Children's Hospital Colorado

Constipated Kids? How to Get Regular (And Stay That Way)

A toddler sits on a training potty next to a stuffed teddy sitting on a toy potty.

About a quarter of kids who see a pediatric gastroenterology (GI) doctor have trouble pooping.

It’s almost always constipation, says Christine Waasdorp Hurtado, MD, a pediatric gastroenterologist at Children’s Hospital Colorado. Most often, it doesn’t trace back to a medical cause.

Rather, too little water and fiber leads to hard, painful poops. That makes kids want to hold it, which makes the problem worse. The result is harder and less frequent poops, plus lower abdominal pain. Children experiencing severe abdominal pain need medical help, of course, but constipation is generally a pretty easy fix.

“I spend a lot of time talking about diet changes that help kids poop,” says Dr. Waasdorp Hurtado.

The number-one change: more water and fiber.

What’s so great about fiber?

Essentially a skeleton for plants, fiber gives vegetables their structure and shape. Because humans lack the digestive enzymes to break it down, the two types of fiber — soluble and non-soluble — pass nearly intact through the digestive tract.

That’s why it’s so important to pooping. Soluble fiber attracts water, softening poops and making them easier to pass, while, non-soluble fiber adds “bulk” to poop, helping it move quickly and smoothly through the intestine.

High fiber fruits

All plants have fiber, but some help more than others. Fruits that start with the letter “p,” coincidentally, tend to help the most: peaches, plums, pears, pineapple, papaya and — the granddaddy of them all — prunes.

“It really is true. Prune juice is the best,” says Dr. Waasdorp Hurtado. Besides a big helping of both types of fiber, prunes contain sorbitol, a natural laxative that works by drawing water into the large intestine. Chia seeds are also effective.

These fruits are tasty and healthy on their own, of course, but if you need help getting your kids to eat them, try these combinations:

Breakfast

  • Top sliced peaches with Greek yogurt and honey.
  • Add chopped prunes to whole-grain, fiber-rich breakfast cereal.

Smoothies

  • Make a tropical smoothie by blending pieces of peeled papaya and pineapple; add Greek yogurt and a little orange juice and puree until smooth.
  • Make a green smoothie with peeled pear, pineapple, spinach, and water or milk.

Snacks

  • Spread nut butter or sunflower butter on pear slices; cut prunes into small pieces and put them on top for a variation of “ants on a log."
  • Add prunes, dried papaya and dried pineapple to a can of mixed nuts for instant trail mix.

Fruit salad

  • Peel and cut the plums, peaches, pineapple, papaya and pears into small pieces. Put them in a large bowl. Squeeze some lemon juice and drizzle some honey over the top. For added flavor, sprinkle in fresh, chopped basil.

Fiber every day keeps the doctor away

In tough cases, Dr. Waasdorp Hurtado recommends non-stimulant laxatives like Miralax, which are basically a supercharged fiber boost. For most constipation, though, more of any fruit or veggie will do. The same applies to whole grains like whole wheat and corn (rather than refined ones like white flour, which has most of its fiber removed).

A good rule of thumb for fiber intake in grams is to take years in age and add five — so a 5-year-old should get 10 grams each day. Just one medium apple contains nearly half that amount.

Most American kids don’t get enough fiber. Making sure they do, says Dr. Waasdorp Hurtado, is essential to keeping them in good health — even if they seem to be pooping just fine.


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