Constipation is stool that is dry, hard, and difficult or painful to pass. The number of times children have a bowel movement will depend on their age, diet, and activity level. This can vary from 2 to 3 times daily to once every 4 days.
When to Get Help
Call your doctor or go to the hospital if your toddler has dry, hard stool and any of the following:
blood in the stool
fever
vomiting
Causes of Constipation
Low fibre intake
Low fluid intake
Low levels of physical activity
Avoiding or delaying the body's signal to have a bowel movement
A genetic disorder that affects the digestive system
A medical treatment or medication that slows movement in the digestive system
Schedule Toilet Time to Help Manage Constipation
Sometimes your child may avoid going to the bathroom, which can cause a drier stool, pain, and can be the beginning of long-term constipation.
Schedule a regular toilet time for children to help them get used to going to the bathroom. You can start by asking your child to sit on the toilet for a few minutes after every meal. Stay with your child - you can read or sing with your child while he or she is sitting on the toilet. Celebrate with your child after she has a bowel movement.
Offer More Fluid to Help Manage Constipation
If your child is not drinking enough fluid, it can lead to constipation. An easy way to tell if your child is drinking enough fluid is to look at the colour of his urine. If it is dark yellow, you need to offer fluids more often.
Tips
Offer at least 2 cups (500 mL) of milk, yogurt drinks, or calcium- and vitamin D-fortified soy or rice beverages every day.
Offer water throughout the day when your child is thirsty.
Increase Physical Activity to Help Manage Constipation
Daily physical activity can help decrease constipation. Try to add an extra 30 minutes of physical activity to your child's day. Reduce the time your child watches videos, television, or plays video games.
Tips
Take a walk without a stroller.
Put some music on and dance, dance, dance!
Take your child outside to play.
Join or organize a play group in your community.
Offer More Fibre to Help Manage Constipation
Fibre is the part of cereals, breads, and other whole grains, vegetables and fruit, beans, and lentils that our bodies cannot digest. It is important to include fibre from a variety of foods so that your child gets the right amount of vitamins and minerals.
A high fibre diet is used to help prevent and treat constipation. Fibre holds water inside the digestive system and helps soften the stool.
Increase fibre slowly, to help your child's body get used to eating more fibre. If your child changes too quickly to a high fibre diet, he may have gas and may feel full quickly. You need to offer more fluid to your child if you are increasing the amount of fibre. Not getting enough fluid can make constipation worse.
High Fibre Choices
The following is a list of foods that can be used to slowly increase the amount of fibre your child eats. For the fibre content of some of these foods, please see the end of this handout.
Do not force or beg your child to eat. As a parent, your responsibility is to provide nutritious food choices. Your child is responsible for what and how much she chooses to eat at meals or snacks.
You may need to offer new foods many times before your child accepts them. Serve small portions at first (1 tbsp. or 15 mL) and allow your child to ask for more.
To increase the fibre in your child's diet, it is important to include cereal fibre in addition to a variety of fruits and vegetables. Wheat bran and oat bran are the best at helping your child avoid constipation. Try to have your child eat at least 1 tbsp. (15 mL) of cereal fibre 3 times a day.
Remember: Some foods can cause choking in children under 4 years old. Nuts, seeds, popcorn, raisins, raw vegetables, and fruit are high-risk foods. Cut food into small pieces and cook to soften.
Grain Products
whole-wheat pasta
brown or wild rice
whole grain breads, crackers, muffins, and cookies
bran or whole grain breakfast cereals with at least 3 grams of fibre per serving, such as 100% bran, bran flakes, Corn Bran Squares, and shredded wheat
cooked cereals such as Red River, Sunny Boy or oatmeal
Note: Give 1 cup (250 mL) of fluid with each serving of cereal fibre to ensure your child is getting enough fluid.
Vegetables and Fruit
green peas, sweet potato, corn, squash, broccoli, and carrots
pear with skin, prunes, dried apricots, apple with skin, orange, blueberries, raspberries, and strawberries
Meat and Alternatives
baked beans, refried beans, kidney, romano, pinto, navy, or black beans
chick peas and split peas
lentils
Fibre in Packaged Foods
Packaged foods often provide information about the amount of fibre in the food. Read the "Nutrition Facts Panel" to help you choose foods that are highest in fibre. Look for these nutrition claims on the food package:
A very high source of fibre has at least 6 grams of fibre per serving.
A high source of fibre has at least 4 grams of fibre per serving.
A source of fibre has at least 2 grams of fibre per serving.
Tips to Add Extra Fibre
Grain Products
Wheat bran and rice bran are tolerated best in cooked products such as applesauce, hot cereals, pancake mixes, casseroles, meat loaf, burger patties, vegetable dips, yogurt, sauces, soups, or coating mixes.
Oat bran can be used in cooked foods or served on its own.
Corn bran and psyllium powder can mix easily into foods and do not change the texture of the food a lot.
Mix high fibre cereals such as All-Bran Buds with lower fibre cereals such as Corn Flakes.
Add sliced banana or berries to cereal.
Replace all or part of the flour in a recipe with whole-wheat flour when baking cookies, muffins, or pancakes.
Vegetables and Fruit
Offer more vegetables and fruits. Leave the skins and peels on if your child can chew them well. If not, then grate or mash fruits and vegetables and add them to the food that will be eaten. Let your child help prepare them.
Chopped blueberries, raisins, zucchini, pineapple, carrots, dried fruit, and nuts can be added to recipes when baking cookies, muffins, breads, or pancakes.
