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  • Q&A with Australian Health Practitioners

    Is anything wrong with my child's diet that is causing constipation?

    Hi my 2 year old is having hard poos she is not doing poos everyday . It seems to be every 2 days and they are hard and she cries while pushing her poos out. She is a fussy eater with fruit and veg.

    I have been given her Lactulose sy 10 ml daily but I only give it to her when they are hard. Should I give that to her daily? She is still having Cows Milk 500mls a day and she is having 500 mls of water and juice a day.

    Her diet is as follows:
    - weatbix for breakfast but only one with milk.
    - meat and some veg every night
    - one of those fruit pureed packets a day.
    - 2x yoghurts a day.
    - now and then has white bread

    She has a low muscle tone in her legs and she is not walking on her own as yet and she has a walking frame to help her walk.

    Is there anything I should change ?
  • Find a professional to answer your question

  • 2

    Thanks

    Dr Beth Thomas

    Paediatrician

    Beth works at the Angliss Hospital (Ferntree Gully) which has paediatric inpatients and outpatients and a Special Care Nursery. She also works at Monash Medical … View Profile

    If you can increase the amount of fibre in her diet, that would give her body more to work with. Fibre is found mostly in fruit (especially pears and corn) and vegetables and salads and complex carbohydrates (like the Weet-Bix you are already giving her). If she isn't eating much fruit and veg, this might be the place to start. Some children prefer vegetables raw, other prefer cooked, some like salad and some prefer fruit. Some prefer bite-sized cherry tomatoes, or carrot sticks with hommus to dip into. If you can find a way that she likes to eat fruit/veg this would be the best way forward. Modelling can help here - if she sees you eating fruit/veg and enjoying it, that might help her to feel positive about it too. Equally important is to avoid foods which are “binding” such as banana.

    Other options would include “artificial” fibre supplements such as Benefibre or Metamucil, which can be taken as a drink, or various kinds of brans like oat bran or rice bran which can be added to foods. Bran can be added to rice or casseroles and disappears without changing the taste of the food. It is probably not quite as good as natural fibre, but better than nothing! Also look at switching her bread/rice and other grains to the highest fibre forms you can find.

    Then there's medication if neither of the above work, or while you are waiting for her habits to change. Lactulose is a good one, as it is not absorbed into the body and does not cause abdominal pain from increased bowel contractions. It is safe for long-term use and tastes reasonable. It might help if you gave it to her every day, or gave a reduced dose for maintenance (such as 5 mls daily when she is well, 10mls daily when she is constipated).

    Ultimately, the idea is to try to keep her bowel actions soft enough that she can go without pain. Her bowel actions will need to be soft all the time for her to get past the fear of pain and “holding on” behaviour which often results from painful experiences. Ideally it would be better to accomplish this before trying to toilet train, when a painful experience can derail the whole process.

    It is quite likely that if her low tone in her legs extends to her bowel, that this might be a lifelong problem. Some people are always more vulnerable to getting constipated and there are many people walking around with “slow bowels” which predispose to this problem. Once they are aware of the issue, early and vigorous management is the key. It is also difficult if the person is not able to exercise, as physical movement is another trigger for the bowel to become more active.

    Times to be especially vigilant will be if she is sick and eating/drinking less, as this will slow the bowels further, and especially if she is running a fever. Higher temperatures will burn off more fluids from her body, potentially leading to more constipation.

    Talk to your GP or paediatrician about “tweaking” her diet and medications. Constipation can make the child (and her parents) miserable, and it can become a chronic problem as the child becomes older and more aware of her body. Children sometimes say they are “never going to poo again” which, as you can probably imagine, doesn't help the issue at all! Keeping her pain-free is the key to avoiding this fear-based holding on, which is one of the main psychological factors in constipation.

  • 1

    Thanks

    Leah's mission is quite simply to help others take steps to walk their life journey. We have four primary 'parts' creating our life experiences. The … View Profile

    Hi there,

    Constipatation, ideally will respond well to the tips given by Dr Thomas.  

