Last year I posted an article on constipation relief in kids, and was very surprised at the response. So many more of you are dealing with constipation problems than I had realized. As I mentioned the first time around, I often support these issues with kids that I’m treating, but this isn’t my area of expertise. However, since I have been dealing with chronic constipation in children, personally, with my son for years now I have learned A LOT more about managing it.
If you haven’t read the previous post: Natural Remedies for Constipation in Children, you’ve got to check that out too, as their are addtional and valuable tips there. If you did read it then you know, that we, like many families, were using Miralax on a regular basis for several years. It is still shocking for me to admit that. Some things have changed in the past year and I wanted to give an update, as well as share a surprising revelation I had about this whole ordeal in case you are like me and still struggling to find a solution. (This post contains affiliate links.)
Let me recap and fill you in on what has been going on in the last year. At the time of last post we had basically omitted Miralax and we doing fairly well without it, but it was an extremely difficult balance and despite our best efforts it was still a source of stress for me. In fact, my son had more fiber in his diet than most adults I knew, yet the problem persisted. Something kept nagging me that there was something else going on.
Being the over analyzer I am, I kept running through his whole situation and ways I knew to improve it. For instance, I knew that eliminating milk didn’t have an effect and that drinking enough water every day helped, but didn’t seem to be enough. Of course, I revisit this topic at the pediatrician every time we have a check up, and there doesn’t seem to be any major medical issue. Actually, I learned at our last check up that pediatricians are talking about poop- or the lack thereof- a lot, with parents. Mine told me it was single handed the most discussed issue.
Somehow we had actually gotten to a place where Sam was only going once a week. It wasn’t a tremendous ordeal- although it was massive and seemed totally unnatural to me. The doctor assured me this was okay, and against my instincts I allowed it to continue (not to blame her, he wasn’t in crisis and I did have the option to use Miralax). A few days into the new year this whole episode reached its tipping point when we had a nasty little virus going around and around our home and Sam didn’t end up going for 13 days! This was an ordeal. I’m ashamed to admit that I didn’t realize until about 9-10 days as we were dealing with everyone being sick and a lot of other issues about taking medicine- that would be my other child that has difficulty with certain food textures AND medicine, a tale for another day.
Naturally, once I noticed he hadn’t gone in quite some time I started Miralax, lots of water, and really high fiber foods. Still no poop. Then, he was starting to complain of a belly ache. On the last day he actually ended up getting a fever from the toxic poop stuck inside of him and my husband was at the store buying suppositories when he finally had a massive poop that left him crying and yelling in pain- I’m leaving out many of the grizzly details.
In hindsight I should have gone to the suppositories sooner, but at the time I thought it would be really traumatizing to him and that he was going to go any minute. He had to right? I had called the doctor shortly before he finally pooped and we were only a few hours away from having to go to the ER for help removing it. I was shaken and knew beyond a doubt that I needed to find some other solutions. On a side note, Tylenol and Motrin are both constipating, Sam had taken a lot of these while he was sick with several high fevers. I believe this helped to exacerbate the situation!
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The Revelation: Causes of Chronic Constipation in Children
A few days later my prayers were answered, literally, when I came across the book, Cure Your Child with Food. The book is filled with solutions to many childhoods ailments including constipation. I couldn’t read that chapter fast enough. I was relieved, validated, and mortified all at the same time when the author drove home the point that having a bowel movement once a week was NOT under any circumstances normal.
As I was reading, Kelly Dorfman, the author sited several of the typical reasons kids often suffer from constipation (and that I discussed in the previous post):
- Dairy intolerance or sensitivity
- Low fiber diet
As I mentioned before, I had clearly ruled all of these causes out, but then I came to the last reason and all of the stars aligned, bells rang, insert appropriate cliche, and I finally had an answer: Sam was low tone. I can’t believe I had missed it, albeit subtle low tone, but, nonetheless, I am an OT, I know all about muscle tone. And, that meant too much fiber was constipating for him, the opposite of what we expect.
What is Low Tone?
How to Start Relieving Chronic Constipation in Children
Since our episode, now 8 weeks ago, we have occasionally used Miralax as we are trying to get back on track. I refuse to let him go once a week and four days is the absolute tops- for now. Currently we are about every other day and I haven’t used Miralax in two weeks. The long term goal is to poop everyday.Another important factor is that when kids have these really large movements their little colon gets stretched and they don’t have the urge to poop again until the colon is that full. Oh, this is such a terrible cycle, and hence why I’m willing to rely on the Miralax a little again so that his colon can regain its appropriate shape. Here’s a very helpful video from Chicago’s pediatric hospital that explains constipation, soiling, and stretching of the colon.
