5 Things You Can do Today to Help Your Constipated Child

It can be heartbreaking to watch your kids suffer from constipation. Read below for some tips.

After three different people asked me about natural ways to relieve their kids’ constipation, I thought I write about it. It can be frustrating and heartbreaking when your baby, toddler, or even, school-aged child is suffering from constipation. Incorporating a little extra fiber might help. (These dietary changes could be considered home remedies and you should always consult a medical doctor. )

What Exactly is Considered Constipation in Children?

It is a condition in which your child may have:

· hard, dry stools that are difficult to pass

· having fewer than two bowel movements per week

Additional Symptoms of Constipation in Kids May Include:

· having a swollen abdomen, or bloating

· abdominal pain, cramping, nausea, or poor appetite

· having daytime or nighttime wetting

· soiling (stool in his/her underwear that looks like diarrhea)

· shifting positions that make it look like your child is trying to have a bowel movement, but he/she is really trying to avoid/delay it

What Causes Constipation in Kids?

Just like adults, children’s bowel patterns differ from child to child. Most children have bowel movements 1 or 2 times a day, but others may go 3 days without having normal stools. Going 3 days or more without having a bowel movement is OK, as long as your child is healthy with normal stools that are passed without pain or discomfort.

Constipation is a common problem in kids, the most common causes being:

· a low fiber diet

· in infants, transitioning to solid foods

· withholding – delaying or avoiding a bowel movement because he/she is afraid of the pain that comes with passing stool, a yearning for independence or control, too busy playing or waiting for a more comfortable place to use the bathroom (like waiting to get home to use the bathroom instead of at school).

· Illness and/or medications (especially iron supplements)

· Changes in environment or routine (moving, starting a new school or activity)

When You Should See a Doctor

If the symptoms last more than 2 weeks or do not go away with treatment with natural remedies at home.

You should take your child to the doctor right away if your child experiences any of the following:

· bloating that doesn’t resolve

· bleeding from his/her rectum

· vomiting

· weight loss

What Should My Child Eat if He/She is Constipated?

Fiber – A good rule of thumb is 5 servings of fruits and vegetables per day. (Fibers from different foods will also help stimulate the growth of healthy bacteria in her gut microbiome, which you can read more about here.)

These are the recommendations of the Food and Nutrition Board of the Institute of Medicine. Your child’s needs may differ:

The Nutrition Facts label on a food product can tell you how much fiber per serving food has.

· Excellent sources of fiber have 5 grams or more per serving

· Good sources of fiber have 3 grams or more per serving

Good sources of fiber are:

Fruits and Veggies (with their skin!)

Whole fruits with their skin have about 3 grams of fiber (Pears have 4.5, peaches have 2). A cup of raspberries has 8 grams! Dark colored vegetables. Kale, swiss chard, broccoli and cauliflower are great. Consider making kale chips in the oven for a yummy snack. Dried fruits: raisins, prunes (a powerful, natural laxative), dates, figs, apricots. (Avoid candied fruits.)

Dried fruit, including prunes, dates and apricots, can help increase fiber and relieve constipation

Beans

Canned is OK, just rinse them well to remove the salt solution. Kidney, chickpeas, black beans, cannellini, lentils, split peas. (1/2 cup kidney beans have 7.4 g fiber and navy beans have 3!) Add them to soups and whole-grain pasta. Make a dip or spread. Make them the centerpiece of taco night, or just serve them plain. (My kids love to eat plain small, white beans. I put them in a small espresso cup with a small spoon and they love it.)

You can also integrate them into energy balls; the beans moisten the recipe without adding extra sugar and they add fiber. I make a batch of these energy balls each week and throw them into the kids' lunch boxes - or mine :)

Nuts and Seeds

If your child does not have a nut allergy, then add them as snacks (make a trail mix by mixing with dried fruits), top oatmeal and yogurt with them or grind them to use in baking. Don’t forget chia seeds and flax seeds, which can both act as laxatives. For kids, add a tiny bit (1/2 – 1 tsp) to yogurt, oatmeal, smoothies.