    You report that she has poor muscle tone in her legs and there may also be less muscle tone in her tummy muscles too that move the food wastes through the body.  

    Other issues can be a reaction to the chemicals and proteins in foods.  I suggest speaking with a dietitian trained in food sensitivities, and see if by tweeking or altering the diet can make a difference. 

    For some constipation is a combination effect, and by speaking with qualified personal it will help identify and be sure your child is then eating enough nutrients to keep her healthy. 

    Has she taken anti biotics?  A treatment with Inner Health Plus - For kids can be a good start on many levels.  

    Keep up the water, fibre, trial cereals other than weetbix, it might be too dry.  Remember that fibre needs water to make it soft and easier to move through the body. So be sure to encourage lots of water, fruit and vegies hidden and obvious; keep her moving and active and if all else fails, ask for more specific help. 

    To your little one. 

    Leah 

  • Jan Dannevig

    HealthShare Member

    This sounds a lot like me and i didn't find out till very late in life that I had low stomach acid, this caused constipation all my life and extremely weakness all the time. Does she sleep too much? Sleeping too much means the food she is eating is not converting to energy. Before I found out what my problem was it was not unusual to sleep 18 hours a day. I was told by doctors to eat more ruffage, this only makes the problem worse. Hope this might give you another direction to look at.

  • Leah's mission is quite simply to help others take steps to walk their life journey. We have four primary 'parts' creating our life experiences. The … View Profile

    Yes Janpower23, digestive function can be a big part of the problem.  There are several parts involved, and if one isn't working well, then, it will impact on the overall function.
    In a child though I would hope this wouldn't be the case, and it is worth looking at the various factors that influence digestive function.  Another thing to consider, added to the previous list i provided is spinal alignment.  The nerves travel through the spine, and branch off at various parts to control the various segments of the digestive system.  Since children are often falling and running into things, there is a significant possiblity that a jarring has occured that may of slightly misaligned the nerve function. 
    I speak of this personal and also pyshiological anatomy. 

    Having a good work up, looking at:  fluid, diet intake - quanitity, sources, and potential reactants; exercise, stress, posturing and alignments can all go towards helping to eliminate the possible reasons why it is occuring. 

    Hope this helps. 

    Leah 

  • 1

    Agree

    Lynette Lamb

    Dietitian, Nutritionist

    For Medical Nutrition Chronic constipation and diarrhoea Gut/Bowel diseases & disorders Including Reflux Coeliac Disease and re Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), … View Profile

    Constipation in 2 year old there are a number of considerations.  need to treat the symptom of constipation and if persistant further investigation is required.  I would certainly see a specialized dietitian for:   Nutrition assessment including fluid,  stategies to look at foods that bind and foods that improve stool consistency and function and a dieititan can determine if food sensititivites involved.  It is understandably if your bubs has some food adversities with constipation as constipation can reduce appetite and there can also be diarrhoea (over flow.)  Laxtatives/stool softeners can assist however there needs to be a plan and is utilized as part of a management plan. I would talk to GP.   Generally should be able to utilize food and fluid to improve stool function.  Fluid is the most important component for constipation if increased fibre is given without fluid there can be abdominal pain and bloating.  Lactulose can also cause former.  All the best.

  • 2

    Thanks

    Kerry Read

    Physiotherapist

    Headline Physiotherapy for the Head Neck and Jaw deals specifically with TMJ Facial Pain Headache Migraine and other musculoskeletal issues involving the cranial area. All … View Profile

    You've received some wonderful answers so far which I hope have alredy helped. One thing which may be worth considering is her ‘pooing position’! Considering her low tone, she may be helped by having good support in a full squat position on a potty, where she feels secure and is not having to work to keep her position. Sometimes this is assisted by gentle circular massage of the back, and allowing her to sit for some time, with a good book, relaxed and reassured.
    I don't think any previous respondents have asked if she has been tested for coeliac disease? This can lead to constipation and is worth investigating with your doctor.

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