“Regular” Kids

As a Pediatric Dietitian, one of the most common concerns I hear from parents is how to manage constipation in their child. Every day, thousands of kids visit the Emergency Room for abdominal pain related to constipation. Ask any of your mom friends, they will probably tell you that their child has experienced constipation at some point in their life. Constipation is not normal, but it is very common.

Just to make sure we are all on the same page, constipation is defined as having less than three bowel movements a week or bowel movements that are dry, hard and difficult to pass. If either of these situations sound familiar, I have some suggestions that will hopefully help. To make them easier for you to remember, I call them the Five F’s of healthy bowel habits.

1. Fiber. Fiber is a carbohydrate that cannot be digested. Because fiber cannot be digested, it adds bulk to stools. Fiber is found in fruits, vegetables, legumes and whole grains. Try to incorporate these foods into every meal and snack your child consumes.
2. Fluids. All the fiber in the world isn’t going to be helpful if your child isn’t getting enough fluids. Adequate water intake is often overlooked as a significant factor in constipation. It is difficult to give a blanket recommendation for fluid intake, but I would encourage your child to drink at least 16 ounces of water a day, at a minimum. More is a bonus.
3. Fitness. Being physically active literally helps food move faster through the digestive tract. The faster the food moves, the less water that can be absorbed, thus creating a softer stool.  Encourage your kid to get 30 minutes of continuous physical activity every day.
4. Feeling. Kids will often fight the natural urge to eliminate. Ignoring the urge can make it difficult to go later on. Kids need to learn the feeling and sensation in their body and honor it as soon as possible. Remind your child that they can come back to their toys after going to the bathroom or if you are out in public, try to find a bathroom right away.  School age kids may need to be encouraged to advocate for themselves to use the school restroom in a timely manner.
5. Flush fun. This is code for toilet time. Most kids love the thought of flushing their poo away. Your child should sit on the potty every day, preferably 15-30 minutes after a meal. This is the time when the body is naturally ready to pass a stool, technically called the gastrocolic reflex. It is important that your child feel comfortable sitting on the toilet with their feet touching the floor. You can use a step stool or a set of books if needed.

Occasionally, kids can have very healthy bowel habits and still struggle with constipation. It can become a vicious cycle to feel pain when voiding, thereby avoiding going to the bathroom, which can lead to impaction and even more difficult to pass stool. Chronic constipation can affect your child’s appetite and can also cause nighttime bedwetting. If this is a concern, please discuss it with your child’s pediatrician to see if medication management is necessary.

I hope these tips can help your child become “regular!”