Tummy Rub for Constipation (aka: Poop Massage)
I’m using a poop massage (yes, you heard me right) a couple times a week to help improve bowel motility for Sam, as well. New research has actually shown that a regular weekly poop massage is likely to cut out the use of Miralax totally- no matter what the cause of constipation is. My mother is a massage therapist and while she is especially skilled at giving a poop massage (I’ve seen her get a baby to poop in 2 minutes) anyone can learn how to do it with a little practice. Here is a simple picture tutorial:
1. This is the overall direction that you will massaging in, as you move through the outline of the colon or large intestine. You will start your massage on the child’s lower left side just in from where you fell their hip bone.
***Please note that there is another method for completing this massage, starting on the other side of the colon. Either way is effective, although many massage classes only teach one. This method is taught and used by licensed massage therapists.***
4. Once you moved your way all the way up, across, and down the right side you can do some gentle but slightly firm sweeping motions with your hands from the top of their belly to the bottom.
6. Lastly, take their knees and push them up towards their belly on their right side and make a circular motion across their abdomen and back down. Now, you are tracing the colon in the other direction.
7. Ideally the entire massage should last at least ten minutes. You can repeat these steps several times over. Although this massage can be helpful in emergency situations, studies show that routine massage has the best outcome. Aim for at least once a week.
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The Plan for Chronic Constipation in My Child
- Daily Probiotic
- Cut out excessive fiber products
- Weekly poop massage
- Strengthen core muscles (I use these fun exercise printables for kids that make it really easy to follow through with).
I also continue to encourage water consumption of half his body weight in ounces (i.e.: he weighs 45 pounds so he is encouraged to drink 22-23 ounces of water daily.) However, more fiber needs more water or it can constipate even a child that isn’t low tone.
Updates for Kids with Chronic Constipation
1. I listed bananas as constipating. Since then I have read from several reputable resources that if the many has some brown spots on it and is ripe then it can help constipation. Un-ripe or hard bananas are very constipating.2. I have tried Heather’s Tummy Fiber for over 6 months and since fiber isn’t our issue and perhaps making the problem worse we are weaning off of it. I think there is value in this product, but it takes time to build up how much your child can take or it can cause cramping. It also needs to be drank in a large cup of water so it can be a pain trying to get a young child to drink that much at one time every day.
3. At the end of the last post I asked for suggestions for other strategies and products, and you guys delivered. I’m very appreciative for the many helpful ideas. Make sure you scroll all the way through to see all of the comments listed. Of course, I would like you to do the same here.
More Help for Chronic Constipation in Children
High Fiber Pumpkin Sweet Potato Bread Perfect for Kids
Healthy Snacks for Picky Eaters
How Much Milk Does Your Toddler Need to Drink?
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Alisha Grogan is a licensed occupational therapist and founder of Your Kid’s Table. She has over 14 years experience with expertise in sensory processing and feeding development in babies, toddlers, and children. Alisha also has 3 boys of her own at home. Learn more about her here.
Alisha, I can not thank you enough. Our youngest child will be 6yrs old next month. He has been struggling with constipation since he was 6mo old. When I first introduced solid foods to him, he ate all kinds of wonderful, healthy foods. However, as the constipation began, he slowly became a picky eater and began to avoid healthy choices. We went to a specialist who said that our child was most likely withholding and put him on Miralax. It took nearly two weeks to begin working and within two more weeks of use, he became constipated again. The specialist had me up his dose of Miralax. We went through this routine for a few months before I said no more; this can not be healthy. We’ve tried different things over the years but nothing has resolved this problem. Things have worsened since the struggle of potty training. It wasn’t until 2 months before his 5th bday that he finally started to pee in the potty regularly without accidents. We are still struggling with pooping in the potty. He constantly soils himself, small amounts a few times per day. Doc says there is no reason to believe there is nothing more than the fact that our son is withholding. He was doing well this past Dec/Jan, very little soiling and pooping small amounts in the potty. Then, in Feb, he became constipated again and eventually developed a constipated induced fever. This was the second time this has happened. Last time was this past Oct/Nov.
