Episode 34: Childhood Constipation with Registered Dietitian Laura Wilson
On this episode we’re excited to welcome Registered Dietitian, Laura Wilson, on the podcast to chat all about childhood constipation. Tune in to hear tips on how to detect when your child is constipated, how to get things moving, and what foods or life events can contribute to healthy bowels.
Lisa Tang 0:05
Hello, and welcome to the Healthy Habits Happy, Homes podcast, hosted by the Guelph Family Health Study.
Sabrina Douglas 0:11
If you’re interested in the most recent research and helpful tips for a healthy, balanced living for you and your family, then this podcast is for you. In each episode we will bring you topics that are important to your growing family and guests who will share their expertise and experience with you.
Lisa Tang 0:27
Our quick tips will help your family build healthy habits for a happy home.
Sabrina Douglas 0:38
Welcome back to the Healthy Habits, Happy Homes podcast. I’m Sabrina.
Lisa Tang 0:42
And I’m Lisa. And today we have Laura Wilson as our guest. Laura is a registered dietitian with the Guelph Family Health Team. She has two adorable three-and-a-half-year-old boys. And Laura was actually also a former health educator for the Guelph Family Health Study. So, she’s here today to share her expertise– personal and professional– with childhood constipation. So welcome, Laura. Thanks for joining us.
Laura Wilson 1:09
Thanks for having me.
Sabrina Douglas 1:10
So, Laura, you were part of the Guelph Family Health Study when it first started. Can you tell us a bit about what your role was with the study and also a bit about your master’s research?
Laura Wilson 1:20
Sure. So, like Lisa mentioned, I started off as a health educator with the Family Health Study. So, I sort of started right as the study was getting going. I was also involved at that time, and was sort of helping to develop some of the materials that we use with the families, which was a great experience. It didn’t directly relate to my master’s research, but sort of connected. I was working with Dr. Jess Haines. And, we were sort of bringing a parenting program that she had developed and run before we’re bringing it to parents in their workplace and kind of testing it out in that new setting.
Lisa Tang 1:54
Awesome. So, now since you’ve kind of moved from the Guelph Family Health Study to the Guelph Family Health Team, could you tell us a little bit about your current role, and how the Guelph Family Health Study prepared you for that role.
Laura Wilson 2:08
So , I work at Diabetes Care Guelph. I’m a dietitian, and diabetes educator with the team there. And the Family Health Study was a great kind-of segue from school into my clinical role right now because I got a really great introduction to working with families and people one-on-one, great training and motivational interviewing and goal setting, which is really central to what I do right now in my role.
Sabrina Douglas 2:35
Lisa Tang 2:36
I think I can hear your little kids in the background. Yeah. Hello, kiddies is in the background. So that makes two of us. Oh, the joys of working from home during COVID. Right, Laura?
Laura Wilson 2:46
Sabrina Douglas 2:47
Thanks for sharing. And thank you for being here today to talk about this very important topic: children’s’ bowel movements, specifically the childhood constipation challenge. So, to start off, could you please define childhood constipation? Tell us and the listeners how to know if your child is constipated?
Laura Wilson 3:08
Sure. So childhood constipation is super common. And it can look really different for each child. But generally speaking, it would be a decreased number of bowel movements. And some might define it as like three or less per week, but it’s really going to depend on your child and what’s normal for them. And, the bowel movements are going to be hard or difficult for them to pass. They might cause some pain. So, that’s how you would know.
Lisa Tang 3:33
Thanks, Laura. Now, I mean, I would love to say that this is not exactly dinner conversation, right? But I mean, if I’m being totally honest, this has for sure come up at dinners in my home when my kids were young, not so much now. I mean, it’s not something you talk about with your nine-year-old at dinner, but when my kids were little, my husband and I would often be like, “Is that kind of normal”? So my question to you, I guess, is what should a normal bowel movement look like for a young child?
Laura Wilson 4:05
Great question. So, I guess it’s going to depend again, for each kid it’s going to be different, like, one of my boys, (not to share too much… but) he is definitely like a daily pooper. The other one is not at all– every couple of days is not at all abnormal for him. So, everybody’s going to look a little bit different but you want to make sure that your child isn’t having troubles passing, that it’s not causing them pain or they are not bloated, there’s no decrease in appetite associated with it. And then, when they are able to pass the bowel movement that it’s, you know, it’s an easy process. It’s pain free, generally, and fairly soft.
Sabrina Douglas 4:42
Okay, and are there common causes of childhood constipation, or maybe, like, specific dietary patterns that have been associated with constipation in kids?
