II. Indications
- Constipation in Children over age 1 year
III. Precautions
- Dietary recommendations in Pediatric Constipation have changed over time
- Current guidelines focus on increasing fiber and fluids (after disimpaction protocol)
- Prior recommendations limited diet, but without evidence
- Milk products were eliminated and replaced wth non-milk products
- Foods labeled as "constipating" were eliminated (e.g. apples, bananas, jello, carrots, rice)
IV. Management: General Measures
- Increase Dietary Fiber as below
- Avoid Caffeine
- Encourage salads
- Encourage increased fluid intake
- Age 1 to 3 years old: 4 cups per day
- Age 4 to 8 years old: 5 cups per day
- Age over 8 years old: 7 to 8 cups per day
V. Management: Dietary Fiber
- See Dietary Fiber
-
General Fiber recommendations
- Increased fiber without adequate hydration may result in worsening Constipation (see fluid intake above)
- Unprocessed or minimally processed Dietary Fiber sources are preferred
- Give 14 g fiber per 1000 kcals (or at least 5 g/day + 1 g/ageY)
- Excess fiber above these levels does not improve Constipation
- Increase amount of bran in daily diet
- Unmilled bran or bran flakes
- Bran muffins
- Shredded wheat
- Graham crackers
- Oatmeal
- High fiber cookies
- Brown rice
- Whole wheat bread
- Cheerios
- Ralston or Wheetena
- Granola
- Add Bran flour to jelly, cereal, hamburger or casserole
- Child under age 6 years old: 2 heaping teaspoons
- Child over age 6 years old: 3 heaping teaspoons
- Encourage raw unpeeled fruits and vegetables tid
- Prunes, Figs, Dates, Raisins
- Peaches, Pears, Apricots
- Beans, Peas
- Celery
- Cauliflower, Broccoli, Cabbage
VI. Resources
- Eating, Diet, & Nutrition for Constipation in Children (NIH NIDDK)