Kids' Digestive Complaints

When we think of digestive concerns, we typically imagine adults; however, tummy troubles can also occur in children as early as infancy. Whether it’s colic, reflux, or constipation, there are natural ways to help resolve your child’s digestive complaints.

Infantile colic

Infantile colic (or simply colic) is described as uncontrollable crying, irritability, and fussiness for more than three hours a day in otherwise healthy infants. It typically begins around two weeks of age and resolves by three to four months.

Symptoms are usually worse in the late afternoon and evening, and infants will often pull their legs up to their abdomen and arch their back when crying. Although no single cause of colic has been identified, it has been linked to an immature digestive system, excess gas, and food intolerances.

Treatment

In breastfed infants with colic, it is important to evaluate and alter the mother’s diet. Exclusion of allergenic foods such as dairy products, wheat, eggs, soy, peanuts, and tree nuts may help decrease symptoms of colic. In formula-fed infants, switching to a hypoallergenic formula can be beneficial.

Gentle botanical extracts such as camomile (Matricariae recutita), fennel (Foeniculum vulgare), and lemon balm (Melissa officinalis) can be soothing for the digestive system. Probiotics, specifically Lactobacillus reuteri, may also decrease the crying and fussing of colic, though evidence is less clear.

Gastroesophageal reflux

Gastroesophageal reflux (GER) is a common occurrence in infants in which the contents of their stomach are spit up shortly after feeding. GER may progress to gastroesophageal reflux disease (GERD), a more problematic form that can include symptoms such as recurrent vomiting, poor weight gain, refusal to feed, and sleep disturbances.

GER and GERD can also occur in older children. Symptoms may be more similar to those experienced by adults, such as abdominal pain, a burning sensation in the stomach, painful swallowing, and upper respiratory problems including chronic cough and hoarse voice.

Treatment

An allergy to cows’ milk protein has been associated with reflux in infants. Eliminating dairy from both the infants’ and mothers’ diet may be beneficial. If infants are breastfed, slower, smaller, and more frequent feedings can be easier for them to digest and can consequently decrease reflux. Studies have shown that laying infants in the left lateral position (on their left side) instead of on their back may also reduce reflux-related vomiting.

In older children, avoidance of caffeine, chocolate, and spicy cuisine is recommended, as these foods can potentially trigger reflux symptoms. Healthy weight loss can also be helpful for children who are overweight.

Constipation

Constipation is a common digestive concern in both infants and children. Signs and symptoms of constipation to look out for include

• dry, hard, pebblelike stool that is difficult to pass
• fewer than three stools per week
• crying, discomfort, or pain before passing a stool
• hard belly
• loss of appetite

Treatment

Constipation can occur during the introduction of solids in infants, as their stomach needs time to learn to digest new foods. Choose foods that are higher in fibre, such as puréed apples, apricots, pears, prunes, plums, and spinach, to help improve stool frequency. In older children, increase their intake of high-fibre foods such as whole grains, brown rice, fruits, and vegetables.

Constipation has been associated with lack of fluids, so ensure your child is drinking plenty of water throughout the day. Abdominal massage can also help ease constipation. Use a clockwise motion, as this will promote the natural movement of intestinal contents. In addition, research suggests that multi-strain probiotics can help increase stool frequency and consistency in children with constipation.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is characterized by abdominal pain and changes in bowel habits, such as constipation, diarrhea, or both. Bloating and gas may also accompany IBS. Before giving a diagnosis, your child’s health care practitioner will rule out other potential causes for his or her symptoms, such as inflammatory bowel disease and celiac disease. Researchers aren’t clear about what causes IBS, but diet and altered gut flora seem to play a role.

Treatment

Recently, there have been a lot of studies about the role of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) in IBS. FODMAPs are small, poorly absorbed carbohydrates (sugars) that are fermented by intestinal bacteria, producing gas and causing an increase in intestinal fluids. They are found in a variety of foods, especially those high in fructose and lactose. Research suggests a diet low in FODMAPs can help relieve symptoms of IBS.

The elimination of common food intolerances such as dairy products, wheat, eggs, citrus fruits, caffeinated beverages, yeast, and potatoes can also improve IBS symptoms, especially bloating and gas. Probiotics, which help restore natural gut flora, may decrease abdominal pain, bloating, and gas associated with IBS.

Stress has also been linked to an increase in IBS symptoms, especially in school-aged children. To help reduce stress and anxiety, explore deep breathing, yoga, exercise, and other relaxing techniques with your child.

When to see a health care practitioner

If your child experiences any of the following symptoms, further medical attention may be needed:

• recurrent vomiting and/or diarrhea with fever
• blood in stool or vomit
• severe abdominal pain
• failure to gain weight

Trust your instincts. If you are concerned, don’t hesitate to call your child’s health care practitioner.

Supplements to soothe digestive complaints

The following supplements are natural and safe for children with upset stomachs. For recommendations that are specific to your child, check with a health care practitioner.

Probiotics can help replenish healthy gut flora and enhance the immune system to protect against infections in the digestive tract.

Herbal teas that may help soothe the stomach include camomile, fennel, and lemon balm.

Omega-3 fatty acids such as fish oil target inflammatory pathways, which may decrease the gut inflammation associated with many digestive complaints.