Laura Wilson 4:54
Yeah, for sure. Diet can definitely be a cause. Generally, a diet that’s low in fiber and low in fluid can certainly lead to constipation. But, that’s not it, it’s not all diet. Activity. A lack of activity can definitely cause some constipation, because movement can kind of help the stool pass through the intestinal tract. Also, a change in routine or stress. I feel like that’s probably one of the more common ones– more like a disruption to the routine. So, for example, starting school. There’s a big one, you know. Different people in different settings may or may not be comfortable pooping outside of the home. They also may have a new structure to their day where they can’t use the bathroom as freely they want like at home. So, that can definitely happen. Also, potentially some, you know, some behavioural causes, like fighting with parents holding it in for that reasons, things like that. Also, if there’s been previous constipation, that can definitely lead to future constipation, because if they have a history of it being painful, a lot of children aren’t going to want to use the bathroom and they may start holding it in again, like that.
Lisa Tang 6:04
It’s funny, you should mention kindergarten, because actually– this was not a huge problem with my with my two older kids– but my daughter, when she went to kindergarten, she was embarrassed to, or still is, kind of embarrassed to go to the bathroom. She’s fine for, like, pee, but she doesn’t want to go Number Two in front of her class– not that it’s in front, but the washroom is actually located in the kindergarten room, so, she ended up holding it, which led to a bit of a problem. So, do you ever think that holding it could be –have you seen that as a common issue? I know when I worked at the Family Health Team, kids were, kind of, coming in and holding it. Do you have any strategies to deal with that?
Laura Wilson 6:49
Definitely, super common. One of my boys, same thing. They’re in daycare, and one of them refuses to poop at daycare. He will hold it all day. So, he’ll come home with sort of like little marks in his underwear, but, the other one has no problem. So, definitely really common. I don’t see children in my practice, like in my clinical role, so I couldn’t comment from that other than just my personal experience with it. I think just over and over trying to make him comfortable. His brother actually is a real help, because the two of them kind of bond and he’ll go into the bathroom with him. I think it’s just time.
Lisa Tang 7:25
I think just time and patience. I mean, for sure. I remember, definitely putting my kids in there with a book or whatever, and trying to kind of take the pressure off, so to speak, no pun intended. It was more just giving them that time to be there and then have that bowel movement, kind of in a relaxed setting. I think if we’re kind of trying to get our kids off the pot really quickly, I think they can feel a little bit of pressure then. And that tends to, or at least in with some of the patients I used to see, that used to be kind of a bit of an issue, as well. For sure. Sorry, go ahead.
Laura Wilson 7:59
I was just gonna say, definitely building on what you said, just not getting mad if they don’t poop, right? Creating a happy environment. A little bit of a reward, too, if they are successful. Stickers work wonders in young children. So, that’s been good for us.
Lisa Tang 8:12
Right? But high-value stickers, like, my kids weren’t going to go poo for like a regular sticker, right? There had to be a fuzzy one or one of those puffy stickers, like a high-value sticker, for sure. Thinking beyond that kind-of tendency for our kids to hold their bowel movement, whether it’s either in school because they’re embarrassed or perhaps because they’re actually just really enjoying whatever it is they’re playing with, which is super common, are there any other good tips, or perhaps some dietary strategies for dealing with childhood constipation?
Laura Wilson 8:48
Yeah, for sure. So since a lower-fiber, low-fluid diet can lead to constipation, try to increase both of those. So, just making sure water and other fluids are available throughout the day regularly with meals and then water in between meals as they’re playing. Things like that. Also, lots of fiber, I find that foods that start with ‘P,’ like pears, prunes, plums, and peaches. Those all can be really helpful. Prunes work well in our house. Other sources of fiber will be your whole grains, whole-grain cereals and breads, things like that, including those regularly in the diet can definitely help. And, then behaviourally, some of the stuff we talked about: a little bit of a reward, a special treat, a big sticker for when they are successful, making it a fun sort-of happy environment, not stressful environment. Let them take their time. All of those are really, really important to creating a good positive experience.
Sabrina Douglas 9:19
Great, and would you recommend anything in terms of preventing constipation in children, or would it be like the same tips that you’ve already mentioned?
Laura Wilson 9:55
Yeah, a lot of the same things that I just mentioned in terms of treating would also be really, really important for prevention.
Lisa Tang 10:02
Since we’re on the topic of bowel movements and getting our kids to go to the bathroom, do you have any tips on potty training, seeing as how you have twins and so you had to potty train two babies.
Laura Wilson 10:14
I wish I had great tips. We just kind of went for it. We started day one of lockdown, because I figured we’re all home and we can’t go anywhere anyways, so let’s make lemonade out of lemons. One of my boys got it right away. It just, you know, it took him 24 hours and he just got it. The other one took eight solid weeks of accident after accident. But he got it, he eventually got it. We were just consistent. I think consistency is so important. I reminded them I asked “Are you dry?” over and over and over. Big excitement if they were still dry? How about you? Good tips?
