Constipation. Chances are, if you have a child with a feeding tube, constipation is an issue you are quite familiar with. Many children require a feeding tube because they have low tone muscles or problems with motility. These issues also make constipation a chronic issue. Bradley has always struggled with constipation due to motility issues caused by 2 bowel surgeries he required as a baby. It can be very frustrating!
What works miracles for one child’s constipation may do little to nothing for another child’s. So, there is indeed a process of trial and error in figuring out what will work with your child. While some kids do require intervention with medication, many children do wonderfully using a more natural approach.
The good news is that there are lots of natural foods to try that can greatly help with constipation (and a few of these suggestions help with diarrhea as well!). The list below is a compilation of suggestions* by fellow tubie mamas from around the world, and I hope the answer for your child can be found in this list! Of course, many of these ideas can be used simultaneously.
Water
I know, this seems incredibly obvious. But, one of the
first questions to be asked if a child is constipated is whether the child is receiving a sufficient amount of water to move stool. Some children require a little extra water to keep things moving. So, step one, unless there is a medical reason not to do so, increase free water a little and see if that helps.
All of the remedies listed below ultimately work because they hold water in the bowel resulting in a softer, easier to move stool. If there is not enough water being given, however, these remedies will not work and will actually cause constipation to worsen as they will make the stool very hard and difficult to move through the bowels.
Fiber…or not
Fiber gives stool bulk, which helps with moving it through the bowels. Giving a high fiber diet with extra water can be a game changer for many children. It also feeds the good bacteria in the gut, which further helps with constipation. However, this is not true for everyone, and extra fiber can actually have the opposite effect and worsen constipation for children with specific issues. Some children with low muscle tone simply cannot move a lot of fiber through the gut. Therefore, when increasing fiber, I always recommend doing so slowly to give the gut time to adjust and to test whether this will be a solution or a disaster.
Foods like blueberries, spinach, cabbage, kale, dates, cherries, kiwi, brown rice, oatmeal, whole grain bread, and quinoa can help with constipation by providing higher fiber.
Prunes
The simplest solution for many children’s 
constipation is prunes. Prunes are both rich in fiber and high in sorbitol, which is a natural laxative. Sorbitol holds water in the bowel, which results in a softer, easier to move stool. For Bradley, I blended prunes at a ratio of 2 prunes to 3 ounces of water and gave a serving equal to the 2 prunes daily followed by an additional 4 ounces of water. For example, I’d make a large blend of 20 prunes and 30 ounces of water and freeze this into 10 portions. I would then give one portion along with an additional 4 ounces of water.
This worked beautifully for him. However, adding prunes to his blended food did nothing to help. Prunes worked most effectively when given with plenty of water on an empty stomach. I have heard the same from many parents, although some children do just fine with prunes simply added to their blended food.
Some people prefer to use prune juice. I personally prefer whole prunes because the fiber of the prunes is retained. But, if you like the prune juice and it is working, go for it! Some have also had success with apricot juice, pear juice, apple juice, and white grape juice.
P Foods
P is for Poo! And it’s also for foods that help kids poo. Pears, pumpkin, peaches, prunes, and papaya added to a blend can help create a softer, easier to move stool. Some children do much better with a blend of these foods for their servings of fruit for the day.
Ground Flax Seed
Flax seed has a high amount of mucilage. This means when soaked in water, it forms a gel-like compound that helps move stool through the bowels. Components of flax seed can also reduce inflammation in the digestive tract, which can greatly improve digestive health overall. 
Our bodies are not able to digest whole, unground flax seeds because we cannot break down their outer shell. Therefore, flax seeds need to be ground prior to consumption to experience their full benefits. It is far better to purchase whole flax seeds and grind them just prior to consuming. The healthful oils in flax seeds quickly oxidize and go rancid after grinding, which means many wonderful benefits are lost.
Grinding flax seeds is actually quite easy. Simply place the seeds in a dry blender container or a coffee grinder, and they will quickly grind to a fine powder. I consume ground flax seed in a daily smoothie. I place whole flax seeds in the dry blender first without adding anything else. I turn on the blender to grind the seeds into a powder and then add the remaining ingredients for the smoothie. Try a tablespoon of ground flax seed daily.
