Coping with constipation in babies and toddlers Part 2
The role of diet in managing constipation
Correct these problems in your little one’s diet to help manage constipation:
- Make sure there is enough fibre in the diet. There are two types of fibre: Soluble fibre is found in foods such as oats, legumes, bananas, and carrots. Insoluble fibre can be found in bran, whole grains, skins of fruits and vegetables, and leafy greens. An easy way to calculate your child’s fibre needs is multiply weight by 0.5, so a child weighing 12kg will need about 6g fibre. ½ cup fruit or vegetable contains about 2g fibre, while ½ cup legumes contains about 7g fibre. Remember, pureeing food breaks down the fibre, so try to keep it textured for babies or serve as finger foods for toddlers. For fussy eaters who refuse high fibre foods, consider adding ½ teaspoon psyllium husk, flaxseed powders or oat bran into porridges as short-term solution. Increase fibre slowly – sharp increases can cause bloating and pain and will make toilet experiences even more uncomfortable.
- Ensure your tot is drinking enough fluid – work with 150mL/kg for infants below 1 year, and 120mL/kg for toddlers.
- Juices high in sorbitol can help stools pass easier. Prune, pear and apple juices will work well – dilute them to prevent sorbitol overload, or add a few tablespoons to mashed food.
The role of allergies in causing constipation
Allergies can result in constipation, possibly by causing inflammation of the lining of little colons. Cow’s milk protein allergy is the most common cause, although egg and wheat allergy may also be at play. Try holding back cow’s milk for a few weeks to see if the constipation resolves, and reintroducing it slowly to assess its effect. This should be done with medical supervision only, and with supplements to prevent deficiencies!
Which fluid should I be using for constipation?
Before 6 months, only offer breast milk or first formula milk – this will provide all baby’s fluid needs. Between 6 months and 12 months, continue to offer breast milk or formula milk as well as a few sips of water with meals. If you have noticed constipation when you upgraded to second formula milk, try to revert back to first formula milk – the additional iron in the new milk may be the problem. Make sure that you are preparing formula milk according to directions, as over-concentration can cause constipation. If you suspect a cow’s milk protein allergy, consult a health professional about switching to a hydrolysed or soy formula.
After 12 months, you can continue to breast feed or switch formula milk to normal dairy milk. Remember, at this stage your little one will only require about 2 cups of milk a day – the remaining liquid should come from water, although you can occasionally offer diluted fruit juice. Again, if you suspect a cow’s milk allergy, consult a health professional about suitable alternatives.
Other interventions for constipation
In addition to diet, try the following to manage constipation:
- Encourage a little more activity, either with outside play for toddlers or even by moving your baby’s legs in a bicycle motion.
- Consult a physiotherapist about tummy massage and correct posture on a potty or toilet.
- If defecation is really painful, causing your little one to retain stools, ask a doctor about a gentle laxative.
- Encourage toilet time after eating, as this is when the whole gastrointestinal tract is most active.
- If your tot tends to hold back stools, remember it is likely from a traumatic or unpleasant experience – be supportive, caring and encouraging at all times, and reinforce positive toilet behaviours with a sticker or star chart.
Read part 1 of coping with constipation in babies and toddlers
Recipes that compliment this discussion:
Dessert Oat Biscuits