Many children have constipation. Nutrition and other lifestyle changes can support a healthy gut throughout your child’s life.
What is constipation?
Normal stool is:
- Soft and easy to pass.
- Passed 1 to 3 times per day, or once every 2 to 3 days.
Signs of constipation:
- Stooling less often than normal.
- Stools are like small hard balls.
- Stool is wide or clogs the toilet.
- Straining to pass a stool.
- Passing stool is painful.
How can I treat constipation through nutrition and lifestyle changes?
- Drink enough fluid.
- Include high-fiber foods in the diet.
- Add nutrition supplements, with the help of your healthcare provider.
- Eat and drink on a regular schedule.
- Be physically active.
- Find time each day to relax and avoid rushing when sitting on the toilet. Mornings and after a meal may be a good time to practice toilet sitting.
Fluid keeps things moving. The amount a person should drink varies by their age and weight. Ask your child’s healthcare provider or dietitian to give you a daily fluid goal.
- Beverages are not the only source of fluids. Soup, yogurt, popsicles, fresh fruits and vegetables, and other liquid-containing foods can also count toward goal fluids.
- Look for clear or very pale urine. This is a sign of good hydration.
Ways to encourage good fluid intake:
- Carry a refillable water bottle during the day.
- Flavor water with fruits, vegetables, and herbs. For example, try adding sliced cucumber and mint, strawberries and lemon slices, or lime and basil to a pitcher of water and allow to stand for a few hours in the refrigerator.
- Make iced or hot herbal teas (such as mint, ginger, chamomile, or hibiscus).
- Warm broth and soups.
- 100% fruit popsicles.
Fiber adds bulk to stool and pulls water into the intestines, making stools soft and easy to pass.
- It is important to drink enough fluid to allow the fiber to work.
- Fiber also helps keep the bacteria in the gut healthy!
Ways to encourage and increase fiber intake:
Include a fiber-rich food in every meal and snack. Build up intake slowly to avoid gassiness. Fruits and vegetables like apples, pears, and cucumbers that have a fibrous but tasty skin are good choices. Wash fruits and vegetables before eating to decrease environmental contaminants. If possible, use organic produce.
- Whole grains: Look for “whole grain” as the first ingredient.
- Choose high-fiber cereals for breakfast.
- Look for whole grain breads with 4 grams of fiber per slice.
- Use whole grain tortillas to make home-made pizza.
- Substitute part of flour in recipes with whole grain flour.
- Replace white rice with quinoa, brown or wild rice, or millet.
- Include popcorn as a snack.
- Add fresh or dried fruit to cereal, yogurt, and salads.
- Use fresh or frozen fruit in smoothies or popsicles.
- Add dried fruits to trail mix.
- Use fresh, canned, or baked fruit as dessert.
- Fruits like kiwi, berries, pears, apples with peel, prunes (plum), persimmons, dates, figs, apricots, and raisins are especially helpful in preventing or relieving constipation.
- Mash and spread on bread with nut or seed butter. Add to baked goods.
- Vegetables: Give lots of opportunities to taste new vegetables!
- Mix pureed vegetables into soups or pasta sauce.
- Chop into small pieces and mix in a salsa dip, chili or on pizza.
- Let your child choose vegetables to turn a salad into a rainbow of colors.
- Cut into spears or slices and serve with a favorite dip.
- Add leafy greens, carrots, avocado, spinach, beets, pumpkin, or sweet potato to a fruit smoothie.
- Legumes: Includes beans, peas, lentils
- Add to a favorite soup, stew, or chili. Puree beans or lentil to thicken a soup or sauce.
- Toss peas or chickpeas in a salad or pasta dish.
- Oven roast chickpeas with a little oil and spices for a crunchy snack.
- Puree black beans or chickpeas with oil and flavorings (garlic, lemon or lime, herbs). Use as a dip or spread for veggies, whole grain crackers or tortilla chips. Use as a spread on sandwiches.
- Nuts and seeds:
- Add ground flaxseed to hot cereals, smoothies, or baked goods.
- Use as a substitute for egg in baked goods.
- Make a trail mix with your favorite nuts and seeds or try new ones.
- Thicken puddings and smoothies with chia seeds.
- Use nut and seed butters as a spread. Add to smoothies, soups, and stews.
- Wisk equal amounts of water and sunflower seed butter, peanut butter, or tahini to make a sour cream substitute. Add more water as a substitute for cream in soups and stews.
- Other helpful foods:
- Try pear nectar or prune juice. Drink prune juice plain, mixed with water or orange juice, or use it to sweeten herbal tea. Limit to 4 ounces daily.
- Try adding black strap molasses to oatmeal or toast.
- Include fermented foods in the diet, such as yogurt, sauerkraut, or fermented vegetables for beneficial bacteria.
Dairy foods (like milk, cheese, and yogurt) are the main source of calcium for many children.
- Calcium is important for building healthy bones, but sometimes excessive dairy can cause constipation.
- Limit dairy products to 2 to 3 servings per day.
Most children do not get enough magnesium in their diet. Magnesium is very important for gut health. Slowly increase the amount of these magnesium-containing foods in the diet:
- Dark leafy greens
- Beans and lentils
- Whole grains
In addition to food, magnesium supplements can be helpful. Ask your healthcare provider or dietitian whether this is appropriate, and what dose is recommended. Look for magnesium citrate or magnesium oxide. It is best to start at a low dose, then gradually increase until stool is soft and easy to pass. Make sure to go slow and be patient so the body has time to adjust.
Limit harmful factors
These factors can harm the healthy bacteria in the gut and worsen constipation:
- Fast food
- Food additives (preservatives, artificial colors and flavors, and thickeners)
- Viral illnesses