Lisa Tang 10:52
No, I, you know, I again, consistency, for sure worked with us. And then, we actually had this little transportable potty, that we were able to kind of put in different areas of the house, although it’s kind of gross. But, I found that they got really bored sitting in the bathroom. And, so, this way, it was just like this little potty that they could kind of go in and that was really helpful. And the same thing with you, “Are you dry?” Big celebration, if they are. Even bigger celebration if they make it into the potty. And, then, of course, the big ticket sticker items, but again, they got like a lower price dollar store sticker for for Number One, and they got a bigger, higher quality sticker for Number Two. So, that was kind of — that was kind of how we dealt with the kids. But again, every child is different, even among my three, I would say that my firstborn caught on a lot faster than my second, and my third was somewhere in between. So, I think just –I guess one of the big tips I have said to some some friends with younger children is, the same strategies don’t work for every child. So, it’s kind of learning that child’s strategies and what kind of makes them excited about being successful with that venture. And, then kind of working with that… was what worked for us.
Sabrina Douglas 12:26
All right, well I don’t have any tips for this, obviously, but I’m frantically taking notes for the future. So, thank you both. [laughter]
Lisa Tang 12:33
Laura, thank you so much for all of your tips so far, like how to prevent constipation and kind of potty training tips. I’m wondering, I’d like to go back to something that you mentioned earlier about making sure children are well-hydrated as a way to kind of prevent these constipation issues. Can you tell me what is a great way, or some tips, on how to get our kids to drink more fluid?
Laura Wilson 13:01
Good question. Sometimes that can be really challenging, especially if they’re distracted or having fun playing. So, I like to always keep water available and always offer water and or milk with meals so that it’s available for them. I’m never going to force my kids to drink, but just making it really readily available. But, some fun ways that I’ve used with my own kids is some fun water bottles. They love using water bottles with straws in them or little spouts, can use some fruit in there. Or even in the summer months as we’re getting warmer, free some fruit into ice cubes, but those little little fun ice cubes in their water. They think that’s great. So, those can be some nice incentives there.
Lisa Tang 13:42
I love the fruit idea because, you know, my kids love this.They love cucumber water. I don’t even think — one of them doesn’t even like cucumbers. But, for some reason if it goes in the water, all of a sudden it’s fancy. And now we like to drink water. So, I think I love that idea. I’m glad it works for your kids, too. So, our kids definitely have something in common there.
Sabrina Douglas 14:02
Thanks. Great suggestions. Thanks Laura, you provided a lot of great insight into how we can help parents with childhood constipation. Before we sign off, do you have three take home tips that you can give to parents on the topic?
Laura Wilson 14:15
Sure. One, I would say, especially if we’re also talking about potty training, to just lots of reminders, “Do you have to pee?” “Do you need his bathroom?” “Are you still dry?” And if they’re, you know, if they’re playing like my kids in particular, I can tell when they have to poop, I can just tell they do the little dance. So, just you know, getting them to stop what they’re doing. Ask them if they need to use the bathroom. Just nice reminders. So that’s a big one. Number two, from a diet: don’t forget about those “P” foods, pears, prunes, plums, peaches and lots of fluid. Those are the big like sorta diet lifestyle ones, I guess three would be make it a low-stress, fun environment, where they’re not feeling embarrassed, ashamed, scared– any of those, sort of, negative feelings associate with using the bathroom.
Lisa Tang 15:01
Thanks, Laura. This has been really useful potty talk. I like it. It’s been very helpful. I think. And, hopefully helpful to some of our listeners. Now, I’m curious just because we have you on here on the on the Healthy Habits, Happy Homes podcast, and you used to be a health educator for the Guelph Family Health Study. I’m wondering if you have a great memory or a funny memory that you’d like to share from your time with the GFHS?
Laura Wilson 15:33
Oh, wow. So I have lots of great memories. It was a great role to be in as a health educator. I got to visit a lot of wonderful families. One that kind of jumps out, and is a little bit funny, as I had a family who had a set of twin boys a little bit younger than my boys are currently. And, I remember going into that house and it was a bit of a madhouse– there were balls flying all over the place– and I would leave exhausted, and just no idea how that mom did what she did. And, here I am, three-and-a-half years later, with my own set of twins, figuring it out one day at a time. So, that was kind of a funny little twist of fate there.
Sabrina Douglas 16:08
I love that, it’s like foreshadowing. Well, thanks, Laura for coming on the Healthy Habits, Happy Homes podcast. We hope the listeners find this interview helpful and we wish you all the best.
Laura Wilson 16:20
Thanks. Thanks for having me.