Whole Grains

Whole grain breads, hot oatmeal, bran, buckwheat, barley, bulgur, whole rye, whole wheat pasta. Cold cereals: Post Wheat ‘N’ Bran Spoon Size, Market Pantry (Target) frosted mini wheats, Grape Nuts, All Bran and Kellog’s frosted mini wheats, original are some of the best tasting (but not toooo much sugar), high-fiber cereals.

Fluids

So important! You should not bulk up your child’s diet without adding extra fluid. Clogging up his or her plumbing with too much stool bulk could lead to impaction, so ensure that your child is getting enough fluid from non-dairy drinks and fruits.

The Institute of Medicine recommends that, roughly, most children aged:

· 1 to 3 need at least 35 ounces of fluid per day

· 4 to 8 years old need at least 46 ounces per day

· 9 to 13 year old boys need at least 65 oz per day

· 9 to 13 year old girls need at least 57 oz per day

If your child is a big milk drinker (like mine), try to limit liquid milk to ~ 2-3 cups per day.

So tell me about your experience and what has worked for you!

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References:

U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2015-2020 (PDF, 10.3 MB) . 8th ed. Published December 2015. Accessed November 29, 2018.

https://healthyeating.sfgate.com/many-glasses-milk-should-kid-drink-1100.html. Accessed November 29, 2018.

https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Kids-Need-Fiber-Heres-Why-and-How.aspx. Accessed November 29, 2018.

Halloween Toast Cut Outs

Cookie cutters make this cute breakfast or hors d’oeuvres super easy and versatile

Even if I’m not throwing a Halloween party, I still like to do little things to stretch a holiday as much as I can for the kids. I decorate inside the house, even if I don’t decorate outside; I slip little love notes in my kids’ lunchboxes on festive note paper (thanks to my Aunt who has supplied me with the most unique, personalized note pads and pencils since I was a kid – and I still have them); and I create festive food.

I don’t remember where I got these cookies cutters, but they’re autumn themed and include a pumpkin. So, I simply cut the shapes out of toast. I mean, what’s more fun than toast in the shape of a leaf? (Well, for my kids, probably one smothered in Nutella.)

I shmeared on some natural peanut butter, placed some blanched, sliced almonds as the eyes and mouth and presented a fun, Halloween breakfast. (I ate the crusts :)

These little toasts, of course, lend themselves to many variations. For a party, toast up slices of bread in the oven, cut out shapes and top with anything. Here are some suggestions:

-goat cheese and honey

-goat cheese and fig jam

-goat cheese or mozzarella and sun dried tomatoes

-avocado topped with a sprig of cilantro

-ricotta and jarred roasted peppers

-ricotta, cinnamon and strawberries

-cream cheese and smoked salmon

-marscapone and peaches

-marscapone and blueberries

-pesto and sun dried tomatoes

-cheddar cheese and tart apple (maybe broil this)

The possibilities are endless. If you have time, you could use cookie cutters to cut out shapes out of thicker vegetables, like potatoes, sweet potatoes, and winter squashes (which would have to be cooked.)

Tell me if you made festive foods this year!!

The Beginner's Guide to the Microbiome and Probiotics

Improving your gut health with probiotics, prebiotics or fermented foods can heal your microbiome, help your digestion and prevent you from getting sick. With plenty of bad bacteria in your gut, you can’t afford NOT to take a probiotic.

Photo by Sara Cervera on Unsplash

We Can’t Talk about Probiotics Without Talking About the Microbiome

So, what, exactly, is the gut microbiome?

Trillions of bacteria live in our intestine (aka, the gut) and the microbiome is the genetic material of all the microorganisms (aka, microbes) that live on and inside the body – mostly inside your intestines and your skin. Because most microbes live in the large intestine, it is referred to as the gut microbiome. The colon is actually the perfect environment for bacteria to growth thanks to its slow transit time, readily available nutrients and favorable pH. (think: perfect Petri dish :)

This includes bacteria, fungi, protozoa and viruses. It was in the early 1900’s that we learned that lactic acid bacteria may have health benefits and that we may actually be able to replace harmful bacteria with good bacteria.

