Eating Pooping and Growing Hope Wills, MA, RD, CSP

1
Eating Pooping and GrowingHope Wills, MA, RD, CSP
2
Objective

• Discuss the impact of constipation on health and
  nutrition
• Discuss dietary and behavioral strategies to
  reduce constipation
• Discuss pros and of traditional and
  non-traditional management

3
Is it Constipation?

• Baby makes a face when they have a Poop.
• Toddler experiences goat turds every day.
• Preschooler has soft bowel movement every other
  day.
• School age child becomes irritable before they
  have a bowel movement.

4
Definition of Constipation

• Infrequent and often incomplete elimination of
  stool
• Hard painful stools

5
Some facts

• Constipation affects 10 of all children
• In children with special needs the rate can go up
  gt 50
• The main site affected is the COLON
• The role of the colon is to absorb the water from
  the contents in the intestine
• The large intestine is made of smooth muscle

6
Gut Nervous System

• Can operate separately from the central nervous
  system
• Alterations in motility of the gut can result in
  a primary defect of the enteric neurons
• OR lack of coordination between the two nervous
  systems

7
Causes of Constipation

• Low muscle tone (or poor coordination of muscles)
• Mobility
• Diet
• Hydration status
• Hormonal regulation (hypothyroid, menstruation
  cycle)

8
What do the experts say?

• Study in the J of Child Care. Jennings et
  al.(2009)
• 84 children, pre adolescent
• 33 experienced constipation
• Children with higher intake of water and fiber
  with less constipation (not significant)
• Children with higher levels of activity
  experienced more constipation (???)

9
The Vicious Cycle
painful pooping
hard stool
avoid pooping
constipation
10
Impact of Constipation.

• Appetite decreases
• When you are full of poop, you are not hungry
• Sometimes children will associate foods with
  abdominal discomfort and then avoid that food
• Prolonged presence of stool in the gut, produces
  GAS and BLOATING

11
Impact of Constipation .

• Behavior
• Increase in irritability
• Avoidance of activities that
• surround pooping

12
Dietary Intervention

• Fluid intake
• A fluid is anything that becomes a liquid at room
  temperature
• Water always a good choice
• Juices (apple, prune, pear)
• Foods that contain a lot of water (berries,
  melons, juicy fruits)
• Adding blended fruits and vegetables

13
Dietary Intervention

• Increase Fiber intake
• Vegetables (hard sell)
• Fruits
• Cereals (cooked and ready to eat)
• Whole grain products (enriched)
• Fiber supplements

14
Types of Fiber

• Insoluble Fiber
• Indigestible portion
• Moves bolus along the GI tract
• Food sources
• Fruits
• Vegetables
• Whole wheat products
• Wheat bran
• Corn bran
• Seeds and nuts

15
Types of Fiber

• Soluble Fiber
• Has ability to bind up fatty acids
• Water soluble forming gel-like substance
• Food Sources
• Oat bran
• Barley
• Beans
• Fruits (apples, oranges, bananas)
• Vegetables (okra, squash, gourds)

16
Fiber Supplements
17
How much fiber

• Children - Age 5 gms per day
• Adults - 25 - 35 gms per day
• Men gt women
• Insoluble gt soluble (31)

18
Behavioral Interventions

• MARKING time
• MAKING time (scheduled events)
• Rituals for RELAXATION
• Reading
• Music
• Movement/Massage

19
Non Traditional

• Herbs
• Massage
• Cranio-sacral
• Abdominal massage
• Teas
• Sassafras
• Senna

20
What are parents worried about?

• Pooping independently
• Interference with ability to absorb nutrients

21
Questions from Families

• Please feel free to ask questions at this time.
• If I dont have the answer to your question I am
  happy to get your email, look it up and get back
  to you.
• Please.