Constipation in children is a very common occurrence, affecting roughly 10 percent of children. It is characterized by bowel movements occurring less frequently than usual or stool that tends to be hard, dry, and difficult and painful to pass. The following are common causes of constipation in children:
- Milk allergy – about 70 percent of cases of childhood constipation end by eliminating cow’s milk from the diet and substituting with soy or rice milk
- A low-fiber diet – just as with adults, a high-fiber diet is important for intestinal health
- Certain medications or drugs, such as antacids, opiates and antidepressants
- Various diseases and anatomic abnormalities
- Stool withholding – children may hold back stools because they are stressed about potty training, are embarrassed to use a public bathroom, don’t want to interrupt playtime or are fearful of having a painful or unpleasant bowel movement
Probiotics for Children
There is some preliminary evidence that probiotics, or beneficial bacteria, are useful in childhood (and adult) cases of constipation. It makes sense. After all, bacteria constitute about 30 percent or more of the typical stool weight. Rather than using a single strain of probiotic bacteria, my recommendation is to use a multi-strain formula composed of highly viable and compatible strains such as Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus lactis, Lactobacillus fermentum and Lactobacillus rhamnosus.
In a pilot study involving 20 children (average age of 7.4 years) with constipation, daily supplementation with a probiotic (100 million to 1 billion colony forming units of Bifidobacterium breve) for four weeks was found to significantly increase the frequency of bowel movements. Children who began the study with an average of less than one bowel movement per week improved to an average of about five per week after four weeks. They also had increased stool consistency and a significant decrease in fecal incontinence—from nine incidents per week at the beginning of the study to 1.5 in week four. In addition, there was a significant decrease in the number of abdominal pain episodes—4.2 at the beginning of the study to 1.9 in week four.
Previous clinical studies have shown even newborn infants can safely take probiotics at a daily dosage of up to 9 billion bacteria.
Tabbers MM, de Milliano I, Roseboom MG, Benninga MA. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study. Nutr J. 2011 Feb 23;10:19.