Initial Treatment Considerations for Pediatric Constipation
Baseline testing
Before starting treatment, do a Bowl Movement Beet Test to understand transit time. This can be repeated to see if improvement if transit time is evident.
The beet test allows you to get a sense of whether you fall into that ideal 12-24 hour range since you'll be able to see the bright red pigment in your stools.
Fiery red poop 24 hours or more later means you've got a “slow transit time,” also known as constipation.
Bristol Stool Chart: Identify what the average stool looks like using the chart below. Ideal is a type 3. This can also be used for a baseline of improvement.
BM frequency: Before treatment, document how often a BM is produced and what time of day. Ideally, we have daily BMs in the morning and possible 1-2 more BMs throughout the day to match eating frequency.
Lifestyle Recommendations
Castor Oil Packs: to be done for 7 days straight and then 3 days per week while constipation is resolving. Directions
Squatty Potty to improve posture with toileting.
Supplementation Recommendations
Growing Up Prebiotics: 1-2 packets daily depending on age.
Before Bed: Reacted Mag: 1-2 capsules depending on age
Lact-Enz 1 capsule opened and sprinkled on food 1-3x per day to support upper digestion and microbiome balance.
Rescue: for when you need to stimulate a BM if it has been more than 2-3 days. You can use Orthomolecular’s Ready! Set! Go! product or Senna Chocolates.
Nutritional Recommendations
First nutrition goal: Improve breakfast.
Kodiak Cake pancakes with fruit. Can she do dairy milk instead of oatmilk or milk alternatives?
Smoothie with 1tsp ground up flaxseeds
Egg bites with fruit
Oatmeal with 1 tsp ground up flaxseeds
Muffins with pumpkin or oats in them for more fiber
Yogurt Parfait with 1tsp ground up flaxseeds or Chia seek pudding (make sure chia seeds have soaked for at least 3 hours before consuming)
HERE is a link to make ahead breakfast ideas.
How much fiber is your child getting? A good starting place is 10-15gm. 15-20gm may be needed, but we want to go slow and make sure hydration is on point.
Sources:
Fruits like apricots, peaches, plums, prunes, and lemon water are great for stimulating bowels. Pumpkin or papaya, especially in smoothies, is great to.
Ground up seeds like flaxseeds
Chia seeds that have been soaked for at least 3 hours
Veggies especially carrots. Carrot salad
Fluid Intake Recommendations
Hard stools tell us dehydration may be a factor.
Coconut water can be an excellent way to improve constipation. Adding some fruit juice like apple, pear juice, or prune juice to it for flavor can also be helpful.
Water water with a splash of the fruit juices in it can also be calming to the digestive system and stimulate BMs.
Redmond’s Relyte: 1/2 scoop in 20oz
Referrals
Consider pelvic floor PT
Follow Up Testing Recommendations
May be recommended at 6 week mark:
Hair Tissue Mineral Analysis
Blood work including Thyroid testing
GI Map stool test
Follow Up
6 weeks
Goal for Next Visit
Improve transit time with Beet Test (please do test before starting treatment and then repeat test before we meet next! Document timing of beet transit)
Bristol Stool Improvements
Regular morning BMs