How to Naturally Support Constipation in Children

In this blog, Dr. Ashley Shea talks all about constipation in children and how to address it! From underlying causes, to at home remedies and ways that naturopathic doctors can help get your little one's digestion back on track by addressing the root cause!

Digestion and transit time varies from person to person. “Normal” bowel movements can range anywhere from 3 per day to 3 per week. We believe that daily elimination through bowel movements is optimal for detoxification and overall wellness. 

If your child is experiencing stomach pains, cramping, excessive gas or bloating, decreased appetite, nausea and/or vomiting and irritability, they may be experiencing constipation! 

Constipation is a common childhood symptom, affecting up to 30% of children each year. Apart from anatomical and physiological causes,  over 90% of childhood constipation is functional. Which makes diet and lifestyle changes the treatment of choice! 

SIGNS OF CONSTIPATION

• < 1 stool per day 
• Dry and hard stools 
• Pencil thin stools 
• “Rabbit droppings”
• Stool leakage 
• Straining or pain
• Blood on wiping 
• Incomplete feeling 
• Hesitancy to use the washroom 

CONSEQUENCES OF LONG STANDING CONSTIPATION

• Fecal impaction 
• Incontinence 
• Hemorrhoids and fissures 
• Rectal prolapse
• Dysbiosis 
• Bathroom Anxiety 
• Bedwetting
• Behavioral issues 

B R I S T O L   S T O O L   C H A R T

Type 1 and 2 are considered constipation. 

“Normal” is Type 3 and 4 (sometimes 5). This is what we aim for. 

Type 6 and 7 are considered diarrhea. 

C A U S E S 

• Functional. The most common cause of constipation (over 90%). When no anatomical or physiological processes are causing the constipation. 
• Metabolic. Thyroid, Diabetes, Hirschsprung, Cystic Fibrosis 
• Anatomical. Stenosis, Strictures, Prolapse
• Food Allergies/ Sensitivities. Celiac disease, Lactose intolerance, Cows milk allergy
• Diet + Lifestyle. Low fiber, Low water intake, Lack of exercise, High white flour, sugar or processed food intake, Lack of exercise 
• Dysbiosis. Recurrent antibiotic use, Poor diet, Chronic stress
• Medication/ Supplements. Chronic laxative use, Iron, NSAIDS.
• Anxiety, Stress, Depression, etc. 
   

T R E A T M E N T  O P T I O N S

The main treatment for functional constipation is diet and lifestyle changes. These are simple changes that require some effort from the family. 

F I B E R 

We can break down fiber into soluble and insoluble forms. To no surprise we need both for proper digestion, but they are for different reasons. 

SOLUBLE FIBER - absorbs water to make a gel; speeding up stomach emptying and transit time. 

• Examples - oats, legumes, mushrooms, berries, apples, psyllium, 

INSOLUBLE FIBER - does not dissolve water, but adds bulk to the stool to stimulate peristalsis, slow stomach emptying and transit time. 

• Examples - beans, nuts, broccoli, cauliflower, carrots, grains, vegetables

ADEQUATE INTAKE

• 1-3 years = 19 grams per day 
• 4-8 years = 25 grams per day 
• Girls 9-18 = 26 grams per day 
• Boys 9-13 = 31 grams per day 
• Boys 14-18 =  38 grams per day 

T i p s 

• ½ plate of vegetables and fruit with every meal! Lead by example and include fruits and veggies into your diet as well! 
• 1-2 kiwi’s per day can help improve constipation. 
• Prunes and date - either eaten whole, cooked in oatmeal or softened in water overnight and consumed/ cooked with the water. 
• Let your child choose a new fruit or vegetable that they have yet to try! 

W A T E R 

I think it speaks for itself, but water is key when thinking about healthy, soft (but not too soft), easy to pass bowel movements. Even mild dehydration can lead to constipation. With an increase in fiber is it SO important to increase your water intake to prevent impaction or worsening constipation. Water should always be the main source of hydration once solids are introduced. 

RECOMMENDED INTAKE

• 2-3 years = 42 oz
• 4- 8 years = 57 oz 
• 9-13 years = 71-81 oz 
• 14- 18 years = 80- 100 oz

T i p s 

• Having a glass of water first thing in the morning and before every meal. 
• Adding citrus, fruits or vegetables like cucumber in the water to make it more fun! Let them choose their combination. 
• Letting them choose a fun water bottle. 
• Reward chart; if they reach their goal for the day they may get a yummy snack! 

E X E R C I S E 

Bowel movement depends on muscle contractions in and around the digestive system. Movements increase blood flow to our digestive organs to fire them on and get them moving. Those who lack exercise or who are more sedentary are generally more constipated.  

RECOMMENDATION 

• At least 60 minutes of moderate to vigorous physical activity each day. 
• At least 3 days of aerobic exercise, and 3 days of bone/ muscle building exercise.

T i p s 

• Try increasing the amount of physical activity per day by 10 minutes. In no time this will add up to 60 minutes. 

S U P P L E M E N T S 

As always it is always best to check in with your practitioner before starting any new supplements. Ensuring the right form, dose and timing is crucial for seeing best results! Some of our go to supplements to start with childhood constipation are; 

• Magnesium Citrate - magnesium helps relax the nervous and muscular system to allow bowel movements to happen. The citrate portion brings water into the bowels to soften the stools and allow for an easier pass! 
• Probiotics- we love probiotics when it comes to gut health. Having a healthy microbiome is not only essential for proper digestion, but mental- emotional and immune health as well. There are countless brands and combinations out there. We like to individualize probiotics based on you and your needs! 
• Castor oil - as a topical!! We do not recommend consuming internally, as it can cause a big (BIG) mess. But topically castor oil rubs along the path of the intestines are a great way to stimulate bowel movements.