The gastrointestinal tract is uniquely suited to digest all the different foods we eat to help our children grow and thrive. However, there are times when the body reacts to certain foods and cause discomfort.
A food allergy occurs when the body sees food as harmful and the immune system reacts to the allergens. When the response involves antibodies known as immunoglobulin E (IgE), symptoms such as hives, trouble breathing, or vomiting can appear quickly. Other times, non-IgE mediated allergies may cause symptoms such as abdominal pain or diarrhea that are delayed up to three days. The most common food allergens in children include milk, soy, egg, wheat, peanuts, tree nuts, fish, and shellfish.
A food intolerance or food sensitivity occurs when the body has trouble digesting certain foods, but the immune system is not involved. A common example is lactose intolerance where the intestinal enzymes cannot completely process the ingested milk sugar. Food intolerance can lead to similar symptoms as food allergies, but the reactions tend to be less severe.
In many cases, treatment of allergies and intolerances involves removing certain foods from the diet. However, overly restricting a child’s diet could have a negative impact on their nutrition and growth. In certain situations, medications may be useful as well. Your child’s pediatrician or pediatric gastroenterologist can help guide you through the diagnosis and treatment of these conditions.
Inadequate Hydration – Aside from losing fluids by using the bathroom, most children are very active and sweat quite a bit. These “insensible losses” force the colon to draw out more water from digested food leading to incredibly hard poops! Keeping them hydrated especially on warm days is important! Beginning in toddler-hood, kids should be getting about 1 liter a day minimum.
Stool Holding – Kids are some busy people! They are engaged in school, after-school activities, playing with friends, video games etc. Making the time for them to sit on the toilet is important. Toilets at schools are gross. “Toilet Time” at home is particularly important in toddlers and young children learning to develop healthy stooling habits. The colon is naturally squeezing 20-30 minutes after breakfast and dinner making these good times to encourage sitting.
Diet – Getting the right proportions of food can be challenging in early childhood. Kids are picky – and lets be honest, most parents don’t have time to plan an elaborate meal. The key to a balanced diet is allowing for adequate fiber in the form of whole grains, fruits or vegetables at least 5-9 servings per day. Some of my current favs: Mammachia Chia Squeeze (Chia is a great source of fiber and Omegas!), Brussels sprouts, and tangerines. www.choosemyplate.gov for more info!
Fiber – Fiber is good… too much fiber? Not so good. Insoluble fibers such as bran, lentils and green leafy vegetables work by breaking up stool. But too much can result in added bulk (i.e. basically making more poop). Soluble fiber such as oats, beans and oranges draw in water and soften stool. But too much can actually cause bloating/diarrhea/dehydration. For children 2-10 years old, the old adage is age + 5 = grams of fiber per day.
Milk-Protein Allergy and Other Food Allergies – Food protein intolerances (different from classic anaphylactic allergy) often result in abdominal pain, occasional nausea/vomiting and diarrhea. The constipation is secondary to the limited variety of foods available to those children suffering from allergies. Using food diaries and coming up with a comprehensive nutrition plan with your pediatrician or pediatric gastroenterologist is important to prevent vitamin deficiencies and constipation.
These area some less common but more insidious causes of constipation and cannot be missed! They include: celiac disease, IBS, thyroid disease, medication-related constipation, and anal fissures. If you worry that there may be an underlying reason for your child’s constipation that isn’t listed above, we are here to help!