By Sarah Hanratty – Registered Nutritional Therapy Practitioner
If your child has bowel movements that are infrequent, large in volume or if they strain as they pass them then constipation may be an issue. The NHS describe constipation as having less than three bowel movements per week. However, having a bowel movement only every other day could be problematic if it makes the stool dry, large or difficult to pass. Ongoing constipation is not only uncomfortable for your child but it can also cause problems with bed wetting, appetite and ‘overflow diarrhoea’. I recommend aiming for your child to have regular bowel movements; which could be described as a daily movement or up to three times a day. Ultimately, bowel movements that are smooth, formed and easy to pass should be our objective.
Hydration:
It’s common for children to develop constipation when they are weaned onto solid foods. When this happens, offering more water to drink between meals can be helpful. The amount of hydration a child needs depends on age, activity level and the weather. It is best to offer regular drinks of water throughout the day. General guidelines are that around 120ml-150ml should be offered 6-8 times a day for children under five. It is important that a child is taking on enough water before altering the diet to include more fibre.
Different types of fibre:
After ensuring adequate hydration you can check your child is having enough fibre rich foods. Increase fibre rich foods slowly to allow time for the gut to adjust to the change in diet. There are two different types of fibre; insoluble and soluble. Insoluble fibre is found in wholegrain, nuts and seeds as well as in the skin of fruit and vegetables. This type of fibre adds bulk to a stool as well as acting like a ‘brush’ sweeping through the bowel. Soluble fibre works differently; it absorbs water to influence the form and consistency of stools making them easier to pass. Soluble fibre is found in oats, flaxseeds, beans, lentils and root vegetables. It’s best to include both types of fibre to ensure a balanced affect on stools. Peas and sweet potatoes are easy child-friendly ways to increase soluble fibre in the diet.
Short-term approaches to ensure regular bowel movements include; soaking a prune in hot water, waiting for the water to cool, removing the prune and offering the water to your child to drink. This is a good alternative to giving prune juice which would contain additional sugar. Alternatively, you can soak a teaspoon of ground flax seed and then add this to smoothies, overnight oats or porridge to help move the bowels along. Soaked chia seeds could also be used in a similar way. The gel-like consistency can assist with regular bowel movements.
Feed the gut bacteria:
If constipation occurs after a bout of illness or use of antibiotics it may be that your child’s gut bacteria need some support. Some sources of soluble fibre contain probiotics that help to feed to the good bacteria in the gut; food sources of prebiotics include leeks, onions and cabbage.
Magnesium for movement:
Our bodies need sufficient magnesium for peristalsis; the movement that enables faeces to move though the colon. Ensuring your child is eating plenty of magnesium rich foods is also useful. Good sources of magnesium include leafy green vegetables, avocado, yogurt and bananas.
Abdominal massage:
To physically encourage bowel movements, you can gently massage your child’s abdomen in a clockwise direction. Use a little olive, almond or vitamin E oil to aid the movement. You can also place a hot water bottle wrapped in a towel on the abdomen after massaging to help move along any compacted faeces. This is particularly useful where ‘overflow diarrhoea’ is occurring. Often faeces can be building up on the wall of the colon and massage and heat from the hot water bottle can help loosen this.
Opportunity and positioning:
Some children, they are simply too busy to go and sit on the toilet and they will hold in their bowel movement. Suppressing the urge to go can make it more difficult to have a bowel movement. Offer your child opportunities to use the toilet and give them enough time. It can be helpful to have a stool that they can rest their feet on that raises their knees higher that their hips (in a squat position). This is a more natural movement to allow the bowels to move and one that toddlers may have adopted when they were in nappies. Adopting this position can make a really big difference to the ease of bowel movements.
If you have concerns about your children’s bowel movements, please speak to your GP.