Peds

Pediatric Constipation Dietary Management

search

Pediatric Constipation Dietary Management

  • See Also
  1. Pediatric Constipation Management
  2. Constipation Management in Infants
  3. Dietary Fiber
  • Indications
  1. Constipation in Children over age 1 year
  • Precautions
  1. Dietary recommendations in Pediatric Constipation have changed over time
    1. Current guidelines focus on increasing fiber and fluids (after disimpaction protocol)
  2. Prior recommendations limited diet, but without evidence
    1. Milk products were eliminated and replaced wth non-milk products
    2. Foods labeled as "constipating" were eliminated (e.g. apples, bananas, jello, carrots, rice)
  • Management
  • General Measures
  1. Increase Dietary Fiber as below
  2. Avoid Caffeine
  3. Encourage salads
  4. Encourage increased fluid intake
    1. Age 1 to 3 years old: 4 cups per day
    2. Age 4 to 8 years old: 5 cups per day
    3. Age over 8 years old: 7 to 8 cups per day
  1. See Dietary Fiber
  2. General Fiber recommendations
    1. Increased fiber without adequate hydration may result in worsening Constipation (see fluid intake above)
    2. Unprocessed or minimally processed Dietary Fiber sources are preferred
    3. Give 14 g fiber per 1000 kcals (or at least 5 g/day + 1 g/ageY)
      1. Excess fiber above these levels does not improve Constipation
  3. Increase amount of bran in daily diet
    1. Unmilled bran or bran flakes
    2. Bran muffins
    3. Shredded wheat
    4. Graham crackers
    5. Oatmeal
    6. High fiber cookies
    7. Brown rice
    8. Whole wheat bread
    9. Cheerios
    10. Ralston or Wheetena
    11. Granola
  4. Add Bran flour to jelly, cereal, hamburger or casserole
    1. Child under age 6 years old: 2 heaping teaspoons
    2. Child over age 6 years old: 3 heaping teaspoons
  5. Encourage raw unpeeled fruits and vegetables tid
    1. Prunes, Figs, Dates, Raisins
    2. Peaches, Pears, Apricots
    3. Beans, Peas
    4. Celery
    5. Cauliflower, Broccoli, Cabbage
  • Resources
  1. Eating, Diet, & Nutrition for Constipation in Children (NIH NIDDK)
    1. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation-children/eating-diet-nutrition
  • References
  1. Mulhem (2022) Am Fam Physician 105(5): 469-78 [PubMed]
  2. (2006) J Pediatr Gastr Nutr 43(3):e1-13 [PubMed]
    1. https://journals.lww.com/jpgn/fulltext/2006/09000/evaluation_and_treatment_of_constipation_in.28.aspx