There is nothing sadder than the angst of a constipated baby or child. Anyone who has been there knows what I am talking about! Oh, the agony! With my oldest I rarely encountered this particular parenting challenge, but when my twins came around, boy, did I have a lot to learn. I am not a doctor, but as a mom I can say that there has to be a genetic component at play here — it was not that I was doing anything different or “wrong” with these two! Some little bodies just process food differently, and I found as a parent it was my job to notice and tweak what I could to help minimize the difficulties.
In my experience — and with many with other parents I’ve met – the constipation woes started right around the time our babies started solids. Not surprisingly, this is quite common! Solid foods can be a big challenge to the system — those immature guts are still learning how things work, how to digest and move things along, and the foods many of us assume we should serve our new eaters are not always the best in terms of keeping things moving. The same challenges may continue or be revisited as they grow into picky toddlers, who often form strong food preferences and don’t always eat in a predictable pattern. Luckily, there is so much you can do to help your children’s digestion and regularity! I was able to able to adapt my girls’ diet to avoid medications for constipation most of the time (though I absolutely feel there is a place for meds with this issue — particularly if you have already tried diet changes!). Here is what I learned along the way.
Baby Cereal: Recipe for a Slow-down
First thing to do if you have a constipated infant is lay off the baby cereal! Baby cereals — those flakes in a box you mix with water or milk — are notoriously difficult for some babies to tolerate (yet a common first food for many!). Most cereals marketed for babies are loaded with iron, which can be really constipating! White rice cereal is very refined and nonexistent in fiber, which leads to a slow-down in the intestines. Packaged brown rice cereal may be tolerated in some babies, as well as oatmeal flakes, though even better might be to make your own batch of whole grain baby cereal (with regular oatmeal, brown rice, whole grain barley, or many other healthy, alternative grains). I found my girls could not handle any boxed baby cereals, but loved and thrived on regular or steel cut oatmeal, brown rice porridge, and quinoa, which I often made in the crock pot and stored for the week to reheat as needed. If the texture is a problem, try pureeing it after it’s cooked — though my girls got used to texture fast and were fine eating it straight from the pot! If iron intake is important to you, there are many other foods high in iron that you can try that are likely to be much less constipating.
Offer More Drinks: Hydration Matters!
One cause of constipation is lack of hydration. Breastmilk has a great, laxative effect, so upping your child’s nursing or breastmilk intake may help a lot! Don’t swap solids for milk in babies under a year — solids should be an addition to their milk intake, not instead of milk. Some people feel that formula can be constipating, but it’s still an important part of an infant’s diet, so don’t limit that! You might be able to find another formula that your baby tolerates better, or may find adding some water or juice helpful depending on the age of your baby (young babies rarely need anything other than milk). For older infants, toddlers, and children, offering water or a small amount of certain juices (our pediatrician recommended one serving of apple or prune juice a day, for example) can be helpful. Prune juice can be added to a smoothie, too! Please be sure to check with your health care provider about any significant diet changes, particularly with regards to milk or formula intake, of course! Adding alternative beverages to a young breastfed baby may result in less breastfeeding and a decline in milk supply, which can cause even more problems. The hydration dance is tricky, but worth pursuing, I’ve found!
Constipating Foods To Avoid
The big three foods to avoid if constipation is wreaking havoc in your home: bananas, cooked apples, and “white foods” made with highly refined white rice or wheat flour. Both bananas and cooked apples or applesauce are up there as often highly recommended first foods, but boy do they slow down the works (unpeeled raw apples are fine though). White, refined starchy foods are also no-nos — which means all cereals, breads, crackers, pancakes, muffins, and treats made with white wheat or rice flour. If you are shopping for baby food in the jars, I know it can be a challenge to even find a jar without one or more of these three ingredients! So many packaged “baby” or “toddler” foods also contain them. I found that either making my own purees, doing whole-food baby-led weaning, or buying regular whole-grain snack foods, cereals, and breads a fairly easy alternative.
A few other foods that may (or may not) cause constipation for some kids: dairy products, high-fat foods, blueberries, squash, popcorn. Strangely, many of these can cause just the opposite issue in other kids (particularly the dairy, blueberries, and popcorn)! If you are still having problems after making some diet changes, I recommend doing something of an elimination diet where you go back to basics and then reintroduce each food one by one, watching for how your child’s digestive tract reacts to each food. I’ve found that as my girls have grown older, they are able to tolerate more and more of the foods that were once off limits to them. Hooray for the occasional banana! Boy, we missed you!
