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Eating Pooping and Growing Hope Wills, MA, RD, CSP

Eating Pooping and Growing Hope Wills, MA, RD, CSP. Objective. 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?.

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Eating Pooping and Growing Hope Wills, MA, RD, CSP

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  1. Eating Pooping and GrowingHope Wills, MA, RD, CSP L. Hope Wills, MA, RD, CSP

  2. Objective • 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 L. Hope Wills, MA, RD, CSP

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

  4. Definition of Constipation • Infrequent and often incomplete elimination of stool • Hard painful stools L. Hope Wills, MA, RD, CSP

  5. Some 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 L. Hope Wills, MA, RD, CSP

  6. Gut 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 L. Hope Wills, MA, RD, CSP

  7. Causes of Constipation • Low muscle tone (or poor coordination of muscles) • Mobility • Diet • Hydration status • Hormonal regulation (hypothyroid, menstruation cycle) L. Hope Wills, MA, RD, CSP

  8. 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 (???) L. Hope Wills, MA, RD, CSP

  9. The Vicious Cycle painful pooping hard stool avoid pooping constipation L. Hope Wills, MA, RD, CSP

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

  11. Impact of Constipation …. • Behavior • Increase in irritability • Avoidance of activities that surround “pooping” L. Hope Wills, MA, RD, CSP

  12. Dietary 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 L. Hope Wills, MA, RD, CSP

  13. Dietary Intervention • Increase Fiber intake • Vegetables (hard sell) • Fruits • Cereals (cooked and ready to eat) • Whole grain products (enriched) • Fiber supplements L. Hope Wills, MA, RD, CSP

  14. Types 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 L. Hope Wills, MA, RD, CSP

  15. Types 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) L. Hope Wills, MA, RD, CSP

  16. Fiber Supplements L. Hope Wills, MA, RD, CSP

  17. How much fiber • Children - Age + 5 gms per day • Adults - 25 - 35 gms per day • Men > women • Insoluble > soluble (3:1) L. Hope Wills, MA, RD, CSP

  18. Behavioral Interventions • MARKING time • MAKING time (scheduled events) • Rituals for RELAXATION • Reading • Music • Movement/Massage L. Hope Wills, MA, RD, CSP

  19. Non Traditional • Herbs • Massage • Cranio-sacral • Abdominal massage • Teas • Sassafras • Senna L. Hope Wills, MA, RD, CSP

  20. What are parents worried about? • Pooping independently • Interference with ability to absorb nutrients L. Hope Wills, MA, RD, CSP

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

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