Infants on solids can be particularly vulnerable to constipation because of their increased requirement for fluid in order to process food. Many mums have been surprised by the sudden ‘firming up’ of their bubs poo when they start on solids. It is important to introduce fluids such as water to avoid constipation.

What is constipation?
Constipation is a difficulty in passing stools, commonly caused by a lack of fluid intake.

We all beat to our own drum when it comes to passing stools, children are no different. Some children poo once every day or two, others every day, some two to three times a day; what ever is the norm for your child is the base line to measure against. Poo should be formed, soft and easily passed. A child who poo’s daily and then suddenly doesn’t go for days may well be constipated. However, signs of constipation are signaled by more than frequency alone.

Other signs include:

• Hard dry stools
• Poo that resembles pellets
• When it is hard to do a poo (this may be associated with or without tummy ache and pain)
• Holding onto a poo for fear of pain on passing the stools

Persistent constipation can cause runny poo to leak past the hard impacted poo into the pants; this is termed ‘soiling’.

 

What causes constipation in children?
There can be one or more causes behind constipation, even weaning and early potty training can be a cause, the common ones include:

Dietary issues such as a lack of fibre or excessive intake of foods (such as refined foods) or fluids (such as milk) displacing foods with fibre

Lack of fluids

• A child puts off going to the toilet
• Some medicines
• Some supplements such as iron
• Inactivity

 

How do you prevent constipation?

Of course prevention is always better than the cure. Following are some ideas on how to ensure your child does not suffer the discomfort of constipation.

Diet

• Encourage a diet high in fruit and vegetables (they not only have fibre but they keep the bowel healthy)
• Ensure your child is eating plenty of wholegrain foods such as breads, cereals as well as beans, nuts and seeds* for fibre.
• Children who have adequate diets but suffer with constipation commonly do not drink enough fluid (water), ensure water is always accessible and remind children to drink (the thirst reflex takes time to develop). About 400-800mls of fluid a day is the average for most young children, as they do get some fluid from food also.
• Introduce a sipper cup at six months of age with clean water and encourage bub to drink a little water around eating times.
• Avoid the excessive use of milk and other calorie dense fluids as they can displace food.

Other

• Encourage physical activity, which can help the small muscles in the intestines move food.
• Acidophilus powder (for example a baby bifida) has been shown to help bowel functioning and soften stools. Some infant formulas have added healthy bacteria also.
• Keep breastfeeding, breastfed babies rarely suffer with constipation.
• Check you are using the correct ratio of baby formula to water.

 

 

What and when should infants drink?
Your little one needs more water to digest their food compared to you. Babies’ kidneys are not fully developed and therefore not as adept as adults at handling the waste products from the digestion and metabolism of food. Infants’ kidneys use more water than adults to dilute and remove waste products from the body.

So…
As solids are increasing in volume in the diet, it becomes more important to monitor the amount of water a child is drinking, particularly in the case where milk feeds are being replaced by solid foods.

• Water is much better than other fluids, particularly juices and cordials.
• Ensure that drink bottles and cups are placed in easy-to-see and reachable positions and check the levels throughout the day.

Dietary guidelines recommend that children:

• Are not given any fruit juice before 6 months of age.
• Are not given juice in bottles or other vessels that pour easily allowing a child to drink juice over the day.
• Are not given juice at bedtime.

It is generally agreed that young children should not be given fruit juice and that water is the most preferred fluid.

Fibre facts
Not all fibre is the same; some will increase the passage of stools through the intestines whereby others tend to slow it. Figure 1 highlights the known effects of different fibres and their sources.

What to do if your child has constipation
Mild constipation will generally resolve itself from increasing fibre and fluid. If however the problem persists seek medical advice about clearing the accumulating stools and prevention from there.

IF YOU ARE UNSURE OR SYMPTOMS PERSIST SEE YOUR MEDICAL PROFESSIONAL

* Children should always be supervised when given nuts and seeds due to risk of choking.

Adapted from the Certificate of Childhood Diet and Nutrition 2005

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