Ground flax seed can actually help with diarrhea as well because of the bulk it gives to stool and its anti-inflammation properties.
Blackstrap Molasses
Blackstrap molasses (which is different than the regular molasses we use in baking) contains magnesium and other minerals that help with motility, which in turn helps with constipation. Blackstrap molasses also happens to be a great source of iron. Try giving a tablespoon per day.
Coconut Oil or Avocado Oil
1 tablespoon per day mixed with warm water can keep things moving.
The Poopinator
This is a recipe developed by a fellow tubie mama blogger, and many have had great success with it. Check it out!
Coffee
Obviously, this is a suggestion for teenagers and adults, not children. Caffeine does help get things moving as it stimulates the bowels and can be a great help when used in moderation.
Chia Seeds
Chia seeds form a gel-like compound, much like ground flax seed. They also contain oils that help reduce inflammation, which will help digestive health. Like flax seeds, chia seeds can help with both constipation and diarrhea because of the bulk they give to stool and their anti-inflammatioin properties.
Probiotic Foods
Fermented foods are great for digestive health for most people. You can make your own fermented vegetables or make your own kefir. I plan to do a post on fermented vegetables soon! Because so much gut bacteria can be lost during episodes of diarrhea, probiotic foods are also very important and helpful for most people struggling with diarrhea as well.
Turmeric
Turmeric is an incredible anti-inflammatory food. Keeping inflammation down in the gut will greatly improve digestive health and overall health. It’s good stuff! The anti-inflammation properties of turmeric can also help some people struggling with diarrhea.
Psyllium Husk
Now that Bradley is on a low FODMAPS diet, he basically cannot have a single food listed above. This is because foods that often help with constipation are difficult to break down in the gut, which is why they retain water in the 
bowel so well. This attribute also means they feed gut bacteria very well. This is wonderful if your child does not have a bacterial overgrowth as feeding the gut flora can vastly improve digestive health. However, it’s horrible if your child does have a bacterial overgrowth since these foods will feed the excess bacteria and allow them to reproduce all the more. Ack!
Fear not. If your child is struggling with a bacterial overgrowth due to slow motility and also struggling with constipation due to the slow motility, there is indeed a solution. Psyllium husk is the outer husk of a seed used to grow an herb (mostly in India). The seed actually isn’t particularly special from a nutrition standpoint. The husk, however, is extremely high in a soluble fiber that does not feed gut bacteria. It forms a gel that is easy to move through the bowel and has worked fabulously at managing Bradley’s constipation issues. I have also read that psyllium husk is a keto-friendly food for those on a keto diet.
I mix 1 tablespoon of psyllium husk whole flakes into 6 ounces of water (no need to blend…simply stir into the water) and then flush with 2 ounces of water. I give the husk and water mixture immediately after mixing simply because it becomes a little more difficult to pull up with a syringe after it has sat for a few minutes (though certainly is still doable).
IMPORTANT NOTE: psyllium husks swell slowly in water. If your child is going to consume psyllium husk orally, use extreme caution as the husks can swell in the throat, causing a choking hazard. Always use plenty of water if using orally and allow it to fully expand prior to oral consumption. Because Bradley is in the early stages of learning to eat, even though he can eat smooth purees, I only give psyllium husks through his feeding tube to avoid this potential danger since swallowing is a skill he is still developing. If your child has any difficulty swallowing, I strongly recommend giving the psyllium husks via the g-tube.
Non-Food Suggestions
I always recommend starting with food first. If that doesn’t work, it may be time to try non-fresh food solutions. Moms have recommended Fruit-eze, Natural Calm Magnesium, Senna Tea, Oxypowder, Smooth Move Tea, Magnesium, and Natural Calm.
*Always research thoroughly and discuss with your child’s medical provider, especially if your child is on medication. Even natural solutions can be problematic for people living with certain conditions or taking certain medications.
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Crunchy Tubie Mama 