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Question
My three-year-old daughter suffers
from constipation. Prunes and pear juice aren't
working, and she can be a picky eater. What do you
recommend?
-- Denise Friend
Answer
Constipation is a common problem for
children and is usually temporary. Strictly speaking,
a child is constipated if he or she has fewer than
three bowel movements per week or if the stools are
hard, dry, and unusually large or difficult to pass.
Because constipation can make bowel movements painful,
youngsters may try to avoid having them. (In addition,
about 60 percent of constipated children experience
recurrent abdominal pain, a common stress-related
condition in youngsters.)
The causes of constipation in kids
are usually simple and relatively easy to correct: not
enough fiber in their diets, not drinking enough
liquids or not getting enough exercise. Then, too,
constipation can occur when youngsters ignore the urge
to have a bowel movement. They can do this for reasons
ranging from not wanting to take a break from playing
to embarrassment at using a public bathroom or because
a parent isn't around to help when the urge occurs.
Medication can also be a factor. So if your daughter
is taking any type of a drug, make sure that it isn't
to blame. Those that can
cause constipation include aspirin and codeine,
vitamins with high doses of iron, the bismuth in
Pepto-Bismol, as well as some chemotherapy agents (vincristine)
and some psychiatric drugs (imipramine).
I consulted my colleague, Sandy
Newmark, M.D., a pediatrician here at the University
of Arizona Program in Integrative Medicine, about the
best way to deal with constipation in young children.
Here are his recommendations:
- Decrease dairy products: These
foods can be constipating. You'll need to provide
your daughter with an alternative source of
calcium such as calcium-fortified soy milk or a
calcium-fortified breakfast cereal.
- Increase fluids: Encourage your
daughter to drink lots of water.
- Increase fiber: Give her lots of
high-fiber fruits and vegetables as well as
high-fiber cereals, whole grain breads and beans.
Although these measures will
probably do the trick, if her episodes of constipation
last longer than three weeks and prevent her from
participating in her normal activities, you might want
to consult her pediatrician. Don't be tempted by the
laxatives designed for children on the market. They
can be dangerous to youngsters and should be given
only under the direction of a pediatrician.
By
Andrew Weil, M.D
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