Flax: add 1 Tbsp per day to a smoothie, oatmeal, yogurt or applesauce.
Note: If you’re increasing fibre, make sure FLUID is increased along with fibre to push things along!
Water is the only thing that helps my babies get over their constipation. Not fibre, juice, prunes – just simple water.
My youngest boy refused to drink from an open cup when he was a baby (boob-aholic), but I found he would take water from a dropper just fine.
If your baby or child doesn’t drink much (or any water), give it a try to increase even by an ounce for young ones. For older kids, the American Academy of Pediatrics recommends 4 cups of fluid per day for a 1 to 3-year-old and 5 cups for a 4 to 8-year-old.
Apple juice, pear juice, or prune juices help draw water into the bowels, act as a stool softener, and prevent painful bowel movements. It’s the sugar they contain called sorbitol that accomplishes this.
Offer ¼-1/2 cup (2-4oz) juice per day for little ones with a meal. You can dilute it with 1/4-1/2 cup water for extra flid if they drink it all. And we all know that plain old prunes are a great natural laxative! Here’s a Prune Energy Ball recipe your little ones might like, and I’ve also included a link to grab my Fruit Lax recipe at the end of this blog.
While expensive, there is no physical harm to adding probiotics temporarily working toward creating a healthy gut. I like to use the website probioticchart.ca to determine which probiotics to use for different age groups and health concerns.
5) Consider Dairy Intolerance:
If your child is unresponsive to laxatives, their constipation may result from dairy intolerance.
When my 4-month-old was exclusively breastfed and still constipated, I took dairy out of my diet for a month (and I can tell you – there’s no substitute for cheese!). It made no difference, which is what most will find. But it’s worth a try if you can provide the nutrients in dairy from other food sources in your diet.
What about Laxative medications for constipation in kids?
One of my children had blood in the stool recently. He had an x-ray, which the GP said looked fine. But the pediatric gastroenterologist looked at his x-ray, conducted a physical examination, and said he was fuuuullll of poo.
Then once finding out I’m a dietitian, the GI doc first laughed at me – I’m my own best client 😉 And then, he recommended Polyethylene Glycol (PEG – brand names Restoralax in Canada or MiraLax in the US) daily to produce a soft bowel movement. Or “soft snake poos,” as he called them!
For some people, diet, physical activity and fluid are just not enough to treat constipation. And the problem with constipation is that it can easily become a chronic problem. Your intestines get “lazy.” And also fearful of pooing for a child because it hurts. And it can become a vicious cycle.
I was surprised by the dose for a child. He recommended a Restoralax dose similar to adults. I’m not saying this is the same recommendation your doctor would give you, so ask your doc.
And the Restoralax worked….until I got lazy and ran into the same problem. This time it came along with stomach pain and nausea for the poor little guy….while we were on vacation, of course!
So back to the Restoralax! We’ve fallen into about an every 2-3 day dose, which seems to be working. You can also decrease the dosage and offer it daily to find an amount that leads to soft stools but not diarrhea.
Is Restoralax safe for kids?
I’ve heard lots of rumours online that PEG is toxic. But basically, everything is toxic, according to random people on google…
If I’m going to be giving this to my child regularly, I want to make sure it’s safe and doesn’t have negative effects in children. Even the Restoralax website says it’s not for children, yet I know doctors recommend it all the time.
There has been a fair amount of research on PEG in children.
One study with 83 children taking Restoralax for an average of 8.7 months found normal serum electrolyte levels, osmolality, albumin levels, and liver and renal function test results.
And a review study comparing laxatives in child constipation found polyethylene glycol was generally safe and had lower rates of minor side effects compared to other laxatives.
Common side effects of laxatives include gas, abdominal pain, nausea, diarrhea and headaches. Restoralax claims not to cause any of these, but I’ve heard otherwise from some moms. As with everything, it would be individual.
Suppositories are also an option if you need a quick fix, but can be painful. Talk to your health care provider first. Milk of magnesia, lactulose or corn syrup can work as stool softeners in infants and children. Stimulant laxatives like Senna are reserved for adults. But if the natural options aren’t working, ask your doctor and pharmacist what’s best for your child first.
Another benefit of PEG is often better accepted as it has no favour and mixes easily into any drink. My kid doesn’t take Metamucil but has no problems with Restoralax in some juice.
Constipation is a very common and difficult issue in children (and adults!). I hope the natural laxatives for kids’ options works for you. If not, you’re not a failure if you have to use laxatives. Best of luck!!
Want to grab my free Fruit Lax recipe to help clear up constipation? Click here to get the recipe.