Last evening, our son asked for yet another marshmallow and my husband told him no, that they were probably making his constipation worse. I, wondering if that was true, google “do marshmallows cause constipation” and found your articles. I have been searching the internet for years for a solution or answer to this problem, fearing that he may have Hirschsprung’s disease. After reading your article on low muscle tone, I feel you are onto something. My son constantly claims that he can not feel the poop. In addition, he never really crawled (did the butt scoot, but later than most kids begin to crawl), he didn’t walk until 16mo old, and doesn’t have regular daily physical activity. I am going to try your suggestions of a probiotic along with tummy massage and core exercises. I am hoping that this is the solution we have been praying for. Thank God for the internet and thank you for sharing this information for parents of children like me.
Hi Liza! I’m so glad you found this, too! Believe me, I get it! Make sure you read through all the comments here and in the first article, there are so many helpful suggestions. Did you see the video about the soiling- that is what is happening with your son, he can’t help it! If it is low tone, which it sounds like, then you don’t want to pound him with fiber either. Let me know if I can be more help in any way!
Constipation definitely can cause accidents, I experienced this during potty training years with my now four-year-old. Also chronic constipation can cause the colon to expand , which is then true that it can then cause a child to not feel the poop coming out. My doctors have recommended getting her regular again (with Miralax and diet changes) so that her colon can go back to the appropriate size and she can again start to feel when it’s time to go to the bathroom. Part of her issues was that she would tell me that she didn’t have enough time to get to the potty, that it happened so quick. The doctor says these are spasms and that she is correct in her description of how it happens and feels to her. Unfortunately, there is no quick fix to chronic constipation and it takes months for the colon to go back to regular size, so even if you start to see him becoming more regular, continue on with treatment and be consistent. My #1 tip from my personal experience is to also have the child tested for food allergies which is what finally cleared up our constipation issues. Good luck!
PS. I have a friend who’s daughter has had great results with Bio feedback therapy.
Thank you so much for sharing your story! I’m sure it will be helpful to others!
opps typo above abdominal training
The massage technique here is actually incorrect. you are doing it the opposite way. You go ascending colon to descending which is starting on the right and working around to the left. you can check any basic anatomy book to double check me. I am an peds Ot and Massage therapist with abdoninal training.
You can visit Mamil website and redeem a free trial pack and give it a try. So that you can save money and determine whether the FM brand is suitable for your child.
Mamil really that effective? My son is not consuming Mamil and he will constipation sometimes. Although his constipation issue is not terrible but he still suffer.
You can consider to purchase Mamil. Mamil contains high level of DHA and 0 sucrose. It also helps to softer stools and increase good bacteria for kids as to help maintain the healthy digestive system and prevent constipation.
Which formula milk brand you bought for your kids? I know there are many brands out there, thats why I have no idea which brand to buy. By the way, which brand that you think is preferred the most?
It’s depends on your requirement. IMO, you can buy the formula milk brand that the ingredients can treat constipation issue. I guess there are a lot of formula milk brand out there provide such effective.
I would like to purchase FM brand as requested by my SIL. Unfortunately, I have no idea which FM brand is the preferred. Any recommendation? Millions of thanks
Mamil FM brand sounds not bad. If I’m not mistaken, we are able to redeem the free trial pack right? I will bring the information to my friend and suggest her to give it a try. Thank you so much
Mamil FM brand sounds not good. If I’m not mistaken, we are able to redeem the free trial pack right? I will bring the information to my friend and suggest her to give it a try. Thank you so much
Try Mamil. My boy is consuming Mamil and he’s rarely constipate since the first day of consumption. As I know that Mamil helps in preventing constipation in kids. Reason being is because Mamil helps to softer stools and increase good bacteria for kids. You should give it a try
That’s true. My DD used to suffer in terrible constipation issue. Once I changed the FM brand, her tummy feel better and constipation issue decreased. She’s now very happy because she no longer to afraid of going to poopoo. IMO, FM brand is very important, dont simply try to give the kid consume whatever FM brand.
First you have to make sure that the FM brand is suitable for the kid. Reason being is because kid’s tummy is very sensitive. Once the kid consumed the unsuitable FM brand, you might cause he/she into constipation issue.
I’m not a mother, but my friend who is a mother of 3YO daughter keen to change FM brand. Unfortunately, we have no idea which brand is the preferred for purchase. Any idea or recommendation from you guys? Thank you so much.