Fussy Eater Constipation Tips

Fussy eater constipation tips are provided to assist you to give relief to your fussy eater and to reduce the frequency of future bouts of constipation.

My girlfriend’s 4-year-old son had not been to the toilet for a few days. She, at the time, was involved in a Theatre play, and was away from home every single night. No amount of persuasion, or homemade remedies would help. However, at the end of the week, theatre was finished, and her little boy finally went to the toilet.

“See”, he said, “there’s Daddy poo, there’s kiddy poo, and this is baby poo…and their mummy? She’s at the theatre!”

We thought it was a very funny story at the time. However, when it comes to limited bowel movement it tells us that there is a lot at play…No pun intended.

Constipation is a frequent issue that affects 30% of children. It requires all the attention of a mother when she’s home from the Theatre.

When I work with a new family, finding out if their fussy eater suffers from chronic constipation is a priority. Often, they have a lower fibre intake, than other children. But this goes beyond nutrition: it always does. Constipation may affect appetite and exacerbate anxiety associated with eating.

What is constipation?

Children can have irregular bowel movements and not go to the toilet every day without being constipated. Babies who are breastfed may poop once a week, while children may go every 2 or 3 days. Toddlers may be struggling to juggle toilet training and pooping action.

Therefore, the appropriate way to assess and confirm constipation it to check your fussy eater’s stools. It is indicated by dry, nuts/pellets like, or large dry painful stools. These are depicted in the Bristol Stool Chart here. Yes mums and dads you need to have a look, rather than rely on what your children may let you know. Some children will not be able to express what is happening to them.

Signs of constipation

There are quite a few signs of constipation you may see along the way.

Pellet /sausage like dry poop,
Refusing to go to the toilet,
Reduced appetite, the child feels full after a few bites. Appetite may increase after a child passes a large stool. Then it decreases again,
Nausea and vomiting (because the stomach is slow at emptying),
Complaining of abdominal pain or cramps,
Irritability, anxiety. Children may cry, bend their body in two, or lie down in a fetal position. They may cross their legs and refuse to go to the toilet as they become anxious about the pain they experience. They may soil their pants,
Anal fissures, from straining.

Causes of constipation

a refined diet that lacks fibre,
limited hydration,
overconsumption of dairy products,
a lack of physical activity,
ignoring the urge to poop (witholding behaviour), for example, due to associated pain or anxiety.
underlying medical causes (allergies, celiac disease etc).

Children’s Withholding Stools

Children withholding stools is an important behaviour to recognise, as it can significantly impact their health and comfort. Withholding can stem from fear of pain, previous negative experiences, or anxiety about using the toilet. This behaviour often leads to a cycle of worsening constipation, making bowel movements even more uncomfortable and creating a cycle of avoidance.

Signs of withholding include crossing legs, clenching buttocks, or avoiding the bathroom. Children might show behavioural changes such as irritability, mood swings, or general discomfort. It’s crucial to observe these signs and address them early to prevent further complications.

To help children who withhold, creating a positive and stress-free bathroom environment is key. Encourage regular bathroom visits, especially after meals, and ensure the child feels safe and relaxed. Using a footstool to elevate their knees can help them sit in a more natural position, making it easier to pass stools. Positive reinforcement can motivate children to use the toilet more willingly.

By understanding and addressing withholding behaviour, parents can help their children develop healthier bathroom habits, reducing the risk of chronic constipation and associated discomfort.

When should you take your fussy eater to a doctor?

If you are worried about your child, seek medical advice immediately. For frequent, chronic constipation, consult your GP to rule out any specific cause or to prevent worsening conditions such as faecal impaction. Addressing pain and constipation is important before trying home remedies.

A doctor or paediatrician can investigate chronic constipation further. Trust their advice instead of eliminating foods from your child’s diet based on guesswork. Relief is crucial, and the doctor may prescribe laxatives, which should not be self-prescribed for a child. While long-term use of laxatives can reduce bowel movement, they may be necessary for immediate relief.

Hydration matters, because as much as fibre is important to a child’s diet, a bulk of fibre will not move without good hydration. The trick is to offer water at meals and during the day. Use a glass here, a bottle or a cup there. Looking at your child’s urine can give you an indication as to what their hydration status may be like.

