Since I am primarily a pediatric nurse, this is a problem that I have seen and dealt with repeatedly over the years in my practice.
Most constipation problems in young children are diet-related. Unfortunately, many children don’t eat a varied diet and don’t get near enough fiber in their diets. This, along with a tendency for parents to offer milk or juice as a comfort food (bottles in bed or as a soothing device) can cause nutritional deficiencies like anemia as well as constipation (not to mention serious dental problems) I once had a little patient who demonstrated this in the extreme. She was 3 years old and her entire diet consisted of whole milk and the odd bite of a pancake. Her iron deficiency was so severe that she just sat in one place all the time. She had no energy to play or even to laugh. I remember being shocked at how pale her skin was.
Many parents are surprised to find out that the recommended amount of whole milk for toddlers after they have stopped breastfeeding is 2 cups per day. That’s only 16 ounces every 24 hours. After age two, they no longer require the extra fat in whole milk and can be switched to 2% or 1% milk. Of course, if they are breastfeeding this is also a healthy choice.
Children who drink large amounts of milk tend to eat much less solid food and are less likely to try new foods. A child’s stomach is roughly about the size of their own clenched fist, so you can imagine that a bottle (or glass) of milk can fill it completely, not leaving much room for other foods.
Toddlers who take a milk bottle to bed for sleep, and/or drink a bottle upon waking in the morning are less hungry for breakfast and are less likely to eat a healthy meal to start their day (they are already full!) Unfortunately, milk is not the “perfect food”. Milk is low in iron, so kids who drink too much often become iron deficient which can cause problems with their growth and development.
Toddlers will generally only eat the amount calories their bodies need, so if they drink too much milk, they won’t have room for the healthy food they need to meet their nutritional needs. Water is the preferred drink for between meals and with snacks. Offering small amounts of milk with meals only and in a cup rather than a bottle is a good way to set limits on milk consumption for toddlers. Juice is not necessary for a healthy diet and is high in sugar (natural sugar is still sugar as far as the body is concerned) It is far better to offer the actual fruits as a snack rather than juice.
Feeding toddlers can be a tricky business! If you’re looking for some more tips and guidance, check out ‘Toddler’s First Steps’ which is a resource provided by the Province of BC in print form or online. You can click HERE to see the PDF version. This publication is for parents of babies and toddlers aged 6-36 months. It has current and medically approved information about all aspects of parenting toddlers.
If your young baby under the age of 6 months is having constipation problems, it is best to consult with your family doctor for advice. Exclusively breastfed babies will not become constipated, but the introduction of solid foods or the switch to formula or whole milk can cause temporary problems for some babies. Start solids slowly and in very small amounts, gradually increasing the amount over weeks. Offer only one new food every 4-5 days so you can watch for any problems. It can take some time for the baby’s digestive system to adjust to the new foods.
* As always, the information I share here is general, current and comes from reliable sources, as well as my own pediatric nursing experience. It doesn’t replace a doctor’s advice and is not meant to diagnose. If you are concerned about your child’s symptoms, you should always contact your doctor for specific advice- or you could start by calling 811 from within BC or the Yukon to speak to a nurse at Healthlink BC *