Constipation. More Fibre, How?
Ora-Mari Olwagen
Constipation is a very common problem amongst young children. A lack of, or too much fiber can cause constipation. With toddlers, the consumption of too much milk may lead to constipation, as the diet is not well balanced. Too much milk may also suppress appetite. In severe cases medication is necessary to empty the gut. With young children, a small increase in the total fiber intake may be adequate. Strategies for behavior change are also beneficial: being active, regular toilet use, offering rewards for healthy eating and fluid intake.
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Constipation may be caused by:
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Poor/small appetite: eating too little to achieve regular bowel movements
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Irregular meals
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Too little/too much fiber
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Insufficient fluid intake
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Side effects of some medications
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Shy or afraid to use the toilet
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Combination of the above
There are two kinds of fiber: soluble & insoluble.
Soluble fiber: mostly in fruit, vegetables, beans, lentils and oats.
Insoluble fiber: whole grains, pasta and rice.
High fiber foods are low in fat and can be very filling. It can cause younger children to feel full very quickly, even before their energy need is met. Fiber also inhibits essential nutrient absorption; too much fiber may lead to nutrient deficiencies. Adequate fluid and nutrient dense foods should be included in a balanced diet.
General recommendations (>2 years old):
Always increase the amount of fiber GRADUALLY
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Bread: Whole wheat, Best of Both, wholegrain.
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Cereal: High fiber e.g. Weetbix, All Bran, Oats. Try adding fresh/dried fruit. Aim not to buy cereal with added sugar, chocolate or honey.
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Fruit: 2-3 servings per day. Leave the skin on. Fresh, canned and dried can be included. Try homemade frozen fruit lollies.
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Vegetables: Variety is important. 2-3 servings per day. Keep the skin on where possible. Try raw vegetables: carrot sticks, celery, red pepper, cucumber, baby corn, cauliflower.
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Beans: Canned baked beans, butter beans, chickpeas, lentils.
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Nuts: All nuts are high in fiber. Whole nuts should not be offered to children younger than five years (choking hazard). Use smooth peanut butter/other nut butters.
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Choose wholegrain products: brown rice, whole wheat pasta/pitta/tortillas.
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Offer small, frequent meals/snacks.
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Make sure enough fluid is consumed. The best drinks are water and milk. Unsweetened fruit juice (diluted) with meals only (to prevent dental caries).
Fiber recommendation: age in years + 5 to 10g / day (up to a maximum of 18 g / day). For example a toddler of 2 years old should be taking in 2 + 5 to10, which is 7 to 12 grams of fiber daily.
Ora-Mari Olwagen, Pediatric Dietitian, 0793406821,ora@absolutenutrition.co.za,
www.absolutenutrition.co.za