Urine chart
Foods that are beneficial include prunes, pureed apple and juices, fruit (unpeeled, including grapes, pears, persimmons, and kiwis) and vegetables. Oats can be offered at breakfast. Psyllium can be sprinkled over food. Seeded, sprouted, wholegrain and wholemeal pasta, rice or bread, legumes (chickpeas and lentils), seeds and nuts can be offered at mealtimes.
Some naturally occurring sugars like sorbitol, xylitol, or mannitol found in stone fruit like avocado, plum, cherries, peaches, apricots etc, have a laxative effect. They are often used as sweeteners in yoghurt and other products.
Massage and/or warm bath may help babies and children.
Exercise is important, lifting legs up, or any movement that can put gentle pressure around the bowel area may help.
Regular opportunities to sit down on the toilet, i.e. a once a day or after each meal should be provided. However, the toilet routine should not pressurise children to produce stools: children need to be relaxed.
Footstools that raise knees higher than hips will provide good ergonomics for a child sitting on the toilet.
Bananas, especially if unripe, grated apple and excessive milk may increase constipation.

Laxatives and mode of action

Talk to your doctor or pharmacist about what may work best for your child. The following information will give you an understanding of laxatives modes of action, it is not a recommendation.

Sennosides-Containing Laxatives

EXLAX for Kids

Active Ingredient: Sennosides
Mechanism of Action: Stimulant laxative. Sennosides stimulate the lining of the intestines, causing increased bowel movement.
Dosage Form: Chewable tablets or chocolate pieces.
Use: Effective for short-term relief of constipation in children.

Senokot (Australia)

Active Ingredient: Sennosides
Mechanism of Action: Stimulant laxative. Sennosides increase bowel movement.
Dosage Form: Tablets.
Use: Relief of occasional constipation.

Laxettes (Australia)

Active Ingredient: Sennosides
Mechanism of Action: Stimulant laxative. Sennosides increase bowel movement.
Dosage Form: Tablets, chocolate pieces.
Use: Gentle overnight relief of constipation.

Coloxyl with Senna (Australia)

Active Ingredients: Docusate Sodium (stool softener) and Sennosides
Mechanism of Action: Dual-action with stool softening and stimulation of bowel movement.
Dosage Form: Tablets.
Use: Dual-action relief of constipation.

Other Laxative Formulations

MiraLAX (Polyethylene Glycol 3350)

Active Ingredient: Polyethylene Glycol 3350 (PEG 3350)
Mechanism of Action: Osmotic laxative. PEG 3350 retains water in the stool, resulting in softer stools and more frequent bowel movements.
Dosage Form: Powder that can be mixed with liquids.
Use: Suitable for longer-term use and chronic constipation.

Movicol

Active Ingredients: Polyethylene Glycol 3350 (Macrogol 3350), Sodium Bicarbonate, Sodium Chloride, Potassium Chloride
Mechanism of Action: Osmotic laxative. Macrogol 3350 retains water in the stool, resulting in softer stools and easier bowel movements. The electrolytes help maintain the body’s normal levels of sodium, potassium, and water.
Dosage Form: Powder that can be mixed with liquids.
Use: Effective for the treatment of chronic constipation and fecal impaction.

Pedia-Lax Liquid Stool Softener

Active Ingredient: Docusate Sodium
Mechanism of Action: Stool softener. Docusate sodium helps moisten the stool by increasing the amount of water the stool absorbs in the gut.
Dosage Form: Liquid.
Use: Gentle and typically used for mild constipation.

Milk of Magnesia (Magnesium Hydroxide)

Active Ingredient: Magnesium Hydroxide
Mechanism of Action: Saline laxative. Magnesium hydroxide draws water into the intestines, which softens the stool and induces bowel movements.
Dosage Form: Liquid.
Use: Often used for rapid relief of occasional constipation.

Pedia-Lax Chewable Tablets

Active Ingredient: Magnesium Hydroxide
Mechanism of Action: Similar to Milk of Magnesia, it draws water into the intestines to soften stools.
Dosage Form: Chewable tablets.
Use: Provides a more palatable option for children who may have difficulty swallowing liquids.

Benefiber

Active Ingredient: Wheat Dextrin
Mechanism of Action: Bulk-forming laxative. Wheat dextrin adds bulk to the stool, which helps stimulate bowel movement.
Dosage Form: Powder that can be mixed with foods or liquids.
Use: Suitable for maintaining regular bowel movements and preventing constipation.

Comparison Summary

Sennosides-containing products like EXLAX for Kids, Senokot, Laxettes, and Coloxyl with Senna are stimulant laxatives that provide effective short-term relief of constipation by stimulating bowel movements.
Movicol and MiraLAX offer osmotic laxative options suitable for both short-term and long-term use, focusing on stool consistency and regularity.
Pedia-Lax Liquid Stool Softener and Pedia-Lax Chewable Tablets provide mild, child-friendly options.
Milk of Magnesia provides quick relief by drawing water into the intestines to soften stools.
Benefiber is a bulk-forming laxative that adds bulk to the stool to help maintain regular bowel movements and prevent constipation.