Q

My 23-month old son suffers from chronic constipation. What foods will help and which ones should be avoided?


A

Rather than a list, which can be limiting, some guidelines may be of help. First, you need to confirm that it is, in fact, constipation that your son is experiencing. It's normal for children to have a bowel movement once every two or three days, or to have two or three a day. What characterizes constipation is straining to pass feces, hard dry stools and fewer than three movements a week. It's also important to check with your pediatrician to rule out any pathological reason for the problem.

Once you've done that, diet is an important tool in the remedy for constipation. The main cause of diet-induced constipation is a lack of fiber and fluid. High-fiber diets effectively treat constipation in a couple of ways. First, fiber bulks up and softens stools making them easier to pass; second, the rough edges of the fiber mechanically stimulate the nerves of the bowel lining, promoting colonic movement and helping to pass the stools along. Some fibrous foods such as prunes also contain chemicals which stimulate the bowels.

Drinking too little fluid is a classic cause of hard stools, so ingesting plenty of fluids is very important. For your son, proper treatment of his constipation includes gradually increasing the fiber in his diet over the next four to six weeks while also increasing his fluid intake.

Fiber needs to be added slowly for his system to get used to it. A sudden increase in fiber can cause gas, bloating and lots of discomfort. And if it's added without the necessary fluid to soak up the fiber, you could end up with even more of a problem.

Some high fiber foods include:

  • Wheat bran, which you can add to his diet in muffins, breads, casseroles, meat loaf, etc.;
  • Fruits & vegetables - especially spinach, corn on the cob, nectarines and peaches;
  • Cooked prunes, dates, figs and legumes - especially baked beans, black beans, garbanzos and kidney beans; and
  • Whole grain breads and cereals.

It's very important to include plenty of fluid; sometimes warm water can help. Milk and cheese can cause constipation in some people, so, although your son needs at least 16 to 24 ounces of milk or equivalent per day, try to not let him have too much. Some people have found that yogurt cultured with acidopholus and bifidus helps relieve constipation. Stonyfield Farms uses those cultures in their yogurt.

With these changes in is diet, coupled with plenty of exercise, your son should soon get some relief.