What to Eat Now? Laxative Foods for Treatment and Prevention
Luckily, there are lots of great foods your kids will likely enjoy that can help alleviate and prevent constipation. Foods with a laxative effect include most whole grains, fruits, and veggies!
- Whole grain breads (100% whole wheat is ideal), English muffins (we like the “double fiber” variety), and whole wheat bagels or tortillas are great.
- Whole wheat pasta is good, as are whole grain crackers and cereals with whole grains and a high fiber content.
- Cooked whole grains such as brown rice, whole grain barley, or cornmeal are healthy options as well.
- Pears, grapes, cherries, and most raw fruits and veggies (minus those bananas, of course!) have a laxative effect (the grapes were a daily staple here because they worked so well for us!).
- Cooked or raw veggies such as carrots, peas, broccoli, beans, and corn.
- Dried fruits such as prunes, apricots, and cherries. These can be eaten plain by older children or simmered and pureed into a “sauce” to be spoon fed or mixed into hot cereals or yogurt.
- Raw apples (ideally with the skin on) are good in moderation.
- Baked potatoes with skin on are good, but when peeled they react similarly to “white” foods, so tread carefully!
- Dried or canned beans, such as black, white, or pinto beans are high in insoluble fiber (as well as protein).
- Bran muffins and whole grain pancakes are a tasty way to pack some fiber into little mouths as well — and you can add other pureed or shredded fruit or veggies, dried fruits, and nuts if you’d like to up the nutrient content as well!
I know prunes are esteemed as the number one “laxative” food here in the US and there is a reason for it — they do work! I found that making my own puree from a bag of dried plums/prunes was WAY more effective (and tasty!) than the jars of baby food prunes available in the grocery store. Here’s a recipe for pureed prunes that I used — it’s really simple! You can mix it up by adding in different dried fruits to alter or sweeten the taste, if you’d like. I found making a large batch and freezing cubes, “dollops,” or muffin tin-sized portions worked great. A frozen “prune cube” is an easy way to cool down some hot oatmeal, for instance. I’d also mix prune puree into unsweetened yogurt, into pancake batter or muffins, or with other fruit purees. For a long time, prunes in some form or another were a daily staple at our table.
A Recipe: Easy Stewed Prunes
- prunes (and perhaps dried apricots, cherries, etc.)
- water and/or apple juice
- hand blender or food processer
Put 1 cup or more or more prunes into a small pot or pan and cover completely with water. Bring to a boil and then simmer until very soft — 15-20 minutes or so, adding more water if needed. Puree soft prunes along with remaining water with a stick blender right in the pan (this is by far the easiest method!), or transfer to a food processor and blend until smooth. Add more water or apple juice to loosen up the puree to the desired texture (you can also add liquid to the frozen cubes when thawing/reheating). Store puree in an airtight container in the fridge for a week or so, or in the freezer for much longer!
Constipation is a really difficult childhood problem, but often can be controlled (or at least eased significantly) by diet changes. Introducing at least some laxative foods from the start and maintaining a healthful diet high in fiber and fluids are great preventative measures. The cycle of constipation and (and sometimes withholding) is a really frustrating and difficult one, but the rewards are great if you can nip it early, or break through with a restructuring of the diet. Small changes can really make a difference!
- Laxative Diet Plan [PDF] from Cincinnati Children’s hospital. This is recommended for children facing sometimes very serious constipation issues. Depending on your child’s situation, you likely will not need to follow this completely, though the tips (and food list starting on page 3) are quite helpful.
- Fruits recommended by Dr. Sears — Adding fruits and vegetables to the diet are a great way to up the fiber in your child’s diet. Note on this link the foods listed as “least kind to the intestines” are the ones suggested for helping beat constipation.
- Constipation resource page at Ask Dr. Sears — a thorough article explaining the symptoms, causes, and possible treatments of constipation.
Statements on this website have not been evaluated by the Food and Drug Administration. Products and/or information are not intended to diagnose, cure, treat, or prevent any disease. Readers are advised to do their own research and make decisions in partnership with their healthcare provider. If you are pregnant, are nursing, have a medical condition, or are taking any medication, please consult your physician. Nothing you read here should be relied upon to determine dietary changes, a medical diagnosis, or courses of treatment.