l. hope wills, ma, rd, csp eating pooping and growing hope wills, ma, rd, csp

L. Hope Wills, MA, RD, CSPL. Hope Wills, MA, RD, CSP

Eating Pooping and Growing

Hope Wills, MA, RD, CSP

Eating Pooping and Growing

Hope Wills, MA, RD, CSP


ObjectiveObjective

• 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

• 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


Is it Constipation?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.

• 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.


Definition of ConstipationDefinition of Constipation

• Infrequent and often incomplete elimination of stool

• Hard painful stools

• Infrequent and often incomplete elimination of stool

• Hard painful stools


Some factsSome facts

• Constipation affects ~10% of all children• In children with special needs the rate

can go up > 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

• Constipation affects ~10% of all children• In children with special needs the rate

can go up > 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


Gut Nervous SystemGut 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

• 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


Causes of ConstipationCauses of Constipation

• Low muscle tone (or poor coordination of muscles)

• Mobility• Diet• Hydration status• Hormonal regulation (hypothyroid,

menstruation cycle)

• Low muscle tone (or poor coordination of muscles)

• Mobility• Diet• Hydration status• Hormonal regulation (hypothyroid,

menstruation cycle)


What do the experts say?

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 (???)

• 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 (???)


The Vicious CycleThe Vicious Cycle


Impact of Constipation….

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

• 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


Impact of Constipation ….

Impact of Constipation ….

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

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


Dietary InterventionDietary 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

• 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


Dietary InterventionDietary Intervention

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

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


Types of FiberTypes 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

• Insoluble Fiber• Indigestible portion• Moves bolus along the GI tract

• Food sources• Fruits• Vegetables• Whole wheat products• Wheat bran• Corn bran• Seeds and nuts


Types of FiberTypes 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)

• 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)


Fiber SupplementsFiber Supplements


How much fiberHow much fiber

• Children - Age + 5 gms per day

• Adults - 25 - 35 gms per day• Men > women• Insoluble > soluble (3:1)

• Children - Age + 5 gms per day

• Adults - 25 - 35 gms per day• Men > women• Insoluble > soluble (3:1)


Behavioral Interventions

Behavioral Interventions

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

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


Non Traditional Non Traditional

• Herbs• Massage• Cranio-sacral • Abdominal massage

• Teas • Sassafras • Senna

• Herbs• Massage• Cranio-sacral • Abdominal massage

• Teas • Sassafras • Senna


What are parents worried about?

What are parents worried about?

• • Pooping

independently• Interference

with ability to absorb nutrients

• • Pooping

independently• Interference

with ability to absorb nutrients


Questions from Families

Questions from Families

• Please feel free to ask questions at this time.

• If I don’t have the answer to your question I am happy to get your email, look it up and get back to you.

• Please.

• Please feel free to ask questions at this time.

• If I don’t have the answer to your question I am happy to get your email, look it up and get back to you.

• Please.

l. hope wills, ma, rd, csp eating pooping and growing hope wills, ma, rd, csp

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