This week's question came to me a couple week's ago. I submitted it to the RNEC newsletter but will post it here as it is a good question! Here goes: QUESTION: I got a question for "Ask Linda"....one of my families coming up has a 2 1/2 year old daughter with chronic constipation....what suggestions can I give this family? Anything I should add in or avoid when playing in thier kitchen? love Stacy ANSWER: Dear Stacy, Thank you so much for your email and your great questions. First thing I would want to know is how do they define chronic constipation. Is she going to the bathroom at all? Once a week? Once a month? Also, how long has this been occurring? I would want to know what she has been eating over the course of time that she has been experiencing this constipation. Is she having dairy? Does she have any allergies or sensitivities to foods that are clogging up her system? Does the child have any aches or pains? Has the doctor ruled out anything and everything that might be a health concern? How much does the young one eat each day? Does she have any good fats? Does she eat good fruits and greens? How much fiber is she eating? Is she eating food from scratch or highly processed foods? Is she eating meat? If so, how much per week is she eating? Does she exercise and move a lot (is she an active child?) Does she get outside in the sunshine a lot per week? Suggestions for the family would be: • Aside from the answering the above questions, the first obvious suggestion would be for the family to have her checked out routinely by way of physicals. She can visit a naturopath (ND) or MD but it's always good to get a baseline of health. I'm assuming that this has been done and she is healthy overall. • Have the parents keep a food diary for her to see what she is eating and see if there is any connection to constipation. Food diaries can help them see if they notice constipation related to food that she eats. Let's say she has pasta for dinner and is constipated the next morning. If they see a correlation over some time noticing that pasta = constipation, then they can experiment by trying a gluten free pasta to see if that makes things different (or eliminating it altogether). The parents can keep track of her bowel movement frequencies and times, too, in the diary. Most parents seem to know their kids' habits already but it might be helpful write it down and keep an eye on things for a month or so. They can also get books on allergy elimination diets and can do their own version of one (i.e. taking all known allergens out of the diet for a month like dairy, soy, corn, wheat and then putting them back in SLOWLY and one at a time over the course of several months to see if the body reacts to each possible allergen. It can seem time consuming, but easier to do with kids so they don't have to go through allergy testing by way of needles.) • Have the daughter drinks lots of water each day. I've read that young kids can drink about 1 1/2 oz per body weight each day. So if this toddler weighs 30 lbs, she could drink 45 oz per day. I would probably recommend starting with 32 oz and gradually working her way up (that is assuming she's not drinking lots of water.) Just present the child with a sippy cup full of water and remind her to drink it. Bring it with her for car rides and friends houses, etc. She'll get in the habit of drinking regularly. Stop giving the child cow's milk or juices, particularly juices that are from bottles in the grocery store. Juices from the grocery store don't provide any nutrients (even the health food store - it's a better choice but not worth the money) and milk can be avoided without worry of the child's calcium intake. If the parents want to give the child something to drink other then water, make it a FRESH juice they make themselves, nut or seed milks, or a smoothie of some kind. But water should be the staple drink for the child (and everyone) throughout the day. • Does the child have any fears or "holding on" that might be affecting her bowel movements? I don't know how long this child has been out of diapers (or if she is out of diapers) but I do know that sometimes with some kids, they can go through something during potty training - it's almost like they are trying to let you know that they aren't really ready to become "big kids" even when they say they are ready or they have shown that they were in the recent past. It's as if they were doing great sitting on the potty and then they go through a kind of regression where they actually stop themselves from going for whatever reason. If this is the case, know that this too shall pass. The child would do well to have some gentleness and appreciation from the parents for when they do go on the potty and over a short time, they will naturally move to using the potty very regularly on their own. If the parents show outward worry or tension when the child is stopping themselves from going to the bathroom, sometimes it can slow down the process and it will be no fun for everyone for a while. It's a wild thing, but if it helps, suggest to the the parents to see this as the child trying to learn their own autonomy and independence even though it can feel rather frustrating for the parent. This too shall pass. It really will. • Whatever food practices the parents decide to do for the child are more easily assimilated when the parents adjust their diets too. Keeping dairy out of the child's diet while the parents are scoffing down pizza (for example) isn't going to be easy to manage in the long run. Best for the parents to adopt these changes too. Keep in mind that when doing allergy elimination type diets to see if there is a food allergy or sensitivity is only temporary. If there is no allergy to dairy or wheat, for example, then the changes made are purely experimental with an "end sight" nearby. (Often the thought of cutting out a food FOREVER is too foreboding, so think about it being temporary. If there really is a food allergy, chances are great that when they reintroduce the food, they or the child will feel so yucky that eliminating it will have many more positive feedbacks vs. keeping it in... Plus there are so many yummy alternatives now that taste and feel way better than the originals...) RE: adding in or avoiding when playing in their kitchen It's always a challenge to fully answer a question when so many details are missing. I do think that when you are there with them, you can make as many fruit puddings and green smoothies for this toddler and that will be great for her in so many ways, not just intestinal. I would recommend limiting the amount of stimulants (like cacao, honey, agave) to this child. It might help at first with bowel movements but isn't necessary for kids to have lots of sugars and stimulants. It can throw them off in the long run. So fruit puddings, green smoothies, fresh fruit juices, green juices, fruit smoothies, frozen green pops. These are all great. I'm sure you have everyone making food with you when you are with them and so this little one can also help making her own stuff. Keep her banana intake to 1 per day as lots of bananas can be binding. If you'd like, you can add a bit of psyllium powder to her puddings for extra fiber. You can make chia puddings for her and let her have a small amount. Coconut oil would be helpful but she won't need too much of it per day. Avocados are perfect foods for small kids. Maybe in the short time you are with them, you'll be able to glean some insight to see if she has any allergies/sensitivities. This will be a good litmus test when you come in with your raw foods and see how that shift will be on her diet and her constipation problems. I've written all of this assuming that the child isn't eatings lots of fruits and greens already. In my mind, a little child would have 1-3 BMs per day if she was drinking lots of water and eating cleansing fruits, healing greens and good fats. If she still isn't, then some fine tuning would be in order - food combining, learning about possible allergies/sensitivities (including environmental), good fats are added, enough calories eaten each day, ample exercising and movement for this little one and overall checking in to see if there isn't some other unknown going on. Thank you for your question and have keep having fun with all your families! xoxo, Linda +++++++++++++++++++++++++++++++ Ask Linda! Please feel free to submit your questions to linda AT vt-fiddle.com. Questions don’t have to be completely raw food related but please bring questions on health, recipes, diet, weight issues, nutrition, parenting, nursing, pregnancy, spirituality or whatever it is you’d like to ask. I’ll do my best to answer and will most certainly learn from this as much as I can give.