These microbes are actually very helpful; some help digest food, produce vitamins and essential building blocks of protein, produce short chain fatty acids and destroy disease-causing cells. They also digest food to generate nutrients for host cells and metabolize drugs. Out of these microbes, bacteria are most well studied.

How Does Gut Health Affect Your Overall Health?

Everyone’s microbiome is different and is determined by your mother’s microbial environment, your environment and the foods and drugs you ingest. A healthier gut has more healthy bacteria and they’re more diverse (or have more strains of the good bacteria).

Other things that affect your microbial environment:

-Whether you were born naturally or through C-section

-Giving birth naturally actually bathes the baby in mom’s bacteria from her birth canal, which increases the microbial diversity. (There’s some thought that babies may be exposed to mom’s microbes while in utero.)

-Whether you were bottle or breastfed

-Breast milk is tagged, “liquid gold” for a reason. The Bifidobacteria in the milk sugar that babies ingest are important for gut protection (and, therefore, immunity).

-Who you live with and where you live

-Families share bacteria! Did you ever walk into someone’s home and notice that it has a different scent than your own? That’s their unique bacterial scent!

-Playing out in the dirt isn’t such a bad idea – kids who live on farms have a higher bacterial count than city kids. Even kids who have dogs have been shown to have a healthier microbiome.

-Hygiene and antiseptics

-Overuse of antiseptics and sanitizers is of concern as it can kill off strains of not just bad bacteria, but good bacteria, too.

-Use of medications, like Metformin

-Use of pro- and antibiotics (we’ll talk about this below)

-Age and stress

-Age in general is associated with a decreased amount and types of species of bacteria, but studies done on nursing home residents found that they had a less favorable gut microbiota pattern.

-Diet and exercise

-Exercise has been shown to increase the amount and kinds of good gut bacteria.

-Western diets (high in fat, sugar, refined carbohydrates) have been associated with less microbial diversity. People in rural African villages that consume more dietary fiber than Westerners have a very different gut microbiome. The African villagers have bacteria that evolved to allow them to maximize energy intake from the fibers while also protecting them from inflammation and some intestinal diseases. (Super cool, if you ask me!)

-And, it’s been shown that a high fat diet actually decreases our ability to burn off fat. Eek.

Gut health has been associated with:

Obesity/metabolism

Diabetes

Irritable Bowel Disease: Ulcerative Colitis and Crohn’s Disease

Anxiety/Depression/Autism

Arthritis/inflammation

Colon cancer

Acne/eczema/rosacea

So What’s An Unhealthy Gut Microbiome?

One that’s in dysbiosis – in other words, there’s an unfavorable balance of bad bacteria to good bacteria. This causes inflammation and stress on the body and brain. It also affects immunity, can contribute to disease, and causes GI symptoms, like bloating, cramps and abdominal pain.

Think of your gut microbiome as a gatekeeper; it keeps disease-causing substances out of the bloodstream. An unhealthy gut can lead to leaky gut — a condition in which holes form in the walls of your GI tract, allowing toxins and proteins to enter the blood and contribute to disease, inflammation, and allergies.

Would you like your gut barrier wall to look like this:

An unhealthy gut microbiome has ways for pathogens to enter the bloodstream - like this decrepit gate. Photo by Marissa Lewis on Unsplash.com

I didn't think so...

What Can You Do to Improve the Health of Your Gut Microbiome?

This is where probiotics come in.

The word “Probiotic” is derived from Greek, which means “for life”. The word “antibiotic” means “against life”.

Probiotics are defined as live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods, dietary supplements, and beauty products.

For hundreds of years, it’s been known that certain microorganisms may impact health benefits. Probiotics may modify the immune system, regulate the allergic immune cell response and prevent cancer cells from multiplying. Probiotics also help breakdown indigestible fibers for energy use.

But, buyer beware; probiotics are a multi-billion dollar business.