Add vegetables to pizza, casseroles, soups, pasta sauces, and meat loaves. Minced carrots, broccoli, spinach, corn, or peas can be added to almost any recipe.
Cook vegetables in vegetable, chicken, or beef stock instead of water to add more flavour.
Try the following fruit spread recipe. Use this high fibre spread on toast or crackers, add to hot cereal or mix with cream cheese.
Fruit Spread Recipe
1/2 cup (125 mL) raisins
1/4 cup (60 mL) pitted prunes
1/4 cup (60 mL) pitted dates
6 tbsp. (90 mL) prune juice
1/4 cup (60 mL) natural bran
Soak dried fruit overnight in just enough hot water to cover. Pour into a food processor. Add prune juice and bran. Mix well. If the mixture is too thick, add orange juice until a paste consistency is reached. Store in an airtight container in the refrigerator for up to 8 weeks.
This recipe makes 1 cup (250 mL) or 17-one tbsp. (15 mL) servings.
Milk Products
Mix powdered fibre such as corn bran or psyllium powder into yogurt or a milkshake to make a great snack.
Meat and Alternatives
Serve baked beans with whole-wheat toast or a whole-wheat pita.
Add kidney or other beans to soups, tacos, chili, spaghetti sauce, and salads.
Mix some beans, salsa, and cheese and wrap in a whole-wheat tortilla.
Serve hummus or other bean dips with whole-wheat crackers, mini pitas, or vegetables.
Try split pea or lentil soup or serve bean soup with whole-wheat crackers, bread, or pita.
Serve boiled, pureed, and seasoned red lentils alone, as a dip, or add them to sauces and soups.
Kid Friendly Sources of Dietary Fibre
Below are some grain products and the grams of fibre each contain:
Grain Products
Fibre (g)
General Mills, Fibre 1 (125 mL/30 g)
14.0
Quaker, Corn Bran (200 mL/30 g)
4.8
Kellogg's, Bran Flakes, 1 cup (250 mL)
4.3
Quaker, Oat Bran - cooked, 3/4 cup (175 mL)
4.2
Robin Hood, Red River, cooked 3/4 cup (175 mL)
4.0
Kellogg's, Raisin Bran (125 mL/30 g)
3.4
Post, Shreddies (140 mL, 30 g)
3.4
Wheat Bran, 2 tbsp. (30 mL)
3.1
Quaker Life cereal (160 mL/30 g)
2.7
Spaghetti, whole wheat 1/2 cup (125 mL)
2.4
Brown rice, cooked, (125 mL/100 g)
2.0
Whole wheat bread, 1 slice
2.4
Wheat germ, 2 tbsp. (30 mL)
1.9
Fig bar cookies, 2 medium
1.5
Oat bran, 2 tbsp. (30 mL)
1.3
Below are some fruits and vegetables and the gramsof fibre each contain:
Vegetables and Fruit
Fibre (g)
Green peas, cooked, 1/2 cup (125 mL)
5.6
Pear, with skin (1 medium)
5.0
Prunes, 1 jar baby food (128 mL)
4.1
Baked potato with skin, (1 medium)
3.8
Baked sweet potato, with skin (1 whole)
3.8
Baked potato, no skin (1 medium)
3.4
Apple, with skin (1 medium)
2.6
Banana (1 medium)
2.1
Prunes, dried, 3 whole
1.8
Apple, no skin (1 medium)
1.7
Frozen corn, cooked, 1/2 cup (125 mL)
1.7
Note: Most other fruits and vegetables contain 1-2 g per 1/2 cup (125 mL)
Below are some meats and alternatives and the grams of fibre each contain:
Meat and Alternatives
Fibre (g)
Red kidney beans, cooked, 3/4 cup (175 mL)
8.6
Baked beans, plain, cooked, 1/2 cup (125 mL)
10.3
Lentils, boiled, 3/4 cup (175 mL)
6.2
Peanut butter, chunky, 2 tbsp. (30 mL)
2.6
Common Questions
How much fibre should my child have every day? All children are different. Children 1-3 years old need between 6-19 grams of fibre every day. When your child is constipated, offer more high fibre foods along with more fluid.
What about fibre supplements and laxatives?
It is always important to discuss the use of these products with your doctor before you use them.
Is it safe to use mineral oil? Please discuss the use of this product with your doctor before you use it.
A High-Fibre Day Menu
Below is an example of a high-fibre day menu including the grams of fibre:
Breakfast
Quaker Corn Bran cereal, 15 g (100 mL) - 2.4 g
Raisins, seedless, 1/4 cup (60 mL) - 1.3 g
Milk, 1/2 cup (125 mL) - 0.0 g
Orange, sliced, 1/2 medium -1.2 g
Snack
Fig bar cookies, 2 medium - 0.8 g
Milk, 1/2 cup (125 mL) - 0.0 g
Lunch
Grilled cheese sandwich on whole wheat, 1/2 - 2.4 g
Split pea soup, 1/2 cup (125 mL) - 1.6 g
Watermelon, 1/2 cup (125 mL) - 0.3 g
Dinner
Chicken, roasted 2.5 oz. (75 g) - 0.0 g
Brown rice, 1/2 cup (125 mL) - 1.0 g
Green peas, cooked, 1/2 cup (125 mL) - 5.6 g
Snack
Ice cream, 1/2 cup (125 mL) - 0.0 g
Banana, 1/2 medium - 1.1 g
Total Fibre 18.5 grams
Sources: Canadian Nutrient Files 2007b, Dietitians of Canada Pediatric Nutrition 2004
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