What Should You Look for in a Probiotic?

1. Consider checking your probiotic with an unbiased source, like Consumerlab.com. Also, look for a verified/certified/approved seal on the label.

Some organizations like the U.S. Pharmacopeia (USP), NSF International, and ConsumerLab.com attest that the product contains the amount of the ingredient advertised on the label and that it isn’t contaminated with dangerous substances, such as arsenic, bacteria, or lead.

It is not, however, a guarantee that a product has therapeutic value, nor do they test every batch of supplements shipped out.

2. The World Gastroenterology Organization recommends that, when choosing a probiotic, look out for a label that includes:

· Genus and species identified

· Strain designation

· Viable count of each strain at the end of shelf-life

· Recommended storage conditions

· Safety under the conditions of recommended use

· Recommended dose, which should be based on claimed physiological effect

· An accurate description of the physiological effect

· Contact information for post-market surveillance

Ok, So Which Probiotic Should You Actually Take

These are Probiotic Products, the Bacterial Strains it contains, the condition for which it was tested and Dosage Shown to be Helpful:

Which Foods Contain Probiotics?

Yogurt

Kefir

Yakult

Danactive / Actimel

Stoneyfield products

Komboucha

Aged cheeses with live cultures

Kimchi, sauerkraut, miso, tempeh

Of note, the World Gastroenterology Organization says it is not necessarily helpful to eat any old yogurt every day and think you’re getting a specific benefit. Most commercially available acidophilus and Bifidobacterium containing yogurts don’t meet the minimum amount of colony forming units to be beneficial.

So, it’s a good idea to choose probiotic foods/drinks with several strains and at least 1 billion CFUs (colony forming units).

What are Prebiotics?

Prebiotics deserve an article to themselves, but, in short, they are non-digestible parts of foods (fibers) that offer health benefits. Prebiotics are very healthy as they can:

-add fiber to the diet, increase calcium absorption, decrease gastrointestinal transit time, and possibly lower blood lipid levels.

Some foods that contain prebiotics:

Legumes, soy beans, nuts, seeds, chicory root, Jerusalem artichokes, wheat bran, barley, oats, apples, garlic, onion, leeks, asparagus, bananas.

The Takeaway:

• Take a probiotic supplement before breakfast or on an empty stomach (probiotics are killed by stomach acid)

• Probiotics may take about 1 month to colonize and start working

• Keep taking your probiotic – the effects only last as long as you’re taking a consistent dose

• Eat a variety of foods to get the best of everything, especially prebiotic foods like legumes, beans, fruits and vegetables and oats

• Eat fermented foods, such as yogurt, kefir, sauerkraut

• Limit artificial sweeteners – they may increase blood sugar by stimulating growth of unhealthy bacteria

• Breastfeed for at least 6 months

• Ditch the animal protein for a plant-based diet. Plant fibers change your gut microbiome into a healthier one

• Don’t take antibiotics unless necessary and take them for the entire prescribed timeframe

• Get outside more and play in the dirt

So, I challenge you to integrate more probiotic and prebiotic foods in your diet and possibly a probiotic supplement…what have you done to help your gut microbiome??

References:

https://www.genome.gov/27549400/the-human-microbiome-project-extending-the-definition-of-what-constitutes-a-humanhttps://www.gastro.org/practice-guidance/gi-patient-center/topic/probiotics

https://www.pcrm.org/health-topics/gut-bacteria

https://www.worldgastroenterology.org/guidelines/global-guidelines/probiotics-and-prebiotics/probiotics-and-prebiotics-english

Ciorba MA. A Gastroenterologist’s Guide to Probiotics. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2012;10(9):960-968.

De Filippo C, Cavalieri D, Di Paola M. Impaft of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci USA 2010: 107: `4691-14696.

Donovan SM. Introduction to the special focus issue on the impact of diet on gut microbiota composition and function and future opportunities for nutritional modulation of the gut microbiome to improve human health. Gut Microbes. 2017;8(2):75-81. doi:10.1080/19490976.2017.1299309.